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Extreme Temperament and Diagnosis: A Study in a Psychiatric Sample of Consecutive Children

Extreme Temperament and Diagnosis: A Study in a Psychiatric Sample of Consecutive Children Abstract • We report on an epidemiological-clinical study of the New York (NY) Longitudinal Study temperament model in a consecutive sample of children (N = 814) referred to a child psychiatric center. Temperament comparisons in this clinical population were made by using temperament normative values obtained in previous random samples of the general population in the greater Quebec City (Canada) area. Different clinical diagnostic groups (externalized disorders, developmental delays, and mixed disorders) were derived from a review of the entire hospital charts in which the interrater reliability was tested and performed "blind" to temperament scores. The diagnostic groups were confirmed through discriminant function analyses. The results (1) replicated, in this child psychiatric population, two factors of temperament similar to those previously found in random samples of our general population; (2) showed, in the psychiatric population of children, an overproportion of difficult temperaments on both factors; (3) confirmed conversely that a large proportion of children referred for a disorder did not present with an extreme temperament, and, therefore, an extreme temperament and a clinical disorder were not equivalent; and (4) suggested a specificity in the relationship between particular temperament factors and the type of clinical problem. Temperament factor 1 (withdrawal from new stimuli, low adaptability, high intensity, and negative mood) was found to be more associated with externalized disorders (opposition, conduct, or attentiondeficit disorders), whereas temperament factor 2 (low persistence, high sensory threshold, and high mobility) was found to be more associated with specific developmental delays. The findings provided leads for future clinical research on temperament, family functioning, and child psychiatric diagnoses. References 1. Maziade M, Capéraá P, Laplante B, Boudreault M, Thivierge J, Côté R, Boutin P. Value of difficult temperament among 7-year-olds in the general population for predicting psychiatric diagnosis at age 12 . Am J Psychiatry . 1985;142:943-946. 2. Maziade M, Côté R, Thivierge J, Boutin P, Bernier H. Significance of extreme temperament in infancy for clinical status in preschool years, I: value of extreme temperament at 4-8 months for predicting diagnosis at 4.7 years . Br J Psychiatry . 1989;154:535-543.Crossref 3. Earls F, Jung KG. Temperament and home environment characteristics as causal factors in the early development of childhood psychopathology . J Am Acad Child Adolesc Psychiatry . 1987;26:491-498.Crossref 4. Thomas A, Chess S. Temperament and Development . New York, NY: Brunner/Mazel Inc; 1977. 5. Graham P, Rutter M, George S. Temperamental characteristics as predictors of behavior disorders in children . Am J Orthopsychiatry . 1973;43:328-339.Crossref 6. Graham P, Stevenson J. Temperament and psychiatric disorders: the genetic contribution to behaviour in childhood . Aust N Z J Psychiatry . 1987;21:267-274. 7. Ferguson HD, Rapoport JL. Nosological issues and biological validation . In: Rutter M, ed. Developmental Neuropsychiatry . New York, NY: Guilford Press; 1983:369-384. 8. Pfeffer J, Martin RP. Comparison of mothers' and fathers' temperament ratings of referred and nonreferred preschool children . J Clin Psychol . 1983;39:1013-1020.Crossref 9. Lambert NM. Temperament profiles of hyperactive children . Am J Orthopsychiatry . 1982;52:458-467.Crossref 10. Klein PS, Tzuriel D. Preschoolers' type of temperament as predictor of potential difficulties in cognitive functioning . Isr J Psychiatry Relat Sci . 1986;23:49-61. 11. Keogh BK. Individual differences in temperament: a contribution to the personal, social, and educational competence of learning disabled children . In: McKinney JD, Feagans L, eds. Current Topics in Learning Disabilities . Norwood, NJ: Ablex Publishing Corp; 1983:33-55. 12. Gunn P, Berry P, Andrews RJ. The temperament of Down's syndrome infants: a research note . J Child Psychol Psychiatry . 