Dimensions of temperament and character as predictors of antidepressant discontinuation, response and adverse reactions during treatment with nortriptyline and escitalopram

Abstract Background Personality traits may predict antidepressant discontinuation and response. However, previous studies were rather small, only explored a few personality traits and did not include adverse drug effects nor the interdependency between antidepressant discontinuation patterns and response. Methods GENDEP included 589 patients with unipolar moderate-severe depression treated with escitalopram or nortriptyline for 12 weeks. Seven personality dimensions were measured using the self-reported 240-item Temperament and Character Inventory-Revised (TCI-R). We applied Cox proportional models to study discontinuation patterns, logistic and linear regression to investigate response and remission after 8 and 12 weeks, and mixed-effects linear models regarding time-varying treatment response and adverse drug reactions. Results Low harm avoidance, low cooperativeness, high self-transcendence and high novelty seeking were associated with higher risks for antidepressant discontinuation, independent of depressed mood, adverse drug reactions, drug, sex and age. Regression analyses showed that higher novelty seeking and cooperativeness scores were associated with a greater likelihood of response and remission after 8 and 12 weeks, respectively, but we found no correlations with response in the mixed-effects models. Only high harm avoidance was associated with more self-reported adverse effects. Conclusions This study, representing the largest investigation between several personality traits and response to two different antidepressants, suggests that correlations between personality traits and antidepressant treatment response may be confounded by differential rates of discontinuation. Future trials on personality in the treatment of depression need to consider this interdependency and study whether interventions aiming at improving compliance for some personality types may improve response to antidepressants.

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Association between Polymorphism rs1799732 of DRD2 Dopamine Receptor Gene and Personality Traits among MMA Athletes

Genes ◽

10.3390/genes12081217 ◽

2021 ◽

Vol 12 (8) ◽

pp. 1217

Author(s):

Marta Niewczas ◽

Anna Grzywacz ◽

Katarzyna Leźnicka ◽

Krzysztof Chmielowiec ◽

Jolanta Chmielowiec ◽

...

Keyword(s):

High Risk ◽

Personality Traits ◽

Dopamine Receptor ◽

Martial Arts ◽

Genetic Variants ◽

Receptor Gene ◽

Harm Avoidance ◽

Novelty Seeking ◽

Genes Encoding ◽

Dopamine Receptor Gene

Four factors—namely, harm avoidance, novelty seeking, reward addiction and persistence—represent the nature of temperament that is not genetically determined in itself. It was shown in earlier studies that a strong propensity to look for novelty or a tendency to engage in risky behavior is correlated with genetic variants in the area of the genes encoding dopamine receptors. Therefore, the aim of this study is to determine whether there is a relationship between personality traits and genetic variants in the area of the DRD2 dopamine receptor gene in MMA athletes. The participants consisted of 85 mixed martial arts (MMA) athletes and 284 healthy, non-MMA male participants. Their personality traits were measured using the Revised Temperament and Character Inventory. Blood was collected for genetic assays and all samples were genotyped using the real-time PCR method. We observed a statistically significant effect of a complex factor of the DRD2 rs1799732 genotype on MMA participants’ control and reward dependence. Engaging in high-risk sport may be associated with several personality characteristics. The DRD2 rs1799732 polymorphism may be associated with reduced harm avoidance in martial arts athletes, thereby modulating athletes’ predisposition to participate in high-risk sport.

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Interaction effects between the brain-derived neurotrophic factor Val66Met polymorphism and parental rearing on personality traits in healthy subjects

European Psychiatry ◽

10.1016/s0924-9338(11)72522-6 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 817-817

Author(s):

A. Suzuki ◽

Y. Matsumoto ◽

N. Shibuya ◽

R. Sadahiro ◽

M. Kamata ◽

...

