medigraphic.com
ISSN 0185-3325 (Print)
Órgano Oficial del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz

2009, Number 4

<< Back Next >>

Salud Mental 2009; 32 (4)

Dimensiones de temperamento y carácter en pacientes con primer episodio de depresión mayor

Minaya O, Fresán A, Loyzaga C

Language: Spanish
References: 129
Page: 309-315
PDF size: 103.98 Kb.


ABSTRACT

Unipolar depression is considered as one of the main psychiatric diagnosis related to psychosocial functioning impairment. It has been documented that personality features exert a direct influence on how people with depression cope and adapt to the disorder. The relationship between personality traits and depression has been studied in several models. As depressed patients usually exhibit several personality features of more than one personality disorder, a multidimensional theoretical perspective may increase the clinical description of prototypical diagnosis provided by current categorical criteria. The psychobiological model of personality proposed by Cloninger takes into account the respective contribution of neurobiologically-based mechanisms related to adaptative behaviors in response to danger, avoidance and reward, formulating four main temperamental dimensions and three characterological dimensions centered in conscious learning about self-concepts. The four temperament dimensions are: Novelty Seeking (NS) is thought to be related to the behavioral activation system; Harm Avoidance (HA) to the behavioral inhibition system; Reward Dependence (RD) is defined as a bias toward the maintenance of ongoing behaviors; and Persistence (PE) is defined as a tendency to perseverance despite frustration and fatigue. The character dimensions are: Self-directedness (SD) refers to the ability of an individual to control, regulate and adapt behavior to fit the situation in accordance with personal goals and values; Cooperativeness (CO), account for individual differences in identification with and acceptance of other people; and Selftranscendence (ST) refers to spiritual maturity, transpersonal identification and creativity. Several studies that used the psychobiological model or personality reported that personality differences are detectable among persons with a current major depressive disorder when compared to non-depressed. The most frequent finding reported is the association between higher scores in harm avoidance (HA) and depression. Nevertheless,other studies have found that depression is also related with high scores in the temperamental dimension: reward dependence (RD). In terms of character dimensions, it has been reported that depressed patients exhibit low self-directedness (SD) and low cooperativeness (CO).


REFERENCES

  1. Mulder R. Personality pathology and treatment outcome in major depression:

  2. A review. Am J Psychiatry 2002;159:359-371.

  3. Hirschfeld R. Personality disorders and depression: comorbidity. Depress

  4. Anxiety 1999;10:142-146.

  5. Cloninger C, Przybeck T, Svrakic D. The Tridimensional Personality Questionnaire:

  6. U.S. normative data. Psychological Reports 1991;69:1047-1057.

  7. Cloninger C, Przybeck T, Svrakic D, Wetzel R. The Temperament and

  8. Character Inventory (TCI): a guide to its development and use. St. Louis,

  9. MO: Washington University; 1994.

  10. Cloninger C, Svrakic D. Integrative psychobiological approach to

  11. psychiatric assessment and treatment. Psychiatry 1997;60:120-141.

  12. Cloninger C, Svrakic D, Przybeck T. A psychobiological model of temperament

  13. and character. Arch Gen Psychiatry 1993;50:975-990.

  14. Cloninger C. A unified biosocial theory of personality and its role in the

  15. development of anxiety states. Psychiatr Dev 1986;4:167-226.

  16. Cloninger C. A systematic method for clinical description and classification

  17. of personality variants. A proposal. Arch Gen Psychiatry

  18. 1987;44:573-588.

  19. Cloninger C, Sigvardsson S, Bohman M. Childhood personality predicts

  20. alcohol abuse in young adults. Alcohol Clin Exp Res 1988;12:494-505.

  21. Abrams K, Yune S, Kim S, Jeon H, Han S et al. Trait and state aspects of

  22. harm avoidance and its implication for treatment in major depressive

  23. disorder, dysthymic disorder, and depressive personality disorder.

  24. Psychiatry Clin Neurosci 2004;58:240-248.

  25. Farmer A, Mahmood A, Redman K, Harris T, Sadler S et al. A sib-pair

  26. study of the Temperament and Character Inventory Scales in major

  27. depression. Arch Gen Psychiatry 2003;60:490-496.

  28. Kusunoki K, Sato T, Taga C, Yoshida T, Komori K et al. Low noveltyseeking

  29. differentiates obsessive-compulsive disorders from major depression.

  30. Acta Psychiatr Scand 2000;101:403-405.

  31. Richter J, Eisemann M, Richter G. Temperament and character during

  32. the course of unipolar depression among inpatients. Eur Arch Psychiatry

  33. Clin Neurosci 2000;250:40-47.

  34. Marijnissen G, Tuinier S, AES. S, Verhoeven W. The temperament and

  35. character inventory in major depression. J Affect Disord 2002;70:

  36. 219-223.

  37. Smith D, Duffy L, Stewart M, Muir W, Blckwood D. High harm avoidance

  38. and low self-directedness in euthymic young adults with recurrent,

  39. early-onset depression. J Affect Disord 2005;87:83-89.