1981;22:189-194.Crossref 13. Gunn P, Berry P. Down's syndrome temperament and maternal response to descriptions of child behavior . Dev Psychol . 1985;21:842-847.Crossref 14. Bender WN. Differences between learning disabled and non-learning disabled children in temperament and behavior . Learning Disability Q . 1985;8:11-18.Crossref 15. Kolvin I, Nicol AR, Garside RF, Day KA, Tweddle EG. Temperamental patterns in aggressive boys . Ciba Found Symp . 1982;89:252-268. 16. Goldsmith HH, Buss AH, Plomin R, Rothbart MK, Thomas A, Chess S, Hinde RA, McCall RB. Roundtable: what is temperament? four approaches . Child Dev . 1987;58:505-529.Crossref 17. Maziade M, Boudreault M, Thivierge J, Capéraá P, Côté R. Infant temperament: SES and gender differences and reliability of measurement in a large Quebec sample . Merrill-Palmer Q . 1984;30:213-216. 18. Maziade M, Côté R, Boudreault M, Thivierge J, Capéraá P. The New York longitudinal studies model of temperament: gender differences and demographic correlates in a French-speaking population . J Am Acad Child Adolesc Psychiatry . 1984;23:582-587.Crossref 19. Matheny AP, Wilson RS, Nuss SM. Toddler temperament: stability across settings and over ages . Child Dev . 1984;55:1200-1211.Crossref 20. Matheny AP, Wilson RW, Thoben AS. Home and mother: relations with infant temperament . Dev Psychol . 1987;23:323-331.Crossref 21. Goodyer IM, Kolvin I, Gatzani S. The impact of recent undesirable life events on psychiatric disorders in childhood and adolescence . Br J Psychiatry . 1987;151:179-184.Crossref 22. Hollingshead AB. Two-Factor Index of Social Position . New Haven, Conn: Yale University Press; 1957. 23. Hegvik RL, McDevitt SC, Carey WB. The Middle Childhood Temperament Questionnaire . Dev Behav Pediatrics . 1982;3:197-200.Crossref 24. Maziade M, Boutin P, Côté R, Thivierge J. Empirical characteristics of NYLS temperament in middle childhood: congruities and incongruities with other studies . Child Psychiatry Hum Dev . 1986;17:38-52.Crossref 25. Rutter M. Epidemiology of psychiatric disorders . In: Rutter M, ed. Education, Health and Behavior . London, England: Longman Group Ltd; 1970:178-201. 26. Rutter M, Gould M. Classification . In: Rutter M, Hersov L, eds. Child and Adolescent Psychiatry: Modern Approaches . Boston, Mass: Blackwell Scientific Publications Inc; 1985:304-321. 27. Guy W, ed. ECDEU Assessment Manual for Psychopharmacology . Revised. Rockville, Md: National Institute of Mental Health; 1976. US Dept of Health, Education, and Welfare publication (ADM) 76-338. 28. Thomas A, Chess S, eds. Measurement and Rating of Temperament . New York, NY: Brunner/Mazel Inc; 1977:118-131. 29. McDevitt SC, Carey WB. The measurement of temperament in 3-7 year old children . J Child Psychol Psychiatry . 1978;19:245-253.Crossref 30. Maziade M, Côté R, Boudreault M, Thivierge J, Boutin P. Family correlates of temperament continuity and change across middle childhood . Am J Orthopsychiatry . 1986;56:195-203.Crossref 31. Maziade M, Côté R, Thivierge J, Boutin P, Bernier H. Significance of extreme temperament in infancy for clinical status in preschool years, II: patterns of temperament change and implications for the appearance of disorders . Br J Psychiatry . 1989;154:544-551.Crossref 32. Maziade M. Should adverse temperament matter to the clinician? an empirically based answer . In: Kohnstamm GA, Bates JE, Rothbart MK, eds. Temperament in Childhood . New York, NY: John Wiley & Sons Inc. In press. 33. Kagan J, Reznick JS. Task involvement and cardiac response in young children . Aust J Psychol . 1984;36:135-147.Crossref 34. Reznick JS, Kagan J, Snidman N, Gersten M, Baak K, Rosenberg A. Inhibited and uninhibited children: a follow-up study . Child Dev . 1986;57:660-680.Crossref 35. Suomi SJ. Social development in rhesus monkeys: consideration of individual differences . In: Oliverio A, ed. The Behavior of Human Infants . New York, NY: Plenum Press; 1983:71-92. 36. Suomi SJ. Anxiety-like disorders in young nonhuman primates . In: Gittelman R, ed. Anxiety Disorders of Childhood . New York, NY: Guilford Press; 1986:1-23. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Extreme Temperament and Diagnosis: A Study in a Psychiatric Sample of Consecutive Children

