scholarly journals Personality traits among ADHD adults: implications of late-onset and subthreshold diagnoses

2008 ◽  
Vol 39 (4) ◽  
pp. 685-693 ◽  
Author(s):  
S. V. Faraone ◽  
A. Kunwar ◽  
J. Adamson ◽  
J. Biederman

BackgroundDiagnosing attention deficit hyperactivity disorder (ADHD) in adults is difficult when diagnosticians cannot establish onset prior to the DSM-IV criterion of age 7 or if the number of symptoms does not achieve the DSM threshold for diagnosis. Previous work has assessed the validity of such diagnoses based on psychiatric co-morbidity, family history and neuropsychological functions but none of these studies have used personality as a validation criterion.MethodWe compared four groups of adults: (1) full ADHD subjects who met all DSM-IV criteria for childhood-onset ADHD; (2) late-onset subjects who met all criteria except the age at onset criterion, (3) subthreshold subjects who did not meet full symptom criteria and (4) non-ADHD subjects who did not meet any of the above criteria. Diagnoses were made by using the Structured Clinical Interview for DSM-IV (SCID) and the Temperament and Character Inventory (TCI) was used to assess personality traits.ResultsWe found that full ADHD and late-onset ADHD showed similar personality profiles with significant deviations on all TCI scales except reward dependence and self-transcendence. By contrast, subthreshold cases only showed deviations on novelty seeking and self-directiveness.ConclusionsThese data call into question the stringent age of onset of ADHD symptom criteria for adults when making retrospective diagnoses of ADHD. Subthreshold ADHD seems to be a milder form of the disorder that is consistent with dimensional views of the disorder.

2021 ◽  
Vol 9 (4) ◽  
pp. 17-39
Author(s):  
Alexandre Granjard ◽  
Kevin M. Cloninger ◽  
Erik Lindskär ◽  
Christian Jacobsson ◽  
Sverker Sikström ◽  
...  

Background: Long-term unemployment is associated with psychiatric problems, higher risk of suicide, low levels of well-being, and high levels of burnout. In this context, among other factors such as sociodemographic status and IQ, specific personality traits are important for individuals’ chances to finding a job, getting hired, and retaining that job, as well as for coping with the mental health risks related to long-term unemployment. Thus, in order to use person-centered methods to promote public health and sustainable employment during the current and future challenges of the 21st century, an important research area is the mapping and understanding of personality profiles of individuals who are unemployed.  Objectives: We mapped the personality traits and profiles in a sample of Swedish long-term unemployed (i.e., ≥ 6 months without work) in relation to a control group from the Swedish general population. Method: 245 long-term unemployed individuals (136 men and 157 women, range 18 to 60 years; M = 25.7; SD = 9.6) were recruited at the beginning of different well-being and employment projects in Blekinge, Sweden. The participants reported gender, age, and other basic demographics, as well as their personality using the Temperament and Character Inventory (TCI). We calculated the T-scores and percentiles for the personality traits using the Swedish normative data (N = 1,948) and clustered participants in different temperament (high/low novelty seeking: N/n, high/low harm avoidance: H/h, high/low reward dependence: R/r) and character profiles (high/low self-directedness: S/s, high/low cooperativeness: C/c, high/low self-transcendence: T/t). Results: Compared to the general population, the long-term unemployed were extremely higher in harm avoidance (> 1.5 standard deviation), moderately lower in persistence (> 0.5 standard deviation), extremely lower in self-directedness (> 2 standard deviations), and moderately lower in novelty seeking (> 0.5 standard deviation). That is, consistent with past research, our study shows that the personality of long-term unemployed is denoted by being pessimistic, fearful, easily fatigable, underachieving, blaming, helpless, and unfulfilled (i.e., high harm avoidance, low persistence, and low self-directedness), but also by being reserved and rigid (i.e., low novelty seeking). Furthermore, within the unemployed population, as much as 71.60% reported a methodical (nHr) or cautious profile (nHR), and as much as 64.00% reported an apathetic (sct) or a disorganized profile (scT). Moreover, the profile analyses allowed us to show that, within this unemployed population and in relation to each individual’s own profile, about 91.70% were high in harm avoidance, 98.60% were low in self-directedness, 64.00% were low in cooperativeness, and 44.40% low in self-transcendence. Conclusions: These results indicate a high predictive value by the TCI, especially regarding the specific basic health-related traits or abilities (i.e., self-directedness, cooperativeness, and self-transcendence) needed to cope with the risks related to unemployment. Specifically, long-term unemployed populations have temperament profiles that present difficulties for them to adapt to the circumstances of unemployment, but also finding, getting, and retaining a job and character profiles that diminish their possibilities to self-regulate the emotions derived from their temperament through self-directed choices that improve their health and all aspects of their lives. Hence, evidence-based interventions targeting stress reduction and the development of health-related traits or abilities (i.e., self-directedness, cooperativeness, and self-transcendence) are urgently needed.


