Luisa W. Bisol

The Affective and Emotional Composite Temperament (AFECT) model and scale: A system-based integrative approach

UNLABELLED Based on many temperament frameworks, here we propose an integration of emotional and affective temperaments (the AFECT model), forming a common substrate for mood, behavior, personality and part of cognition. Temperament is conceived as a self-regulated system with six emotional dimensions: volition, anger, inhibition, sensitivity, coping and control. The different combinations of these emotional dimensions result in 12 affective temperament types, namely depressive, anxious, apathetic, obsessive, cyclothymic, dysphoric, irritable, volatile, disinhibited, hyperthymic and euphoric. We also developed and validated a self-report scale to evaluate this construct, the Affective and Emotional Composite Temperament Scale (AFECTS). METHODS Exploratory and confirmatory psychometric analyses were performed with the internet version of the AFECTS in 2947 subjects (72% females, 35±11years old). RESULTS The factors interpreted as volition, anger, inhibition, sensitivity, coping and control showed very good Cronbachs alphas for 5 dimensions (0.87-0.90) and acceptable alpha for inhibition (0.75). Confirmatory factor analysis corroborated this 6-factor structure when considering inhibition as a second-order factor with fear and caution as first-order factors (SRMR=0.061; RMSEA=0.053). In the Affective section, all 12 categorical affective temperaments were selected in the categorical choice, with 99% of volunteers identifying at least one adequate description of their affective temperament. LIMITATIONS Only the internet version was used in a general population sample. CONCLUSION The AFECT model provides an integrated framework of temperament as a self-regulated system, with implications for mental health, psychiatric disorders and their treatment. The AFECTS showed good psychometric properties to further study this model.

Bullying victimization is associated with dysfunctional emotional traits and affective temperaments

BACKGROUND Being bullied has been increasingly recognized as a risk factor for the development of psychiatric disorders, but there is very limited evidence on the association of bullying with temperament. METHODS The data was collected in a large web-survey on psychological and psychiatric measures (BRAINSTEP). Bullying was assessed with a question on time exposed to bullying (none, <1 year, 1-3 years and >3 years) during childhood and adolescence. Emotional traits and affective temperaments were evaluated with the Affective and Emotional Composite Temperament Scale (AFECTS). The final sample consisted of 50,882 subjects (mean age 30.8 ± 10.4 years, 73.4% females) with valid answers. RESULTS About half of the sample reported exposure to bullying and ∼10% reported being victimized by peers for longer than 3 years. Longer exposure to bullying was associated with lower Volition, Coping and Control scores, and more Emotional Sensitivity, Anger and Fear, with statistical significance between all groups. To a lower degree, exposure to bullying was associated with lower Caution and higher Desire scores. Bullying victimization was also associated with a much lower proportion of euthymic and hyperthymic types in both genders, which was compensated by an increase mainly in the proportion of depressive, cyclothymic and volatile types. LIMITATIONS Retrospective assessment of bullying with a single question on time exposed to bullying and use of self-report instruments only. CONCLUSIONS Being bullied was associated with a broad and profound impact on emotional and cognitive domains in all dimensions of emotional traits, and with internalized and unstable affective temperaments.

Emotional and affective temperaments and cigarette smoking in a large sample

BACKGROUND Tobacco use has been associated with externalized personality traits. Our aim was to evaluate the association of smoking with emotional and affective temperaments in a large sample. METHODS In this cross-sectional web-based survey, volunteers completed the Combined Emotional and Affective Temperament Scale (CEATS), which assesses emotional (fear, drive, anger, and control) and affective temperaments (e.g. cyclothymic, irritable), and questions about smoking. RESULTS Among the 5379 subjects (1370 males), there were 60% non-smokers, 17% quitters and 23% current smokers. Non-smokers had higher fear and control and lower anger than quitters and smokers, and higher drive than smokers. Quitters had higher drive and control and lower anger than smokers. Smoking was lower among apathetics, depressives, euthymics and hyperthymics and higher in cyclothymics and labiles. Lower drive and higher anger were associated with heavier smoking. Less adaptive temperament was related to higher prevalence of and heavier smoking. LIMITATIONS The data was collected from a convenience sample by the internet, and most volunteers assessed the instrument through a psychoeducational website for bipolar spectrum disorders, leading to a higher proportion of cyclothymics; the assessment of smoking habits was limited to two questions; the study was cross-sectional. CONCLUSIONS Smoking was associated with lower fear, control and drive, higher anger and unstable externalized affective temperaments. Lower control and higher anger were associated with being a heavy smoker and current smoking. Assessment of temperament may help decision about treatments for smoking cessation.