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References (41)

Publisher
American Medical Association
Copyright
Copyright © 1990 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1990.01810170077011
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Abstract

Abstract • We report on an epidemiological-clinical study of the New York (NY) Longitudinal Study temperament model in a consecutive sample of children (N = 814) referred to a child psychiatric center. Temperament comparisons in this clinical population were made by using temperament normative values obtained in previous random samples of the general population in the greater Quebec City (Canada) area. Different clinical diagnostic groups (externalized disorders, developmental delays, and mixed disorders) were derived from a review of the entire hospital charts in which the interrater reliability was tested and performed "blind" to temperament scores. The diagnostic groups were confirmed through discriminant function analyses. The results (1) replicated, in this child psychiatric population, two factors of temperament similar to those previously found in random samples of our general population; (2) showed, in the psychiatric population of children, an overproportion of difficult temperaments on both factors; (3) confirmed conversely that a large proportion of children referred for a disorder did not present with an extreme temperament, and, therefore, an extreme temperament and a clinical disorder were not equivalent; and (4) suggested a specificity in the relationship between particular temperament factors and the type of clinical problem. Temperament factor 1 (withdrawal from new stimuli, low adaptability, high intensity, and negative mood) was found to be more associated with externalized disorders (opposition, conduct, or attentiondeficit disorders), whereas temperament factor 2 (low persistence, high sensory threshold, and high mobility) was found to be more associated with specific developmental delays. The findings provided leads for future clinical research on temperament, family functioning, and child psychiatric diagnoses. References 1. Maziade M, Capéraá P, Laplante B, Boudreault M, Thivierge J, Côté R, Boutin P. Value of difficult temperament among 7-year-olds in the general population for predicting psychiatric diagnosis at age 12 . Am J Psychiatry . 1985;142:943-946. 2. Maziade M, Côté R, Thivierge J, Boutin P, Bernier H. Significance of extreme temperament in infancy for clinical status in preschool years, I: value of extreme temperament at 4-8 months for predicting diagnosis at 4.7 years . Br J Psychiatry . 1989;154:535-543.Crossref 3. Earls F, Jung KG. Temperament and home environment characteristics as causal factors in the early development of childhood psychopathology . J Am Acad Child Adolesc Psychiatry . 1987;26:491-498.Crossref 4. Thomas A, Chess S. Temperament and Development . New York, NY: Brunner/Mazel Inc; 1977. 5. Graham P, Rutter M, George S. Temperamental characteristics as predictors of behavior disorders in children . Am J Orthopsychiatry . 1973;43:328-339.Crossref 6. Graham P, Stevenson J. Temperament and psychiatric disorders: the genetic contribution to behaviour in childhood . Aust N Z J Psychiatry . 1987;21:267-274. 7. Ferguson HD, Rapoport JL. Nosological issues and biological validation . In: Rutter M, ed. Developmental Neuropsychiatry . New York, NY: Guilford Press; 1983:369-384. 8. Pfeffer J, Martin RP. Comparison of mothers' and fathers' temperament ratings of referred and nonreferred preschool children . J Clin Psychol . 1983;39:1013-1020.Crossref 9. Lambert NM. Temperament profiles of hyperactive children . Am J Orthopsychiatry . 1982;52:458-467.Crossref 10. Klein PS, Tzuriel D. Preschoolers' type of temperament as predictor of potential difficulties in cognitive functioning . Isr J Psychiatry Relat Sci . 1986;23:49-61. 11. Keogh BK. Individual differences in temperament: a contribution to the personal, social, and educational competence of learning disabled children . In: McKinney JD, Feagans L, eds. Current Topics in Learning Disabilities . Norwood, NJ: Ablex Publishing Corp; 1983:33-55. 12. Gunn P, Berry P, Andrews RJ. The temperament of Down's syndrome infants: a research note . J Child Psychol Psychiatry . 