2017 ◽  
Vol 41 (S1) ◽  
pp. S211-S211
Author(s):  
N. Smaoui ◽  
L. Zouari ◽  
N. Charfi ◽  
M. Maâlej-Bouali ◽  
N. Zouari ◽  
...  

IntroductionAge of onset of illness may be useful in explaining the heterogeneity among older bipolar patients.ObjectiveTo examine the relationship of age of onset with clinical, demographic and behavioral variables, in older patients with bipolar disorder.MethodsThis was a cross-sectional, descriptive and analytical study, including 24 patients suffering from bipolar disorders, aged 65 years or more and followed-up in outpatient psychiatry unit at Hedi Chaker university hospital in Sfax in Tunisia. We used a standardized questionnaire including socio-demographic, behavioral and clinical data. Age of onset was split at age 40 years into early-onset (< 40 years; n = 12) and late-onset (≥ 40 years; n = 12) groups.ResultsThe mean age for the entire sample was 68.95 years. The mean age of onset was 39.95 years. The majority (60%) of patients were diagnosed with bipolar I. Few meaningful differences emerged between early-onset and late-onset groups, except that tobacco use was significantly higher in the late-onset group (66.6% vs. 16.6%; P = 0.027). No significant differences between the early-onset and late-onset groups were seen on demographic variables, family history and number of medical diagnoses or presence of psychotic features.ConclusionOur study found few meaningful behavioral differences between early versus late age at onset in older adults with bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2007 ◽  
Vol 37 (7) ◽  
pp. 1047-1059 ◽  
Author(s):  
FREDERICK S. STINSON ◽  
DEBORAH A. DAWSON ◽  
S. PATRICIA CHOU ◽  
SHARON SMITH ◽  
RISE B. GOLDSTEIN ◽  
...  

Background. There is a lack of current detailed national data on the prevalence, correlates, disability and co-morbidity of DSM-IV specific phobia (SP), the prevalence of specific objects and situations feared, and associations between impairment, treatment and co-morbidity and the number of specific situations and objects feared, among adults in the USA.Method. The data were derived from a large (43093) representative sample of the adult population in the USA.Results. Prevalences of 12-month and lifetime DSM-IV SP were 7·1% and 9·4% respectively. Being female, young, and low income increased risk, while being Asian or Hispanic decreased risk (p<0·05). The mean age at onset of SP was 9·7 years, the mean duration of episode was 20·1 years and only 8·0% reported treatment specifically for SP. Most specific phobias involved multiple fears, and an increasing number of fears, regardless of content, was associated with greater disability and impairment, treatment seeking and co-morbidity with other Axis I and II disorders.Conclusions. SP is a highly prevalent, disabling and co-morbid disorder in the US adult population. The early onset of SP and the disorders most strongly associated with it highlights the need for longitudinal studies beginning in early childhood. Results suggest the existence of a generalized subtype of SP much like social phobia, which, once revealed, may lead to a classification of SP that is more etiologically and therapeutically meaningful.


2006 ◽  
Vol 15 (3) ◽  
pp. 176-184 ◽  
Author(s):  
Antonio Terracciano ◽  
Robert R. McCrae

SUMMARYAims – This article provides a brief review of recent cross-cultural research on personality traits at both individual and culture levels, highlighting the relevance of recent findings for psychiatry. Method – In most cultures around the world, personality traits can be clearly summarized by the five broad dimensions of the Five-Factor Model (FFM), which makes it feasible to compare cultures on personality and psychopathology. Results – Maturational patterns and sex differences in personality traits generally show cultural invariance, which generates the hypothesis that age of onset, clinical evolution, and sex differences in the prevalence of psychiatric disorders might follow similar universal patterns. The average personality profiles from 51 cultures show meaningful geographical distributions and associations with culture-level variables, but are clearly unrelated to national character stereotypes. Conclusions – Aggregate personality scores can potentially be related to epidemiological data on psychiatric disorders, and dimensional personality models have implications for psychiatric diagnosis and treatment around the world.Declaration of Interest: This research was supported by the Intramural Research Program of the NIH, National Institute on Aging. Robert R. McCrae receives royalties from the Revised NEO Personality Inventory.