Affective temperaments and ego defense mechanisms associated with somatic symptom severity in a large sample

BACKGROUND Several complex mechanisms including biological, psychological and social factors may contribute to the development of bodily symptoms. Affective temperaments may represent heritable subclinical manifestations of mood disorders, and the concept of ego defense mechanisms has also provided a model for the comprehension of psychopathology. The relationship between affective temperaments, defensive functioning and somatic symptom severity remains unknown. METHODS We obtained data from a subsample of the Brazilian Internet Study on Temperament and Psychopathology (BRAINSTEP). Participants completed the Affective and Emotional Temperament Composite Scale (AFECTS), the Defense Style Questionnaire (DSQ-40) and the Symptom Checklist-90-Revised (SCL-90-R). SCL-90-R Somatization scale was used as outcome variable. RESULTS Among 9937 participants (4472 male; 45%), individuals with dysphoric, cyclothymic and depressive temperaments and those who adopted displacement, somatisation and passive aggression as their predominant defense mechanisms presented high somatic symptom severity. Participants with dysphoric temperament and those with higher displacement scores were more likely to endorse numerous bodily symptoms after controlling for age, gender, education and depressive symptoms. Moderator analysis showed that the relationship of dysphoric temperament with somatic symptom severity was much more powerful in people who adopted displacement as their predominant defense. LIMITATIONS The data was collected from a convenience web-based sample. The study was cross-sectional. There was no information on the presence of established physical illness. CONCLUSIONS Affective temperaments and defense mechanisms are associated with somatic symptom severity independently of depressive symptoms. These two personality theories provide distinct but interacting views for comprehension of somatic symptom formation.

Childhood trauma is associated with maladaptive personality traits

The association between childhood trauma and personality traits has been poorly characterized and reported. Our aim was to evaluate whether distinct types of childhood abuse and neglect are associated with various personality dimensions using data from a large web-based survey. A total of 12,225 volunteers responded anonymously to the Internet versions of the Temperament and Character Inventory-Revised (TCI-R) and the Childhood Trauma Questionnaire (CTQ) via our research website, but only 8,114 subjects (75.7% women, mean age 34.8±11.3yrs) who met the criteria for validity were included in the analysis. Childhood trauma was positively associated with harm avoidance and was negatively associated with self-directedness and, to a lesser extent, with cooperativeness. The associations were robust with emotional abuse and neglect but were non-significant or mild with physical trauma. Emotional neglect was associated with reduced reward dependence and persistence. All types of abuse, but not neglect, were associated with increased novelty seeking scores. Reporting of childhood trauma, especially of an emotional nature, was associated with maladaptive personality traits. Further investigation of the effects of different types of childhood trauma on psychological and neurobiological parameters is warranted.

How emotional traits and affective temperaments relate to cocaine experimentation, abuse and dependence in a large sample

UNLABELLED The contribution of specific traits in cocaine experimentation, abuse and addiction is not yet clear. Our aim was to evaluate how temperament was associated with cocaine experimentation, abuse and dependence using a recently developed scale for the assessment of emotional traits (e.g. anger, volition) and affective temperaments (e.g. cyclothymic). An anonymous web-survey provides the optimal means to evaluate sensitive issues such as drug related behavior in the general population. METHODS The data was collected by the Brazilian Internet Study on Temperament and Psychopathology (BRAINSTEP), which included the Affective and Emotional Composite Temperament Scale (AFECTS) and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The final sample consisted of 28,587 subjects (26.6% males, mean age=30.8±9.8yrs). Trait analysis was controlled for age, gender, ethanol and marijuana use. RESULTS For emotional traits, Caution, Coping and Control were significantly lower in the cocaine-using groups when compared to controls, particularly in those with cocaine dependence. Anger and Desire increased in relation to the degree of cocaine involvement. The associations with Emotional Sensitivity and Volition were less robust. For affective temperaments, greater cocaine use was related to a lower proportion of stable types (obsessive, euthymic and hyperthymic) and the anxious type, and to a higher proportion of cyclothymic and euphoric temperaments in both sexes. CONCLUSIONS Specific externalized and unstable traits were associated with cocaine related behavior. Addressing these traits may be important for recovery and prevention strategies.

