A tale of two diatheses: Temperament, BIS, and BAS as risk factors for mood disorder

Meta-Analytic Review of Temperamental Correlates of the Five-Factor Model and Hierarchical Taxonomy of Psychopathology Domains

Background

There is little and heterogeneous knowledge on the links between the temperamental predispositions of psychopathology and the contemporary dimensional models of psychopathology, such as the Hierarchical Taxonomy of Psychopathology (HiTOP) classification system, which can be aligned with the five-factor model (FFM) of personality. This meta-analysis seeks to expand the temperamental theoretical basis of the HiTOP model by incorporating associations of temperament traits of two temperamental theories measured, respectively, by the Temperament and Character Inventory (TCI) and the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) with (a) the FFM's personality domains and (b) HiTOP's five psychopathological spectra.

Methods

A systematic search was done on Web of Science, Scopus, PubMed, ProQuest, Cochrane Database, and Google Scholar for all articles published in English from January 1990 to August 2020. Because of heterogeneity in the results of almost 70% of studies, pooled estimates of correlation coefficients were calculated using the random-effects method. Risk of bias (low-quality studies) and publication bias are reported.

Results

The pooled correlations obtained from the analysis of 35 studies showed that the temperamental profile associated with each FFM domain and HiTOP spectra is distinct. Specifically, TCI-harm avoidance (HA) and all TEMPS temperaments were more strongly related to neuroticism/internalizing, extraversion/low detachment, and conscientiousness/disinhibition. In contrast, TCI-novelty seeking was more strongly related to both disinhibited/antagonistic externalizing and thought disorder.

Conclusions

A large body of research supports maladaptive variants of all FFM domains and some psychopathological spectra of HiTOP related to the abnormal-range temperaments.

Effects of the Interaction between Affective Temperaments and BIS/BAS on Depressive Symptoms in Individuals with Major Depressive Disorder

Depressive symptoms (DepS) associated with major depressive disorder (MDD) are influenced by affective temperaments (ATs), behavioral inhibition system (BIS), and behavioral activation system (BAS). However, the effect of interactions between ATs and BIS/BAS on DepS in MDD remains poorly understood. Herein, we aimed to investigate the effects of these interactions. The Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A), BIS/BAS questionnaire, and Patient Health Questionnaire-9 (PHQ-9) were used to evaluate ATs, BIS/BAS, and DepS, respectively, in 90 participants with MDD. Data were analyzed using hierarchical multiple regression analysis to assess the interaction effect. The interaction (β = 0.199, p < 0.05) between depressive temperament (DepT) (β = 0.319, p < 0.01) and BIS scores (β = 0.300, p < 0.01) exhibited a significant positive effect on DepS (ΔR2 = 0.038, p < 0.05). However, the interaction between ATs and BAS scores did not exhibit a significant effect on DepS. Our findings suggest that interactions between BIS sensitivity and DepT worsen DepS in individuals with MDD. Hence, to manage DepS associated with BIS sensitivity and DepT, evaluating their interaction may be useful in daily clinical practice. This study presents important insights into MDD psychopathology.

Reinforcement sensitivity predicts affective psychopathology via emotion regulation: Cross-sectional, longitudinal and quasi-experimental evidence

The current article presents a model wherein reinforcement sensitivity predicts depression and anxiety via trait preferences for concomitant emotion regulation strategies. In Study 1 (N = 593), BAS sensitivity positively predicted reappraisal and BIS sensitivity negatively predicted it. Reappraisal then negatively predicted depression. BIS sensitivity also predicted rumination, which predicted both depression and anxiety. Study 2a confirmed the model developed in Study 1 with an independent sample (N = 513) and examined the relationships longitudinally. While the cross-sectional relationships were generally maintained, reinforcement sensitivity did not predict reappraisal. In Study 2b, participants (N = 218) were assessed a third time one year later, at the onset of the COVID-19 pandemic. During this stressful time, BAS sensitivity did longitudinally predict reappraisal. These studies highlight the role of emotion regulation in mediating the relationship between reinforcement sensitivity and affective pathology, particularly during times of high stress.

Etiological pathways of depressive and anxiety symptoms linked to personality traits: A genetically-informative longitudinal study

BACKGROUND

The comorbidity of depression and anxiety is associated with an increased risk of prolonged adverse mental health status. However, little is currently known about their genetic and environmental influences that help to explain both the comorbidity and distinctiveness. Using longitudinal twin data, the present study investigated both the overlapping and distinct relationships between depression and anxiety viewed from the perspective of Gray's Reinforcement Sensitivity Theory (RST): two personality traits of the Behavioral Inhibition and Activation Systems (BIS and BAS).