  40. Ampollini P, Marchesi C, Signifredi R, Ghinaglia E, Scardovi F et al. Temperament

  41. and personality features in patients with major depression, panic

  42. disorder and mixed conditions. J Affect Disord 1999;52:203-207.

  43. Elovainio M, Kivimaki M, Puttonen S, Heponiemi T, Pulkki L et al. Temperament

  44. and depressive symptoms: a population-based longitudinal

  45. study on Cloninger’s psychobiological temperament model. J Affect

  46. Disord 2004;83:227-232.

  47. Hansenne M. P300 and personality: an investigation with the Cloninger’s

  48. model. Biol Psychiatry 1999;50:143-155.

  49. Hirano S, Sato T, Narita T, Kusunoki K, Ozaki N et al. Evaluating the

  50. state dependency of the Temperament and Character Inventory dimensions

  51. in patients with major depression: a methodological contribution.

  52. J Affect Disord 2002;69:31-38.

  53. Cloninger C, Svrakic D, Przybeck T. Can personality assessment predict

  54. future depression? A twuelve-month follow-up of 631 subjects. J

  55. Affect Disord 2006;92:35-44.

  56. American Psychiatric Association. Diagnostic and Statistical Manual of

  57. Mental Disorders. Cuarta edición. Washington, DC; 1994.

  58. First M, Spitzer R, Gibbon M, Williams J. Structured Clinical Interview

  59. for DSM-IV Axis I Disorders (SCID-I), clinician version. Washington,

  60. D.C.: American Psychiatric Press; 1996.

  61. Derogatis L. Symptom Checklist 90-R: Administration, Scoring and Procedures

  62. Manual. Baltimore: Clinical Psychometric Research; 1983.

  63. Montgomery S, Asberg M. A new depressive scale designed to be sensi-tive to change. Br J Psychiatry 1979;134:382-389.

  64. Susuki A, Aoshima T, Fukasawa T. A three-factor model of the MADRS

  65. in major depressive disorder. Depress Anxiety 2005;21:95-97.

  66. Rosado A. Estudio de confiabilidad de la escala Montgomery-Asberg

  67. para la evaluación de la depresión. México: UNAM; 1993.

  68. Sánchez de Carmona M, Paéz F, López J, Nicolini H. Traducción y confiabilidad

  69. del inventario de temperamento y carácter (ITC). Salud Mental

  70. 1996;19(Supl 3):5-9.

  71. Sato T, Narita T, Hirano S. Factor validity of the temperament and character

  72. inventory in patients with major depression. Compr Psychiatry

  73. 2001;42:337-341.

  74. Grucza R, Przybeck T, Spitznagel E, Cloninger C. Personality and depressive

  75. symptoms: a multi-dimensional analysis. J Affect Disord

  76. 2003;74:123-130.

  77. Strakowski S, Dunayevich E, Keck P, McElroy S. Affective state dependence

  78. of the Tridimensional Personality Questionnaire. Psychiatry Res

  79. 1995;57:209-214.

  80. Hansenne M, Pitchot W, Moreno A, Reggers J, Machurot P et al. Harm

  81. avoidance dimension of the Tridimensional Personality Questionnaire

  82. and serotonin-1A activity in depressed patients. Biol Psychiatry

  83. 1997;42:959-961.

  84. Mulder R, Joyce P, Cloninger C. Temperament and early environment

  85. influence comorbidity and personality disorders in major depression.

  86. Compr Psychiatry 1994;35:225-233.

  87. Tanaka E, Kijima N, Kitamura T. Correlations between the Temperament

  88. and Character Inventory and the Self-rating Depression Scale

  89. among Japanese Students. Psychol Rep 1997;80:251-254.

  90. Naito M, Kijima N, Kitamura T. Temperament and Character Inventory

  91. (TCI) as predictors of depression among Japanese college students. J

  92. Clin Psychol 2000;56:1579-1585.

  93. Enns M, Cox B. Personality dimensions and depression: review and

  94. commentary. Can J Psychiatry 1997;42:274-284.

  95. Mulder R. Personality pathology and treatment outcome in major depression: A review. Am J Psychiatry 2002;159:359-371.

  96. Hirschfeld R. Personality disorders and depression: comorbidity. Depress Anxiety 1999;10:142-146.

  97. Cloninger C, Przybeck T, Svrakic D. The Tridimensional Personality Questionnaire: U.S. normative data. Psychological Reports 1991;69:1047-1057.

  98. Cloninger C, Przybeck T, Svrakic D, Wetzel R. The Temperament and Character Inventory (TCI): a guide to its development and use. St. Louis, MO: Washington University; 1994.

  99. Cloninger C, Svrakic D. Integrative psychobiological approach to psychiatric assessment and treatment. Psychiatry 1997;60:120-141.

  100. Cloninger C, Svrakic D, Przybeck T. A psychobiological model of temperament and character. Arch Gen Psychiatry 1993;50:975-990.

  101. Cloninger C. A unified biosocial theory of personality and its role in the development of anxiety states. Psychiatr Dev 1986;4:167-226.

