Yukiei Nakai

The influence of childhood abuse, adult stressful life events and temperaments on depressive symptoms in the nonclinical general adult population.

BACKGROUND Previous studies have shown the interaction between heredity and childhood stress or life events on the pathogenesis of major depression. We hypothesized that childhood abuse, affective temperaments, and adult stressful life events interact and influence depressive symptoms in the general adult population and tested this hypothesis in this study. METHODS The 294 participants from the nonclinical general adult population were studied using the following self-administered questionnaire surveys: the Patient Health Questionnaire-9 (PHQ-9), Life Experiences Survey (LES), Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego auto-questionnaire (TEMPS-A), and Child Abuse and Trauma Scale (CATS). The data were analyzed with single and multiple regressions and structural equation modeling (Amos 20.0). RESULTS Childhood abuse indirectly predicted the severity of the depressive symptoms through affective temperaments measured by TEMPS-A in the structural equation modeling. Four temperaments - depressive, cyclothymic, irritable, and anxious - directly predicted the severity of depressive symptoms and the negative appraisal of life events during the past year. The negative appraisal of life events during the past year mildly, but significantly, predicted the severity of depressive symptoms. LIMITATIONS The subjects of this study were nonclinical. The findings might not be generalized to patients with mood disorders. CONCLUSIONS This study suggests that childhood abuse, especially neglect, indirectly increased depressive symptoms through increased affective temperaments, which, in turn, increase the negative appraisal of stressful life events. An important role of affective temperaments in the effect of childhood abuse and stressful life events on depressive symptoms was suggested.

Latitude effect on bipolar temperaments.

BACKGROUND Growing evidence points to an association of daily light exposure and both mood and mood disorders. In recent studies, we demonstrated that higher illuminance of daytime may be positively associated with hyperthymic temperament while lower illuminance of daytime may be positively associated with cyclothymic temperament. However, it is not possible to determine whether hyperthymic or cyclothymic temperament induces higher or lower illuminance via heliotropism or non-heliotropism or whether higher or lower illuminance induces hyperthymic or cyclothymic temperament via light effects. METHODS In order to elucidate these questions, we sought to compare bipolar temperaments between residents who live in regions with varying levels of sunshine. Japan has 4 large islands -Hokkaido, Honshu, Shikoku, and Kyushu. Sapporo in Hokkaido and Oita in Kyushu located at 43° and 33° of latitude differ significantly in mean yearly sunshine. We investigated the data of 189 subjects (94 from Sapporo and 95 from Oita) including their data of Temperament Evaluation of Memphis, Pisa, Paris and San Diego-auto questionnaire version (TEMPS-A). RESULTS Multiple regression analyses revealed that latitude (Sapporo or Oita) effect predicted significant variance of hyperthymic temperament, but not of the other temperaments. LIMITATIONS The limitation of the present study was that there was a small but significant difference in age between the subjects of Sapporo and those of Oita. Therefore, we included age in the multiple regression analysis. Second, there were several climate factors other than sunshine which were significantly different between Sapporo and Oita. We cannot exclude these effects completely. Finally, we did not consider other factors such as psychosocial factors which might have affected bipolar temperaments. CONCLUSIONS The present findings suggest that relatively lower latitude (potentially via more sunshine) may induce hyperthymic temperament.

The structural equation analysis of childhood abuse, adult stressful life events, and temperaments in major depressive disorders and their influence on refractoriness

Background Previous studies have shown the interaction between heredity and childhood stress or life events on the pathogenesis of a major depressive disorder (MDD). In this study, we tested our hypothesis that childhood abuse, affective temperaments, and adult stressful life events interact and influence the diagnosis of MDD. Patients and methods A total of 170 healthy controls and 98 MDD patients were studied using the following self-administered questionnaire surveys: the Patient Health Questionnaire-9 (PHQ-9), the Life Experiences Survey, the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire, and the Child Abuse and Trauma Scale (CATS). The data were analyzed with univariate analysis, multivariable analysis, and structural equation modeling. Results The neglect scores of the CATS indirectly predicted the diagnosis of MDD through cyclothymic and anxious temperament scores of the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire in the structural equation modeling. Two temperaments – cyclothymic and anxious – directly predicted the diagnosis of MDD. The validity of this result was supported by the results of the stepwise multivariate logistic regression analysis as follows: three factors – neglect, cyclothymic, and anxious temperaments – were significant predictors of MDD. Neglect and the total CATS scores were also predictors of remission vs treatment-resistance in MDD patients independently of depressive symptoms. Limitations The sample size was small for the comparison between the remission and treatment-resistant groups in MDD patients in multivariable analysis. Conclusion This study suggests that childhood abuse, especially neglect, indirectly predicted the diagnosis of MDD through increased affective temperaments. The important role as a mediator of affective temperaments in the effect of childhood abuse on MDD was suggested.