1981;22:189-194.Crossref 13. Gunn P, Berry P. Down's syndrome temperament and maternal response to descriptions of child behavior . Dev Psychol . 1985;21:842-847.Crossref 14. Bender WN. Differences between learning disabled and non-learning disabled children in temperament and behavior . Learning Disability Q . 1985;8:11-18.Crossref 15. Kolvin I, Nicol AR, Garside RF, Day KA, Tweddle EG. Temperamental patterns in aggressive boys . Ciba Found Symp . 1982;89:252-268. 16. Goldsmith HH, Buss AH, Plomin R, Rothbart MK, Thomas A, Chess S, Hinde RA, McCall RB. Roundtable: what is temperament? four approaches . Child Dev . 1987;58:505-529.Crossref 17. Maziade M, Boudreault M, Thivierge J, Capéraá P, Côté R. Infant temperament: SES and gender differences and reliability of measurement in a large Quebec sample . Merrill-Palmer Q . 1984;30:213-216. 18. Maziade M, Côté R, Boudreault M, Thivierge J, Capéraá P. The New York longitudinal studies model of temperament: gender differences and demographic correlates in a French-speaking population . J Am Acad Child Adolesc Psychiatry . 1984;23:582-587.Crossref 19. Matheny AP, Wilson RS, Nuss SM. Toddler temperament: stability across settings and over ages . Child Dev . 1984;55:1200-1211.Crossref 20. Matheny AP, Wilson RW, Thoben AS. Home and mother: relations with infant temperament . Dev Psychol . 1987;23:323-331.Crossref 21. Goodyer IM, Kolvin I, Gatzani S. The impact of recent undesirable life events on psychiatric disorders in childhood and adolescence . Br J Psychiatry . 1987;151:179-184.Crossref 22. Hollingshead AB. Two-Factor Index of Social Position . New Haven, Conn: Yale University Press; 1957. 23. Hegvik RL, McDevitt SC, Carey WB. The Middle Childhood Temperament Questionnaire . Dev Behav Pediatrics . 1982;3:197-200.Crossref 24. Maziade M, Boutin P, Côté R, Thivierge J. Empirical characteristics of NYLS temperament in middle childhood: congruities and incongruities with other studies . Child Psychiatry Hum Dev . 1986;17:38-52.Crossref 25. Rutter M. Epidemiology of psychiatric disorders . In: Rutter M, ed. Education, Health and Behavior . London, England: Longman Group Ltd; 1970:178-201. 26. Rutter M, Gould M. Classification . In: Rutter M, Hersov L, eds. Child and Adolescent Psychiatry: Modern Approaches . Boston, Mass: Blackwell Scientific Publications Inc; 1985:304-321. 27. Guy W, ed. ECDEU Assessment Manual for Psychopharmacology . Revised. Rockville, Md: National Institute of Mental Health; 1976. US Dept of Health, Education, and Welfare publication (ADM) 76-338. 28. Thomas A, Chess S, eds. Measurement and Rating of Temperament . New York, NY: Brunner/Mazel Inc; 1977:118-131. 29. McDevitt SC, Carey WB. The measurement of temperament in 3-7 year old children . J Child Psychol Psychiatry . 1978;19:245-253.Crossref 30. Maziade M, Côté R, Boudreault M, Thivierge J, Boutin P. Family correlates of temperament continuity and change across middle childhood . Am J Orthopsychiatry . 1986;56:195-203.Crossref 31. Maziade M, Côté R, Thivierge J, Boutin P, Bernier H. Significance of extreme temperament in infancy for clinical status in preschool years, II: patterns of temperament change and implications for the appearance of disorders . Br J Psychiatry . 1989;154:544-551.Crossref 32. Maziade M. Should adverse temperament matter to the clinician? an empirically based answer . In: Kohnstamm GA, Bates JE, Rothbart MK, eds. Temperament in Childhood . New York, NY: John Wiley & Sons Inc. In press. 33. Kagan J, Reznick JS. Task involvement and cardiac response in young children . Aust J Psychol . 1984;36:135-147.Crossref 34. Reznick JS, Kagan J, Snidman N, Gersten M, Baak K, Rosenberg A. Inhibited and uninhibited children: a follow-up study . Child Dev . 1986;57:660-680.Crossref 35. Suomi SJ. Social development in rhesus monkeys: consideration of individual differences . In: Oliverio A, ed. The Behavior of Human Infants . New York, NY: Plenum Press; 1983:71-92. 36. Suomi SJ. Anxiety-like disorders in young nonhuman primates . In: Gittelman R, ed. Anxiety Disorders of Childhood . New York, NY: Guilford Press; 1986:1-23.

Journal

Archives of General Psychiatry – American Medical Association

Published: May 1, 1990

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