METHODS

A total of 422 twin pairs (298 monozygotic and 124 dizygotic pairs) participated by completing a personality questionnaire at wave 1, and mood symptoms questionnaires at wave 2. The waves were on average 2.23 years apart.

RESULTS

Multivariate Cholesky decomposition indicated that the genetic variance of the personality traits (BIS and BAS) explained all of the genetic variance in depressive and anxiety symptoms. Additionally, genetic factors related to the BIS positively explained depressive and anxiety symptoms, whereas genetic factors related to the BAS negatively explained only depressive symptoms.

LIMITATIONS

Limitations include shorter time interval and the reliance on self-reported data.

CONCLUSIONS

The present study provided evidence explaining the overlap and differentiation of depressive and anxiety symptoms by using data on personality traits in a longitudinal, genetically-informative design. The findings suggested the personality traits from Gray's RST model played an important role in the prediction, and clarified the description, of both depressive and anxiety symptoms.

The dual-system theory of bipolar spectrum disorders: A meta-analysis

Bipolar spectrum disorders are characterized by alternating intervals of extreme positive and negative affect. We performed a meta-analysis to test the hypothesis that such disorders would be related to dysregulated reinforcement sensitivity. First, we reviewed 23 studies that reported the correlation between self-report measures of (hypo)manic personality and measures of reinforcement sensitivity. A large relationship was found between (hypo)manic personality and BAS sensitivity (g = .74), but not with BIS sensitivity (g = -.08). This stands in contrast to self-reported depression which has a small, negative relationship with BAS sensitivity and a large positive one with BIS sensitivity (Katz et al., 2020). Next, we reviewed 33 studies that compared reinforcement sensitivity between euthymic, bipolar participants and healthy controls. There, bipolar disorder had a small, positive relationship with BAS sensitivity (g = .20) and a medium, positive relationship with BIS sensitivity (g = .64). These findings support a dualsystem theory of bipolar disorders, wherein BAS sensitivity is more closely related to mania and BIS sensitivity more closely to bipolar depression. Bipolar disorders show diatheses for both states with euthymic participants being BAS- and BIS- hypersensitive. Implications for further theory and research practice are expounded upon in the discussion.

Reinforcement sensitivity, depression and anxiety: A meta-analysis and meta-analytic structural equation model

Reinforcement Sensitivity Theory (RST) posits that individual differences in reward and punishment processing predict differences in cognition, behavior, and psychopathology. We performed a quantitative review of the relationships between reinforcement sensitivity, depression and anxiety, in two separate sets of analyses. First, we reviewed 204 studies that reported either correlations between reinforcement sensitivity and self-reported symptom severity or differences in reinforcement sensitivity between diagnosed and healthy participants, yielding 483 effect sizes. Both depression (Hedges' g = .99) and anxiety (g = 1.21) were found to be high on punishment sensitivity. Reward sensitivity negatively predicted only depressive disorders (g = -.21). More severe clinical states (e.g., acute vs remission) predicted larger effect sizes for depression but not anxiety. Next, we reviewed an additional 39 studies that reported correlations between reinforcement sensitivity and both depression and anxiety, yielding 156 effect sizes. We then performed meta-analytic structural equation modeling to simultaneously estimate all covariances and control for comorbidity. Again we found punishment sensitivity to predict depression (β = .37) and anxiety (β = .35), with reward sensitivity only predicting depression (β = -.07). The transdiagnostic role of punishment sensitivity and the discriminatory role of reward sensitivity support a hierarchical approach to RST and psychopathology.

To Approach or to Avoid? Motivation Differentially Mediates the Effect of Hardiness on Depressive Symptoms in Chinese Military Personnel

Objective

To investigate the mediation effect of approach/avoidance motivation between hardiness and depressive symptoms.

Methods

Cross-sectional design was utilized. Two independent samples of military servicemen (G1: military personnel in the Armed Forces; G2: Chinese army military cadets) (n1 = 98, n2 =140) were sampled and investigated. The assessment tools of hardiness scale (DRS), behavioral activation and inhibition scales (BAS/BIS), and Center for Epidemiological Survey-Depression Scale (CES-D)/Beck Depression Inventory (BDI) were used. General linear model was conducted to examine the predictive role of hardiness (DRS) and motivation (BAS/BIS) on depressive symptoms (CES-D or BDI). The mediating role of BAS/BIS between hardiness and depressive symptoms was examined.