  102. Cloninger C. A systematic method for clinical description and classification of personality variants. A proposal. Arch Gen Psychiatry 1987;44:573-588.

  103. Cloninger C, Sigvardsson S, Bohman M. Childhood personality predicts alcohol abuse in young adults. Alcohol Clin Exp Res 1988;12:494-505.

  104. Abrams K, Yune S, Kim S, Jeon H, Han S et al. Trait and state aspects of harm avoidance and its implication for treatment in major depressive disorder, dysthymic disorder, and depressive personality disorder. Psychiatry Clin Neurosci 2004;58:240-248.

  105. Farmer A, Mahmood A, Redman K, Harris T, Sadler S et al. A sib-pair study of the Temperament and Character Inventory Scales in major depression. Arch Gen Psychiatry 2003;60:490-496.

  106. Kusunoki K, Sato T, Taga C, Yoshida T, Komori K et al. Low noveltyseeking differentiates obsessive-compulsive disorders from major depression. Acta Psychiatr Scand 2000;101:403-405.

  107. Richter J, Eisemann M, Richter G. Temperament and character during the course of unipolar depression among inpatients. Eur Arch Psychiatry Clin Neurosci 2000;250:40-47.

  108. Marijnissen G, Tuinier S, AES. S, Verhoeven W. The temperament and character inventory in major depression. J Affect Disord 2002;70: 219-223.

  109. Smith D, Duffy L, Stewart M, Muir W, Blckwood D. High harm avoidance and low self-directedness in euthymic young adults with recurrent, early-onset depression. J Affect Disord 2005;87:83-89.

  110. Ampollini P, Marchesi C, Signifredi R, Ghinaglia E, Scardovi F et al. Temperament and personality features in patients with major depression, panic disorder and mixed conditions. J Affect Disord 1999;52:203-207.

  111. Elovainio M, Kivimaki M, Puttonen S, Heponiemi T, Pulkki L et al. Temperament and depressive symptoms: a population-based longitudinal study on Cloninger’s psychobiological temperament model. J Affect Disord 2004;83:227-232.

  112. Hansenne M. P300 and personality: an investigation with the Cloninger’s model. Biol Psychiatry 1999;50:143-155.

  113. Hirano S, Sato T, Narita T, Kusunoki K, Ozaki N et al. Evaluating the state dependency of the Temperament and Character Inventory dimensions in patients with major depression: a methodological contribution. J Affect Disord 2002;69:31-38.

  114. Cloninger C, Svrakic D, Przybeck T. Can personality assessment predict future depression? A twuelve-month follow-up of 631 subjects. J Affect Disord 2006;92:35-44.

  115. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Cuarta edición. Washington, DC; 1994.

  116. First M, Spitzer R, Gibbon M, Williams J. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), clinician version. Washington, D.C.: American Psychiatric Press; 1996.

  117. Derogatis L. Symptom Checklist 90-R: Administration, Scoring and Procedures Manual. Baltimore: Clinical Psychometric Research; 1983.

  118. Montgomery S, Asberg M. A new depressive scale designed to be sensitive to change. Br J Psychiatry 1979;134:382-389.

  119. Susuki A, Aoshima T, Fukasawa T. A three-factor model of the MADRS in major depressive disorder. Depress Anxiety 2005;21:95-97.

  120. Rosado A. Estudio de confiabilidad de la escala Montgomery-Asberg para la evaluación de la depresión. México: UNAM; 1993.

  121. Sánchez de Carmona M, Paéz F, López J, Nicolini H. Traducción y confiabilidad del inventario de temperamento y carácter (ITC). Salud Mental 1996;19(Supl 3):5-9.

  122. Sato T, Narita T, Hirano S. Factor validity of the temperament and character inventory in patients with major depression. Compr Psychiatry 2001;42:337-341.

  123. Grucza R, Przybeck T, Spitznagel E, Cloninger C. Personality and depressive symptoms: a multi-dimensional analysis. J Affect Disord 2003;74:123-130.

  124. Strakowski S, Dunayevich E, Keck P, McElroy S. Affective state dependence of the Tridimensional Personality Questionnaire. Psychiatry Res 1995;57:209-214.

  125. Hansenne M, Pitchot W, Moreno A, Reggers J, Machurot P et al. Harm avoidance dimension of the Tridimensional Personality Questionnaire and serotonin-1A activity in depressed patients. Biol Psychiatry 1997;42:959-961.

  126. Mulder R, Joyce P, Cloninger C. Temperament and early environment influence comorbidity and personality disorders in major depression. Compr Psychiatry 1994;35:225-233.

  127. Tanaka E, Kijima N, Kitamura T. Correlations between the Temperament and Character Inventory and the Self-rating Depression Scale among Japanese Students. Psychol Rep 1997;80:251-254.

  128. Naito M, Kijima N, Kitamura T. Temperament and Character Inventory (TCI) as predictors of depression among Japanese college students. J Clin Psychol 2000;56:1579-1585.

  129. Enns M, Cox B. Personality dimensions and depression: review and commentary. Can J Psychiatry 1997;42:274-284.




2020     |     www.medigraphic.com