Suicide risk, temperament traits, and sleep quality in patients with refractory epilepsy

OBJECTIVES The objective of the study was to access the suicide risk (SR) in patients with refractory epilepsy and its association with temperament and sleep quality. METHODS A total of 50 consecutive patients referred for epilepsy surgery evaluation in the Porto Alegre Epilepsy Surgery Program were included. All patients had a detailed neurologic and psychiatric evaluation, including video-electroencephalogram (VEEG), high-resolution magnetic ressonance imaging (MRI), and neuropsychologic assessment. In addition, structured questionnaires were applied: module C of the MINI-plus (International Neuropsychiatric Interview-Brazilian version 5.0.0), Affective and Emotional Composite Temperament Scale (AFECTS), and Pittsburgh Sleep Quality Index (PSQI). RESULTS Ten patients (20.0%) showed an increased SR. The most frequent location of the epileptic focus was in the temporal lobe (50%; n=25). Final diagnosis on VEEG comprised epilepsy in 74.0% (n=37), psychogenic nonepileptic seizures (PNES) in 8.0% (n=4), and both in 12%. Thirty patients (60.0%) received surgery indication. Mood disorders were the main psychiatric diagnosis, found in 19 subjects (70.4%), with major depressive disorder (MDD) encountered in 15 patients (55.6%). In the group, SR was more frequent in patients with sleep disorders (p=0.001) and elevated scores of high emotional sensitivity (p=0.003). CONCLUSION In this cohort of patients with highly refractory epilepsy, there was a significant association between SR, sleep disorders, and high emotional sensitivity. Careful evaluation of these factors should be performed in these patients to fully access SR.

Abstracts from the 10th South-Brazilian Congress of Geriatrics and Gerontology and de 19th Winter Meeting of the Brazilian Society of Geriatrics and Gerontology – Rio Grande do Sul

PAJAR (Pan American Journal of Aging Research) presents to the scientific community its first supplement with the Abstracts from the 10th South-Brazilian Congress of Geriatrics and Gerontology and de 19th Winter Meeting of the Brazilian Society of Geriatrics and Gerontology – Rio Grande do Sul, held in the city of Bento Goncalves / RS in the period of July 6 to 8, 2017.

The Integration of Mood, Behavior, and Temperament in Mood Spectrum Disorders

Current psychiatric diagnosis relies on the assumption of discrete mental disorders as discrete categories, artificially separating mood, behavioral, personality, and cognitive disorders, producing extensive comorbidity. As an alternative, we propose an integrated framework based on temperament and applicable to both adaptive and dysfunctional situations. The Affective and Emotional Composite Temperament (AFECT) model adopts both an analytical approach based on emotional traits to represent specific neurobehavioral subsystems (Volition/Energy, Desire, Anger, Fear, Caution, Emotional Sensitivity, Anxiety, Control, Coping, and Stability) and the affective temperaments as synthetic typology of 12 global configurations divided in four groups: internalized (depressive, anxious, apathetic), unstable (cyclothymic, dysphoric, volatile), stable (euthymic, hyperthymic, obsessive), and externalized (euphoric, irritable, and disinhibited). This range of features covers the whole mood spectrum from mania to depression, contemplating mixed features and euthymia. This model is operationalized with the AFECTS, a short self-report scale, which has shown substantial variations associated with being a victim of bullying, cocaine abuse, and circadian preference. Here we show that those with a diagnosis of bipolar disorder or borderline personality disorder have strong cyclothymic traits, high Desire and Anger, and low Control, Caution, and Stability and share with subjects with major depression the traits of low Volition and Coping and high Anxiety and Emotional Sensitivity. These results point towards the need to view the mood spectrum dimensionally, taking into account several traits concomitantly.