The effects of mental state on assessment of bipolar temperament

BACKGROUND Although the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-auto questionnaire (TEMPS-A) was designed to identify temperaments which derive from traits but not states, there is a possibility that TEMPS-A scores might be affected by mental state in non-clinical populations. For the purpose of clarifying the effects of mental state on TEMPS-A scores, it is worthwhile to examine associations of the full version of the TEMPS-A with various depressive scales and, if possible, mania rating scales. METHODS TEMPS-A data acquired from 314 medical students and staff was used to investigate the association of temperament scores with mental assessment scores such as the Beck Depression Inventory (BDI), the Quick Inventory of Depressive Symptomatology Self-Report Japanese version (QIDS-SR-J), the Patient Health Questionnaire-9 (PHQ-9), the Hamilton Depression rating scale (HAM-D) and the Young Mania Rating Scale (YMRS). RESULTS Depressive state scores were significantly and positively associated with depressive, anxious, cyclothymic, and irritable temperament scores of TEMPS-A whereas sub-threshold hypomanic state scores were significantly and positively associated with irritable temperament of TEMPS-A. There was no association between depressive state or sub-threshold hypomanic state and hyperthymic temperament scores. LIMITATIONS The nature of the present study is cross-sectional, and it is unknown whether depressive and/or sub-threshold hypomanic states may have affected temperament scores or whether temperament scores might have affected depressive and/or sub-threshold hypomanic scores. Other limitations are that the sample may not represent the entire population and that there is no evidence that Japanese findings can be applicable outside Japan. CONCLUSIONS It is worthwhile to consider the effects of mental state on temperament scores of TEMPS-A even in non-clinical population.

Affective temperaments play an important role in the relationship between childhood abuse and depressive symptoms in major depressive disorder

Previous studies have shown that various factors, such as genetic and environmental factors, contribute to the development of major depressive disorder (MDD). The aim of this study is to clarify how multiple factors, including affective temperaments, childhood abuse and adult life events, are involved in the severity of depressive symptoms in MDD. A total of 98 participants with MDD were studied using the following self-administered questionnaire surveys: Patient Health Questionnaire-9 measuring the severity of depressive symptoms; Life Experiences Survey (LES) measuring negative and positive adult life events; Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego auto-questionnaire (TEMPS-A) measuring affective temperaments; and the Child Abuse and Trauma Scale (CATS) measuring childhood abuse. The data were analyzed using single and multiple regression analyses and structural equation modeling (SEM). The neglect score reported by CATS indirectly predicted the severity of depressive symptoms through affective temperaments measured by TEMPS-A in SEM. Four temperaments (depressive, cyclothymic, irritable, and anxious) directly predicted the severity of depressive symptoms. The negative change in the LES score also directly predicted severity. This study suggests that childhood abuse, especially neglect, indirectly increases the severity of depressive symptoms through increased scores of affective temperaments in MDD.

The moderator effects of affective temperaments, childhood abuse and adult stressful life events on depressive symptoms in the nonclinical general adult population

BACKGROUND We recently demonstrated in the structural equation modeling that four of five affective temperaments, as measured by the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego auto-questionnaire version (TEMPS-A), are strong mediators between childhood abuse and depressive symptoms in the nonclinical general adult population. In this study, we hypothesized that affective temperaments, childhood abuse, and adult life events have moderator effects that interact with one another on depressive symptoms. The hierarchical multiple regression analysis was used to analyze this interaction model. METHODS The 286 participants from the nonclinical general adult population were studied using the following self-administered questionnaire surveys: the Patient Health Questionnaire-9 (PHQ-9), Life Experiences Survey (LES), TEMPS-A, and Child Abuse and Trauma Scale (CATS). The data were analyzed using hierarchical multiple regressions with interactions. RESULTS Depressive temperament enhanced and hyperthymic temperament inhibited the depressogenic effects of childhood abuse, while irritable temperament enhanced and hyperthymic temperament inhibited the depressogenic effects of adult negative (stressful) life events. Adult positive life events had an inhibitory moderator effect on depressive symptoms that was increased by cyclothymic and anxious temperaments. Neglect, punishment, and total childhood abuse enhanced the effects of negative life events on depressive symptoms. LIMITATIONS As the subjects of this study were nonclinical, the findings should not be generalized to patients with mood disorders. In this cross-sectional study, there may be interdependence between the measured variables. CONCLUSIONS This study, using the hierarchical multiple regression analysis with interaction, demonstrated the positive and negative interactions between any two of affective temperaments, childhood abuse, and adult life events, and the influence on depressive symptoms in the nonclinical general adult population. Important moderator roles for affective temperaments, childhood abuse, and adult life events on depressive symptoms were suggested.

Does temperature or sunshine mediate the effect of latitude on affective temperaments? A study of 5 regions in Japan.