Keyword(s):

Personality Traits ◽

Maternal Care ◽

Healthy Subjects ◽

Harm Avoidance ◽

Novelty Seeking ◽

Val66met Polymorphism ◽

Bdnf Val66met Polymorphism ◽

Parental Rearing ◽

Main Effects ◽

The Brain

AimsThere is a growing body of data suggesting the gene-environment interaction in the characterization of personality traits, but variation in ordinary parental rearing among environmental factors has not been focused yet. We examined the effects of the interaction between the brain-derived neurotrophic factor (BDNF) Val66Met polymorphism and parental rearing on personality traits.MethodsSubjects were 710 Japanese healthy volunteers. Perceived parental rearing was assessed by the Parental Bonding Instrument (PBI), which consists of the care and protection factors. Personality assessment was performed by the Temperament and Character Inventory (TCI), which has 7 dimensions, i.e., novelty seeking, harm avoidance, reward dependence, persistence, self-directedness, cooperativeness, and self-transcendence. The BDNF Val66Met polymorphism was detected by the PCR-RFLP method.ResultsParental rearing has significant main effects on all TCI dimensions except novelty seeking, while no significant main effects of the BDNF genotype on the TCI scores were found. The interaction between the BDNF genotype and maternal care of the PBI had significant effects on harm avoidance and self-directedness of the TCI. Post-hoc analyses showed that decreased maternal care was correlated with increased harm avoidance and decreased self-directedness in most of the genotype groups, and for both personality traits the correlation was highest in the Met/Met genotype and lowest in the Val/Val genotype and that for the Val/Met genotype was in between the two values.ConclusionThe present study suggests that the BDNF Val66Met polymorphism moderates the effects of parenting rearing, especially maternal care, on harm avoidance and self-directedness in healthy subjects.

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Harm Avoidance as a Mediator of Treatment Response to Antidepressant Treatment of Patients with Major Depression

Psychotherapy and Psychosomatics ◽

10.1159/000276372 ◽

2010 ◽

Vol 79 (2) ◽

pp. 116-122 ◽

Cited By ~ 15

Author(s):

Lena C. Quilty ◽

Kathryn M. Godfrey ◽

Sidney H. Kennedy ◽

R. Michael Bagby

Keyword(s):

Major Depression ◽

Treatment Response ◽

Antidepressant Treatment ◽

Harm Avoidance

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Temperament and Personality Traits in Patients with Chronic Spontaneous Urticaria: A Cross-Sectional Study

Iranian Journal of Psychiatry and Behavioral Sciences ◽

10.5812/ijpbs.117313 ◽

2022 ◽

Vol In Press (In Press) ◽

Author(s):

Maryam Khoshkhui ◽

Maedeh Kamrani ◽

Maryam Emadzadeh ◽

Zahra Jafari ◽

Farhad Faridhosseini

Keyword(s):

Personality Traits ◽

Cross Sectional Study ◽

Harm Avoidance ◽

Chronic Spontaneous Urticaria ◽

Control Group ◽

Novelty Seeking ◽

Healthy Individuals ◽

Sectional Study ◽

Cross Sectional ◽

Self Transcendence

Background: Considering the psychobiological aspects of various dermatological diseases and the role of personality traits in the development of chronic skin diseases, the present study aimed to assess the personality traits of patients with chronic spontaneous urticaria compared to healthy individuals. Methods: In this cross-sectional study conducted during 2016 - 2018, 100 patients with chronic spontaneous urticaria were selected using the convenience sampling method. Moreover, 100 healthy participants were selected as the control group. Research instruments were Temperament and Character Inventory (TCI) and a demographic checklist. Data were analyzed using descriptive statistics, t-test, and chi-square test using SPSS Software version 23. Results: The patients had higher scores in novelty-seeking (P = 0.041) and harm avoidance (P = 0.015), while the healthy individuals had higher scores in self-directedness (P = 0.003) and cooperativeness (P = 0.001). Moreover, male patients had higher scores in novelty-seeking (P = 0.006) and rewarded dependence (P = 0.013); however, female patients had higher scores in self-transcendence (P = 0.001) and cooperativeness (P = 0.019). Furthermore, there was a correlation between the disease duration of with reward dependence, self-directedness, and self-transcendence. Conclusions: Personality traits seem to be associated with chronic spontaneous urticaria. In this regard, patients with chronic spontaneous urticaria had higher scores in novelty-seeking and harm avoidance and lower scores in self-directedness and cooperativeness than healthy individuals.

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PERSONALITY PROFILES IN A SWEDISH LONG-TERM UNEMPLOYED SAMPLE

The International Journal of Person Centered Medicine ◽

10.5750/ijpcm.v9i4.1015 ◽

2021 ◽

Vol 9 (4) ◽

pp. 17-39

Author(s):

Alexandre Granjard ◽

Kevin M. Cloninger ◽

Erik Lindskär ◽

Christian Jacobsson ◽

Sverker Sikström ◽

...

