Merikangas K R, Swendsen J D, Preisig M A, Chazan R Z
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT, USA.
J Affect Disord. 1998 Oct;51(1):63-74. doi: 10.1016/s0165-0327(98)00157-8.
Although research on the association between temperament and psychopathology has received renewed interest, few investigations have addressed the issues of psychiatric comorbidity or the role of temperament across the life span. The present investigation employed a family study/high-risk design to examine the specificity of associations between temperamental traits and psychiatric disorders in both children and adults.
The sample was composed of 244 probands and 82 children (ages 7-17) from the Yale Family Study of Comorbidity of Substance Abuse and Anxiety. Psychiatric disorders were assessed using structured diagnostic interviews administered by clinicians, and temperament was measured using the Dimensions of Temperament Survey.
In both adults and children, anxiety and depression were generally associated with low scores on adaptability and approach/withdrawal, while externalizing or substance use disorders were associated with low attention scores and higher activity. However, psychiatric comorbidity was associated with the manifestation of both clusters of temperamental traits and far greater impairment and clinical severity. Some temperamental characteristics in children also demonstrated specificity of association with parental psychiatric disorder.
This investigation was limited to the analysis of cross-sectional data and was unable to separate genetic from other familial risk factors.
The results suggest that temperament remains associated with psychopathology across the life span and may reflect diverse familial influences. Clinical intervention and prevention efforts may benefit from focusing on individuals at higher risk for psychiatric disorder through parental psychopathology or the expression of temperament problems in childhood.
尽管关于气质与精神病理学之间关联的研究重新引起了人们的兴趣，但很少有研究探讨精神疾病共病问题或气质在整个生命周期中的作用。本研究采用家族研究/高危设计，以检验气质特征与儿童和成人精神疾病之间关联的特异性。
样本由来自耶鲁物质滥用与焦虑共病家族研究的244名先证者和82名儿童（7至17岁）组成。使用临床医生进行的结构化诊断访谈评估精神疾病，使用气质调查问卷维度测量气质。
在成人和儿童中，焦虑和抑郁通常与适应性和趋近/回避得分低相关，而外化或物质使用障碍与注意力得分低和活动水平高相关。然而，精神疾病共病与气质特征集群的表现以及更大程度的损害和临床严重程度相关。儿童的一些气质特征也显示出与父母精神疾病关联的特异性。
本研究仅限于横断面数据分析，无法区分遗传因素与其他家族风险因素。
结果表明，气质在整个生命周期中仍与精神病理学相关，可能反映了多种家族影响。临床干预和预防措施可能会受益于通过父母精神病理学或儿童期气质问题的表现，关注精神疾病高危个体。