BACKGROUND Previously, we compared the hyperthymic scores of residents in Sapporo, Koshigaya, and Oita (which are located at latitudes of 43°N, 36°N, and 33°N in Japan, respectively) using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-auto questionnaire version (TEMPS-A). We found that residents who lived at lower latitudes had higher hyperthymic temperament scores; however, the mechanism of the effect of latitude on hyperthymic temperament remained unclear. The current study examined the mediators of the latitude effect in additional regions with different annual temperatures and amounts of ambient sunshine. METHODS The Japanese archipelago stretches over 4000 km from north to south and has four large islands: Hokkaido, Honshu, Shikoku, and Kyushu. In addition to the TEMPS-A previously reported data collected at Sapporo (latitude 43°N), Koshigaya (36°N), and Oita (33°N), we collected the TEMPS-A data of 189 and 106 residents from Takaoka (36°N) and Obihiro (42°N), respectively. Taken together, these five regions have different patterns (i.e., highs and lows) of annual ambient total sunshine (hours) and mean temperature (°C). The effect of latitude, sunshine, and temperature on affective temperaments was analyzed for five Japanese regions. RESULTS Multiple regression analyses revealed that latitude predicted significant variance in hyperthymic temperament. Ambient temperature, but not sunshine, significantly affected hyperthymic temperament. LIMITATIONS The light exposure that residents actually received was not measured. The number of regions studied was limited. The findings might not generalize to residents across Japan or other countries. CONCLUSIONS The present findings suggest that latitude affects hyperthymic temperament, and ambient temperature might mediate this effect.

Dose-dependent effects of light on hyperthymic temperament

BACKGROUND In a previous study examining the association of hyperthymic temperament and daily light exposure (illuminance), we compared hyperthymic scores of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-auto questionnaire version (TEMPS-A) acquired from residents in Sapporo and Oita in Japan, which are located at 43° and 33° of latitude. We found that residents of Oita had significantly higher hyperthymic scores than residents of Sapporo. Moreover, a comparison of 3 regions rather than 2 regions may show a dose-response relationship in hyperthymic temperament and illuminance. METHODS Japan has 4 large islands-Hokkaido, Honshu, Shikoku, and Kyushu. Sapporo is in Hokkaido and Oita is in Kyushu. As the 3rd location, we recently collected TEMPS-A data from 125 residents in Koshigaya which is located in Honshu at 36°. We combined the data of the Koshigaya residents with the data of 94 residents from Sapporo and 95 from Oita. RESULTS The mean yearly total sunshine of the past 20 years (1993-2012) was 1684.6h in Sapporo, 1862.9h in Koshigaya, and 2002.9h in Oita. Multiple regression analyses revealed that sunshine predicted significant variance of hyperthymic temperament in a dose-dependent manner. LIMITATIONS The limitation of the present study is the lack of the consideration of the effects of temperature on hyperthymic temperament. Since correlations are fairly small, other factors are also at work for hyperthymic temperament. CONCLUSIONS The present findings suggest that higher illuminance may maintain hyperthymic temperament via light effects in a dose-dependent manner.

Associations among depressive symptoms, childhood abuse, neuroticism, and adult stressful life events in the general adult population

Background Recent studies have suggested that the interactions among several factors affect the onset, progression, and prognosis of major depressive disorder. This study investigated how childhood abuse, neuroticism, and adult stressful life events interact with one another and affect depressive symptoms in the general adult population. Subjects and methods A total of 413 participants from the nonclinical general adult population completed the Patient Health Questionnaire-9, the Child Abuse and Trauma Scale, the neuroticism subscale of the shortened Eysenck Personality Questionnaire – Revised, and the Life Experiences Survey, which are self-report scales. Structural equation modeling (Mplus version 7.3) and single and multiple regressions were used to analyze the data. Results Childhood abuse, neuroticism, and negative evaluation of life events increased the severity of the depressive symptoms directly. Childhood abuse also indirectly increased the negative appraisal of life events and the severity of the depressive symptoms through enhanced neuroticism in the structural equation modeling. Limitations There was recall bias in this study. The causal relationship was not clear because this study was conducted using a cross-sectional design. Conclusion This study suggested that neuroticism is the mediating factor for the two effects of childhood abuse on adulthood depressive symptoms and negative evaluation of life events. Childhood abuse directly and indirectly predicted the severity of depressive symptoms.

The influence of childhood abuse, adult life events, and affective temperaments on the well-being of the general, nonclinical adult population

Background Previous studies have shown the effects of childhood abuse, life events, and temperaments on well-being (positive affect) and ill-being (negative affect). We hypothesized that childhood abuse, affective temperaments, and adult life events interact with one another and influence positive and negative affects in the general adult population and tested this hypothesis using structural equation modeling. Methods A total of 415 participants from the general, nonclinical adult population were studied using the following self-administered questionnaires: the Subjective Well-Being Inventory (SUBI); Life Experiences Survey (LES); Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A); and the Child Abuse and Trauma Scale (CATS). The data were analyzed with single and multiple regression analyses and structural equation modeling (Mplus). Results Childhood abuse indirectly predicted the worsening of positive and negative affects through cyclothymic, anxious, and irritable temperaments as measured by the TEMPS-A in the structural equation model. The cyclothymic, anxious, and irritable temperaments directly worsened the positive and negative affects and the negative appraisal of life events that occurred during the past year, while the hyperthymic temperament had the opposite effects. Limitations The subjects of this study were nonclinical volunteers. The findings might not be generalizable to psychiatric patients. Conclusion This study demonstrated that childhood abuse, particularly neglect, indirectly worsened the well-being of individuals through cyclothymic, anxious, and irritable affective temperaments. An important “mediator” role of affective temperaments in the effect of childhood abuse on well-being was suggested.