Keyword(s):

Standard Deviation ◽

General Population ◽

Personality Traits ◽

Well Being ◽

Harm Avoidance ◽

Novelty Seeking ◽

Personality Profiles ◽

Health Related ◽

Self Transcendence

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.

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Linking novelty seeking and harm avoidance personality traits to basal ganglia: volumetry and mean diffusivity

Brain Structure and Function ◽

10.1007/s00429-013-0535-5 ◽

2013 ◽

Vol 219 (3) ◽

pp. 793-803 ◽

Cited By ~ 22

Author(s):

Daniela Laricchiuta ◽

Laura Petrosini ◽

Fabrizio Piras ◽

Debora Cutuli ◽

Enrica Macci ◽

...

Keyword(s):

Basal Ganglia ◽

Personality Traits ◽

Mean Diffusivity ◽

Harm Avoidance ◽

Novelty Seeking

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EEG-based model and antidepressant response

10.31234/osf.io/hqxzd ◽

2020 ◽

Author(s):

Gustav Nilsonne ◽

Frank Harrell

Keyword(s):

Prediction Model ◽

Treatment Response ◽

Selective Serotonin Reuptake Inhibitors ◽

Rating Scale ◽

Antidepressant Treatment ◽

Severe Depression ◽

Training Dataset ◽

General Point ◽

Treatment Responder ◽

Data Points

In a recent article, Wu et al.1 presented an electroencephalogram (EEG)-based prediction model for antidepressant treatment response1. Here, we point to limitations in the methods used to define response and to validate the prediction model; specifically that change from baseline Hamilton depression rating scale (HAMD) scores needs to take into account the nonlinearity of response, and that the validation analysis transposed the predictor and the outcome.Wu et al. trained their prediction model on data from the treatment arm of the EMBARC study (n = 109) to predict change in HAMD scores. However, the relationship between HAMD scores at follow-up when compared against baseline is typically extremely nonlinear. This nonlinear relationship is caused by patients with more severe depression (higher HAMD) having much larger improvement than those with less severe depression (lower HAMD). This implies that change from baseline for HAMD is not an appropriate measure. A preferred solution is to fit a proportional odds ordinal logistic model with nonlinear adjustment for baseline scale, using for example restricted cubic splines, with raw HAMD at a fixed time point since baseline as the dependent variable. A more detailed discussion of issues relating with analyzing change from baseline in randomized controlled trials has been presented elsewhere2. Wu et al.1 also tested the model on data from the placebo arm. Finding that the model did not predict improvement, they argued that this suggests the predicted effect is specific to selective serotonin reuptake inhibitors (SSRIs). However, an alternative explanation is that the model predictions did not generalize well due to overfitting on the training dataset. Proof of the efficacy of the model hinges on the test of the “antidepressant-predictive signature” in a second independent sample (n = 72). However, in this second dataset, the authors did not test whether the model predicted treatment response. Instead, they tested whether treatment responder status predicted the model prediction of HAMD change. We reanalysed the data to test whether the model predicted treatment response. Data points were estimated from Figure 4 of the paper by Wu et al. using WebPlotDigitizer, resulting in recovery of 71/72 data points. A receiver operating characteristic (ROC) curve was estimated using the pROC package3 in R4, yielding an area under the curve (AUC) of 0.67 (95% CI 0.53-0.81) (Figure 1). This case illustrates the general point that validation of predictive models should target the prediction of interest. The model validation by Wu et al. may be said to demonstrate a fallacy of transposition, as they used treatment responder status to predict the model predicted values. Model performance is barely above chance. Together with the uncertainty with respect to what is being predicted when change scores are the target, this suggests that the time has not yet arrived for clinically useful EEG markers for treatment selection in depression.

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Linking novelty seeking and harm avoidance personality traits to cerebellar volumes

Human Brain Mapping ◽

10.1002/hbm.22174 ◽

2012 ◽

Vol 35 (1) ◽

pp. 285-296 ◽

Cited By ~ 26

Author(s):

Daniela Laricchiuta ◽

Laura Petrosini ◽

Fabrizio Piras ◽

Enrica Macci ◽

Debora Cutuli ◽

...