Results

(1) Across army soldiers and military medical university cadets, hardiness (β=-0.394, P<0.001) and behavioral inhibition (β=0.297, P<0.001) significantly predicted depressive symptoms. (2) For soldiers only, behavioral inhibition mediated the significant association between hardiness and depressive symptoms (β=-0.043, SE=0.027, 95%CI=-0.130~-0.008). (3) For cadets only, behavioral activation-Drive significantly predicted depressive symptoms (β=-0.237, P=0.012), and hardiness operates through behavioral activation-Drive to influence depressive symptoms (β=-0.057, SE=0.036, 95%CI=-0.151~-0.078).

Conclusion

Individuals who are low in hardiness and behavioral activation-Drive and who are high in behavioral inhibition showed more severe depressive symptoms. The relationship between hardiness and depressive symptoms was mediated by behavioral activation-Drive in cadets and behavioral inhibition in soldiers. The proposed model offers a useful approach for the development of hardiness training programs to alter approach/avoidance motivation in the military context. Future training program of hardiness could lay more emphasis on promotion of perseverance in pursuing goals in hardy individuals, which may in turn improve active coping.

Psychopathological Correlates and Emotion Regulation as Mediators of Approach and Avoidance Motivation in a Chinese Military Sample

Background: Approach and avoidance motivation have been thoroughly studied in common mental disorders, which are prevalent in the military context. Approach/avoidance motivational dispositions underlie emotion responses and are thought to influence emotion dysregulation. However, studies on the mediating role of emotion regulation (ER) between motivational dispositions and mental disorders have been insufficient. We examined the psychopathological correlates of motivational dispositions and explored the mediating role of ER. Methods: The Behavioral Inhibition System and Behavioral Activation System (BIS/BAS) scales and measures of mood disorders (depression, anxiety, OCD, and PTSD) were administered to a nonclinical sample of 3,146 Chinese military service members. The Emotion Regulation Questionnaire for Armymen (ERQ-A) (Chinese version) was used to measure ER styles. We examined the reliability and construct validity of the BIS/BAS scales. Approach/avoidance motivations were correlated with symptoms of mood disorders. Mediation analysis was conducted to confirm the mediating role of ER between motivation and mood disorders. Results: The results showed acceptable internal reliability and construct validity of the BIS/BAS scales. Gender (female), family status (single-parent family), and social relationships (having fewer good friends) were significant predictors of high BIS sensitivity. More years of education, an older age, being an only child and being in a single-parent family all significantly predicted high BAS sensitivity. The BIS/BAS scales were predictive of various DSM-V-based mental disorders (depression, anxiety, OCD, and PTSD). Immersion exacerbated the impact of BAS/BIS sensitivities on depressive/PTSD symptoms, while reinterpretation and talking out alleviated the impact of BAS/BIS sensitivities on these symptoms. Conclusions: Motivational dispositions have an impact on mood symptoms under specific conditions. ER strategies (immersion, reinterpretation, and talking out) were shown to be partial mediators between approach/avoidance motivation and mood disorders. These findings highlight the importance of ER in altering the impact of motivational dispositions on mood disorders and as a promising target of psychotherapies.

The relationship of impulsivity and cortical thickness in depressed and non-depressed adolescents

Major Depressive Disorder (MDD) is recognized to be heterogeneous in terms of brain structure abnormality findings across studies, which might reflect previously unstudied traits that confer variability to neuroimaging measurements. The purpose of this study was to examine the relationships between different types of trait impulsivity and MDD diagnosis on adolescent brain structure. We predicted that adolescents with depression who were high on trait impulsivity would have more abnormal cortical structure than depressed patients or non-MDD who were low on impulsivity. We recruited 58 subjects, including 29 adolescents (ages 12-19) with a primary DSM-IV diagnosis of MDD and a history of suicide attempt and 29 demographically-matched healthy control participants. Our GLM-based analyses sought to describe differences in the linear relationships between cortical thickness and impulsivity trait levels. As hypothesized, we found significant moderation effects in rostral middle frontal gyrus and right paracentral lobule cortical thickness for different subscales of the Barratt Impulsiveness Scale. However, although these brain-behavior relationships differed between diagnostic study groups, they were not simple additive effects as we had predicted. For the middle frontal gyrus, non-MDD participants showed a strong positive association between cortical thickness and BIS-11 Motor scores, while MDD-diagnosed participants showed a negative association. For Non-Planning Impulsiveness, paracentral lobule cortical thickness was observed with greater impulsivity in MDD, but no association was found for controls. In conclusion, the findings confirm that dimensions of impulsivity have discrete neural correlates, and show that relationships between impulsivity and brain structure are expressed differently in adolescents with MDD compared to non-MDD.