2016 ◽  
Vol 33 (S1) ◽  
pp. S471-S471
Author(s):  
R. Martín Aragón ◽  
M. Gutiérrez Rodríguez ◽  
S. Bravo Herrero ◽  
C. Moreno Menguian ◽  
N. Rodríguez Criado ◽  
...  

IntroductionSchizophrenia has traditionally been considered to strictly be an early-onset disorder. Current nosologies, including DSMV, are not restrictive with age of onset in schizophrenia and all patients that satisfy diagnostic criteria fall into the same category. Since 1998, International Late-Onset Schizophrenia Group consensus, patients after 60 are classified as very-late onset schizophrenia-like psychosis. Female overrepresentation, low prevalence of formal thought disorder, and a higher prevalence of visual hallucinations are associated with later age at onset. Atypical antipsychotics represent the election treatment because of the reduced likelihood of EPS and tardive dyskinesias, and should be started at very low doses, with slow increases.ObjectiveTo review the current knowledge about very late-onset schizophrenia through systematic review of the literature and the analysis of a case.MethodsCase Report. Review. Literature sources were obtained through electronic search in PubMed database of last fifteen years.ResultsWe present a case of a 86-year-old woman suffering from delusions and hallucinations, diagnosed with very late-onset schizophrenia-like psychosis, after differential diagnosis with other disorders. We analyze ethiology, epidemiology, clinical features and treatment in geriatric patients with schizophrenia.ConclusionsReluctance to diagnose schizophrenia in old people is still present today, probably in relation with the inconsistency in diagnostic systems and nomenclature, and consideration of medical conditions in the diagnosis. Identification of these patients is really important in order to start an appropriate treatment, which can lead to patient clinical stability.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2011 ◽  
Vol 26 (S2) ◽  
pp. 16-16
Author(s):  
M. Pascucci ◽  
A. Di Cesare ◽  
C. Ciciarelli ◽  
M. Pettorruso ◽  
E. Righino ◽  
...  

AimsTo evaluate, in a sample of pathological gamblers, the effects of personality traits and psychiatric comorbidity on the severity of this condition.Methods40 patients were evaluated with the following instruments: EuropASI, modified for pathological gambling; MINI; TCI, and BIS-11. Univariate linear regression analyses were conducted to evaluate the relationships between different scales.ResultsAge of onset was influenced by Novelty Seeking and NS-1 subscale, with higher scores related to earlier onset, Harm Avoidance 2 subscale, with higher scores related to a later onset; the presence of a lifetime panic disorder was related with a later onset; A positive correlation was found between age of onset of pathological gambling and both cigarette and cannabis smoking. Higher NS1 scores were related to a higher amount of money spent during the last month, while higher scores on the HA2 and Cooperativeness 5 subscales were related to a lesser number of days in which the patient had gambled during the last month. Moreover, higher scores in Gambling severity scores are related with the presence of a comorbid alcohol or substance abuse or dependence, dysthymia, post traumatic stress disorder, bipolar II mood disorder, and with higher BIS-11 Motor Impulsiveness, Non-planned Impulsiveness and total scores.ConclusionsPersonality traits and psychiatric comorbidity influence the age of onset of gambling, the severity of gambling and the functional and economic impact of the disease on the patient’s life. An evaluation of these aspects is needed to determine treatment options with a greater understanding of the phenomenon.


2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Daniel Mamah ◽  
C Robert Cloninger ◽  
Victoria N Mutiso ◽  
Isaiah Gitonga ◽  
Albert Tele ◽  
...  

Abstract Specific personality traits have been proposed as a schizophrenia-related endophenotype and confirmed in siblings at risk for psychosis. The relationship of temperament and character with psychosis has not been previously investigated in Africa. The study was conducted in Kenya, and involved participants at clinical high-risk (CHR) for psychosis (n = 268) and controls (n = 251), aged 15–25 years. CHR status was estimated using the Structured Interview of Psychosis-Risk Syndromes (SIPS) and the Washington Early Psychosis Center Affectivity and Psychosis (WERCAP) Screen. Student’s t-tests were used to assess group differences on the Temperament and Character Inventory (TCI). Neurocognitive functioning, stress severity, and substance use were correlated with the TCI, correcting for psychosis severity. CHR participants were more impulsive (ie, higher novelty seeking [NS]) and asocial (ie, lower reward dependence) than controls. They were also more schizotypal (ie, high self-transcendence [ST] and lower self-directedness [SD] and cooperativeness [CO] than controls). CO was related to logical reasoning, abstraction, and verbal memory. Stress severity correlated with high HA and schizotypal character traits. Lifetime tobacco use was related to NS, and lifetime marijuana use to high NS, low SD and high ST. Temperament and character of Kenyan CHR youth is similar to that observed in schizophrenia. Psychosis risk in Kenya is associated with impulsive, asocial, and schizotypal traits. CHR adolescents and young adults with schizophrenia-specific personality traits may be most at risk for developing a psychotic disorder and to require early intervention to improve outcomes.