Keyword(s):

Personality Traits ◽

Harm Avoidance ◽

Novelty Seeking

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Association between neurological soft signs, temperament and character in patients with schizophrenia and non-psychotic relatives

PeerJ ◽

10.7717/peerj.1651 ◽

2016 ◽

Vol 4 ◽

pp. e1651 ◽

Cited By ~ 2

Author(s):

Liliana Galindo ◽

Francisco Pastoriza ◽

Daniel Bergé ◽

Anna Mané ◽

Marisol Picado ◽

...

Keyword(s):

Personality Traits ◽

Biological Marker ◽

Harm Avoidance ◽

Novelty Seeking ◽

Temperament And Character Inventory ◽

Neurological Soft Signs ◽

Character Inventory ◽

High Risk Populations ◽

Self Transcendence

The heritability of schizophrenia and most personality traits has been well established, but the role of personality in susceptibility to schizophrenia remains uncertain. The aim of this study was to test for an association between personality traits and Neurological Soft Signs (NSS), a well-known biological marker of schizophrenia, in non-psychotic relatives of patients with schizophrenia. For this purpose, we evaluated the NSS scale and personality measured by the Temperament and Character inventory (TCI-R) in three groups of subjects: 29 patients with schizophrenia, 24 unaffected relatives and 37 controls. The results showed that patients with schizophrenia were more asocial (higher harm avoidance and lower reward dependence), more perseverative (higher persistence), and more schizotypal (lower self-directedness and cooperativeness, higher self-transcendence). The unaffected relatives showed higher harm avoidance, lower self-directedness and cooperativeness than the healthy controls. Higher NSS scores and sub-scores were found in patients and non-psychotic relatives compared with the controls. Among all the patients, total NSS scores were positively correlated with harm avoidance but negatively correlated with novelty seeking and persistence. Total NSS were also correlated with low scores on self-directedness and cooperativeness, which are indicators of personality disorder. Our results show that susceptibility to NSS and to schizophrenia are both related to individual differences in the temperament and character features in non-psychotic relatives of patients with schizophrenia. High harm avoidance, low persistence, low self-directedness and low cooperativeness contribute to both the risk of NSS and schizophrenia. These findings highlight the value of using both assessments to study high risk populations.

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Neuropsychological and Emotional Correlates of Personality Traits in Parkinson’s Disease

Behavioural Neurology ◽

10.1155/2013/896387 ◽

2013 ◽

Vol 27 (4) ◽

pp. 567-574 ◽

Cited By ~ 9

Author(s):

Janneke Koerts ◽

Lara Tucha ◽

Klaus L. Leenders ◽

Oliver Tucha

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Personality Traits ◽

Emotional Disturbances ◽

Harm Avoidance ◽

Novelty Seeking ◽

Cognition And Emotion ◽

Symptoms Of Depression ◽

Reward Dependence ◽

Healthy Participants

Parkinson’s disease (PD) is, apart from the well-known motor symptoms, also characterized by neuropsychological and emotional disturbances. However, patients also often present with a personality profile of low Novelty Seeking and high Harm Avoidance. This profile can be identified as the disease emerges, which raises the question whether these traits correlate with more fundamental neuropsychological and emotional disturbances. This study determined the neuropsychological and emotional correlates of Novelty Seeking, Harm Avoidance and two other personality traits that are often considered in PD, i.e. Reward Dependence and Persistence.Forty-three patients and 25 healthy participants were assessed with the Temperament and Character Inventory, a symptoms of depression questionnaire and neuropsychological tests.PD patients showed a higher Harm Avoidance than healthy participants, which was predicted by symptoms of depression. Groups did not differ regarding Novelty Seeking, Reward Dependence and Persistence. While cognitive flexibility was a predictor of Reward Dependence, Persistence was predicted by divergent thinking and inhibition. Novelty Seeking was not predicted by cognition or emotion.In conclusion, cognition and emotion are selectively related to personality traits in PD. Whereas Harm Avoidance covaries with emotional symptoms, Persistence and Reward Dependence are related to cognition. Alterations in personality, cognition and emotion in PD are thus not independent from each other.

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