The predictive value of Approach and Avoidance tendencies on the onset and course of depression and anxiety disorders

BACKGROUND

Trait and automatic approach-avoidance (AA) tendencies are central concepts in research on affective disorders. We longitudinally examined the associations of trait and automatic AA tendencies with the risk of onset and chronicity of anxiety and depressive disorders.

METHODS

Participants were subdivided into those with (n = 766) versus without (n = 1,636) a current anxiety or depression diagnosis at baseline. Clinical diagnoses were reassessed after 2-year follow-up. Automatic AA tendencies in reaction to facial expressions were assessed using the Approach-Avoidance Task, whereas self-reported trait AA tendencies were assessed using the Behavioral Inhibition System and the Behavioral Activation System scales. Analyses were adjusted for socio-demographics (basic adjustment) and for severity and history of psychopathology (full adjustment).

RESULTS

Stronger trait avoidance tendencies predicted both increased risk of onset and increased risk of a chronic course of anxiety disorders after full adjustment (Odds ratio_onset  = 1.55, P < .001, and Odds ratio_chronicity  = 1.31, P = .03). The associations between stronger trait avoidance tendencies and increased risk of onset and chronicity of depressive disorders were no longer significant after full adjustment. In contrast, trait approach tendencies and automatic AA tendencies were not related to onset or chronicity of disorders.

CONCLUSIONS

Increased trait avoidance tendencies are a risk factor for affective disorders in general, with possibly a slightly more pronounced role in anxiety than depressive disorders. This underlines the importance of addressing trait avoidance tendencies in both the treatment and aftercare of affective disorders.

Sleep quality, chronotype, temperament and bipolar features as predictors of depressive symptoms among medical students

The assessment of risk factors is a crucial step in the prevention and treatment of affective disorders and should encompass personal dispositions. The aim of this study was to assess the value of chronotype and temperament as independent predictors of depressive symptoms among medical students. The study surveyed 140 students of the Faculty of Medicine with a battery of questionnaires: the Beck Depression Index (BDI), Hypomania Checklist 32 (HCL-32), Pittsburgh Sleep Quality Index (PSQI), Chronotype Questionnaire and Eysenck Personality Questionnaire Revised. The results were tested using Pearson's correlation quotient and general linear model. Ten percent of the participants demonstrated a BDI score suggestive of clinically significant depressive symptoms. BDI score correlated positively with HCL-32 score. A rise in BDI was independently predicted by elevated Neuroticism and PSQI scores and morningness. Those effects were independent from each other and from other parameters of the model. The presence of depressive symptoms might be associated with bipolar features among medical students. Poor sleep quality predicted depressive symptoms, similarly to Neuroticism and independently of temperament and chronotype. Future studies on the associations between personal dispositions and mood disorders among medical students are required to help identify those at greater risk of developing affective illness. Effective prophylaxis and early intervention are warranted to ensure better treatment results.

Six Years of Research on the National Institute of Mental Health's Research Domain Criteria (RDoC) Initiative: A Systematic Review

Six years have passed since the National Institute of Mental Health (NIMH) in the United States launched the Research Domain Criteria (RDoC) initiative. The RDoC introduces a framework for research on the biology of mental illness that integrates research findings across multiple levels of information. The framework outlines constructs that represent specific quantifiable dimensions of behavior (e.g., responses to acute threat, cognitive control) and corresponding units of analysis that can be used to study the constructs, beginning at the levels of genes, molecules, cells, circuits and physiology, and moving up to behaviors and self-reports. In this systematic review, a literature search was conducted to synthesize empirical research published since the proposal of the framework that incorporated the RDoC. Forty-eight peer-reviewed scholarly articles met eligibility criteria for the review. Studies differed according to whether they analyzed RDoC constructs and units of analysis within vs. between clinically-diagnosed and non-psychiatric samples. The most commonly studied constructs were subsumed within the domains of Negative Valence Systems, Positive Valence Systems and Cognitive Systems, providing initial results which primarily connected genetics, brain circuits and physiology research findings with behavior and self-reports. Prospects for future research adopting the RDoC matrix and utilizing a dimensional approach to studying the biology of mental illness are discussed.