2019 ◽  
Vol 40 (35) ◽  
pp. 2964-2975 ◽  
Author(s):  
Lia Crotti ◽  
Carla Spazzolini ◽  
David J Tester ◽  
Alice Ghidoni ◽  
Alban-Elouen Baruteau ◽  
...  

Abstract Aims Calmodulinopathies are rare life-threatening arrhythmia syndromes which affect mostly young individuals and are, caused by mutations in any of the three genes (CALM 1–3) that encode identical calmodulin proteins. We established the International Calmodulinopathy Registry (ICalmR) to understand the natural history, clinical features, and response to therapy of patients with a CALM-mediated arrhythmia syndrome. Methods and results A dedicated Case Report File was created to collect demographic, clinical, and genetic information. ICalmR has enrolled 74 subjects, with a variant in the CALM1 (n = 36), CALM2 (n = 23), or CALM3 (n = 15) genes. Sixty-four (86.5%) were symptomatic and the 10-year cumulative mortality was 27%. The two prevalent phenotypes are long QT syndrome (LQTS; CALM-LQTS, n = 36, 49%) and catecholaminergic polymorphic ventricular tachycardia (CPVT; CALM-CPVT, n = 21, 28%). CALM-LQTS patients have extremely prolonged QTc intervals (594 ± 73 ms), high prevalence (78%) of life-threatening arrhythmias with median age at onset of 1.5 years [interquartile range (IQR) 0.1–5.5 years] and poor response to therapies. Most electrocardiograms (ECGs) show late onset peaked T waves. All CALM-CPVT patients were symptomatic with median age of onset of 6.0 years (IQR 3.0–8.5 years). Basal ECG frequently shows prominent U waves. Other CALM-related phenotypes are idiopathic ventricular fibrillation (IVF, n = 7), sudden unexplained death (SUD, n = 4), overlapping features of CPVT/LQTS (n = 3), and predominant neurological phenotype (n = 1). Cardiac structural abnormalities and neurological features were present in 18 and 13 patients, respectively. Conclusion Calmodulinopathies are largely characterized by adrenergically-induced life-threatening arrhythmias. Available therapies are disquietingly insufficient, especially in CALM-LQTS. Combination therapy with drugs, sympathectomy, and devices should be considered.


2007 ◽  
Vol 22 (5) ◽  
pp. 305-308 ◽  
Author(s):  
Gonzalo Haro ◽  
Joseph R. Calabrese ◽  
Christina Larsson ◽  
Edwin R. Shirley ◽  
Eva Martín ◽  
...  

AbstractPurposeThe aim of this study is to determine if personality traits contribute to the likelihood of substance abuse in Bipolar Disorder (BD).Subjects/materials and methodsFifty-nine patients meeting DSM-IV criteria for BD: 20 without any history of Substance Related Disorder (SRD), 21 with a lifetime history of SRD but without current SRD, and 18 with current SRD. Patients filled out the TCI, the differences were analyzed by ANOVA and the likelihood was obtained by Multinomial Logistic Regression.ResultsOnly Novelty Seeking (NS) is statistically different between the groups. Patients with BD with current SRD have higher rates in NS than those with past SRD, and those without a history of SRD. NS was confirmed as a predicting variable, both to current SRD (OR [CI 95%] = 1.039/1.351; p = 0.011) and past SRD (OR [CI 95%] = 1.004/1.277; p = 0.042) on patients with BD.DiscussionThe results shown would appear to confirm the relationship of NS with the SRD, so long as there is no clear evidence that indicates the association of NS with BD.ConclusionsThere appears a greater predisposition to develop SRD in those patients with a higher degree of NS. The use of the Cloninger's TCI could be used in BD to determine the risk of developing an SRD. Early detection might help improve prognosis.


1999 ◽  
Vol 14 (8) ◽  
pp. 458-461 ◽  
Author(s):  
F. Benazzi

SummaryPsychotic bipolar depression was compared with nonpsychotic bipolar depression. Psychotic (n = 59) and nonpsychotic (n = 176) bipolar depressed outpatients were SCID-DSM-IV interviewed. Psychotic bipolar depression had significantly higher severity, more chronicity, fewer atypical features and axis I co-morbidity, more bipolar I, and fewer bipolar II patients. Age at onset, duration of illness, gender, and recurrences, were not significantly different.


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