Personality of young drivers in Oman: Relationship to risky driving behaviors and crash involvement among Sultan Qaboos University students

OBJECTIVE

Drivers' behaviors such as violations and errors have been demonstrated to predict crash involvement among young Omani drivers. However, there is a dearth of studies linking risky driving behaviors to the personality of young drivers. The aim of the present study was to assess such traits within a sample of young Omani drivers (as measured through the behavioral inhibition system [BIS] and the behavioral activation system [BAS]) and determine links with aberrant driving behaviors and self-reported crash involvement.

METHODS

A cross-sectional study was conducted at the Sultan Qaboos University that targeted all licensed Omani's undergraduate students. A total of 529 randomly selected students completed the self-reported questionnaire that included an assessment of driving behaviors (e.g., Driver Behaviour Questionnaire, DBQ) as well as the BIS/BAS measures.

RESULTS

A total of 237 participants (44.8%) reported involvement in at least one crash since being licensed. Young drivers with lower BIS-Anxiety scores and higher BAS-Fun Seeking tendencies as well as male drivers were more likely to report driving violations. Statistically significant gender differences were observed on all BIS and BAS subscales (except for BAS-Fun) and the DBQ subscales, because males reported higher trait scores. Though personality traits were related to aberrant driving behaviors at the bivariate level, the constructs were not predictive of engaging in violations or errors. Furthermore, consistent with previous research, a supplementary multivariate logistic regression analysis revealed that only driving experience was predictive of crash involvement.

CONCLUSIONS

The findings highlight that though personality traits influence self-reported driving styles (and differ between the genders), the relationship with crash involvement is not as clear. This article further outlines the key findings of the study in regards to understanding core psychological constructs that increase crash risk.

Clinical features, impulsivity, temperament and functioning and their role in suicidality in patients with bipolar disorder

OBJECTIVE

Our aim was to analyse sociodemographic and clinical differences between non-suicidal (NS) bipolar patients (BP), BP reporting only suicidal ideation (SI) and BP suicide attempters according to Columbia-Suicide Severity Rating Scale (C-SRSS) criteria. Secondarily, we also investigated whether the C-SRSS Intensity Scale was associated with emergence of suicidal behaviour (SB).

METHOD

A total of 215 euthymic bipolar out-patients were recruited. Semistructured interviews including the C-SRSS were used to assess sociodemographic and clinical data. Patients were grouped according to C-SRSS criteria: patients who scored ≤1 on the Severity Scale were classified as NS. The remaining patients were grouped into two groups: 'patients with history of SI' and 'patients with history of SI and SB' according to whether they did or did not have a past actual suicide attempt respectively.

RESULTS

Patients from the three groups differed in illness onset, diagnosis, number of episodes and admissions, family history, comorbidities, rapid cycling and medication, as well as level of education, functioning, impulsivity and temperamental profile.

CONCLUSION

Our results suggest that increased impulsivity, higher rates of psychiatric admissions and a reported poor controllability of SI significantly increased the risk for suicidal acts among patients presenting SI.

Digital comparison of healthy young adults and borderline patients engaged in non-suicidal self-injury

BACKGROUND

It still remains unclear whether non-suicidal self-injury (NSSI) in young adult populations represents an actual symptom leading to psychiatric illness, constitutes a disorder itself or is rather a cultural peer influence. The purpose of this web-based qualitative cross-sectional study was to characterize NSSI (type of injury, frequency, tools, body parts, circumstances) in 50 patients with borderline personality disorder (NSSI + BPD) in direct comparison with 50 age and gender matched non-clinical young adults (NSSI - BPD), all of them currently or previously engaged in NSSI.

METHODS

Self-harming participants completed an open-access, anonymous 75-items questionnaire including the temperament questionnaire briefTEMPS-M.

RESULTS

The mean age of NSSI onset was 20.56 ± 6.36 (NSSI + BPD) and 17.5 ± 9.28 years (NSSI - BPD), respectively (p = 0.261). NSSI - BPD participants (1) rarely sought out medical treatment (p < 0.001) and differed significantly from BPD patients; They (2) reported more often fear and disappointment as feelings preceding their self-harm (p < 0.001 each); (3) cut themselves in more locations (p = 0.005) and (4) in rather hidden areas (lower limb, proximal) (p = 0.002); (5) had lower depressive temperament scores (p = 0.007); and (6) scored generally fewer character traits "at risk" (p = 0.043) with a lower total score (p = 0.018). NSSI tended to onset slightly earlier in life and in different shape when BPD was absent.

CONCLUSIONS

Our findings support current approaches of early NSSI recognition and identification of risk profiles. Further prospective studies, which have to be sufficiently large and longitudinal, are needed and of great importance.