Abstract
Current psychiatric diagnosis relies on the assumption of discrete mental disorders as discrete categories, artificially separating mood, behavioral, personality, and cognitive disorders, producing extensive comorbidity. As an alternative, we propose an integrated framework based on temperament and applicable to both adaptive and dysfunctional situations. The Affective and Emotional Composite Temperament (AFECT) model adopts both an analytical approach based on emotional traits to represent specific neurobehavioral subsystems (Volition/Energy, Desire, Anger, Fear, Caution, Emotional Sensitivity, Anxiety, Control, Coping, and Stability) and the affective temperaments as synthetic typology of 12 global configurations divided in four groups: internalized (depressive, anxious, apathetic), unstable (cyclothymic, dysphoric, volatile), stable (euthymic, hyperthymic, obsessive), and externalized (euphoric, irritable, and disinhibited). This range of features covers the whole mood spectrum from mania to depression, contemplating mixed features and euthymia. This model is operationalized with the AFECTS, a short self-report scale, which has shown substantial variations associated with being a victim of bullying, cocaine abuse, and circadian preference. Here we show that those with a diagnosis of bipolar disorder or borderline personality disorder have strong cyclothymic traits, high Desire and Anger, and low Control, Caution, and Stability and share with subjects with major depression the traits of low Volition and Coping and high Anxiety and Emotional Sensitivity. These results point towards the need to view the mood spectrum dimensionally, taking into account several traits concomitantly.
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Appendix: AFECTS, Temperament Scale
Appendix: AFECTS, Temperament Scale
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1.
Emotional traits section—Check the option (score from 1 to 7) that most accurately corresponds to the way you are and act in general. Each item has opposite characteristics, in which the score 4 is neutral between these opposites. There are no right or wrong answers. Answer according to what you are and not to what you would like to be. Check only one option per line. See in the example someone who feels quite secure (very secure would be score 7, very insecure would be score 1).
Example Insecure
1 2 3 4 5 6 7
Secure
Pessimistic
1 2 3 4 5 6 7
Optimistic
1
It’s hard for me to feel pleasure
1 2 3 4 5 6 7
It’s easy for me to feel pleasure
2
Sad and downcast
1 2 3 4 5 6 7
Happy and cheerful
3
I have low self-esteem
1 2 3 4 5 6 7
I have high self-esteem
4
I am indifferent to new activities
1 2 3 4 5 6 7
I get excited about new activities
5
Unmotivated and disinterested
1 2 3 4 5 6 7
Motivated and interested
6
I lack goals and will power
1 2 3 4 5 6 7
I have goals and will power
7
Dull and lacking energy
1 2 3 4 5 6 7
Active and energetic
8
Cool and collected
1 2 3 4 5 6 7
Hasty
9
Moderate
1 2 3 4 5 6 7
Intense, all-or-nothing
10
Flexible
1 2 3 4 5 6 7
Stubborn
11
Patient
1 2 3 4 5 6 7
Impatient
12
Calm
1 2 3 4 5 6 7
Irritable
13
Peaceful
1 2 3 4 5 6 7
Aggressive
14
Controlled
1 2 3 4 5 6 7
Explosive
15
Trusting
1 2 3 4 5 6 7
Suspicious
16
Daring
1 2 3 4 5 6 7
Fearful
17
Uninhibited and spontaneous
1 2 3 4 5 6 7
Inhibited
18
Carefree
1 2 3 4 5 6 7
Worrier
19
I react quickly in the face of danger
1 2 3 4 5 6 7
I freeze in the face of danger
20
Reckless
1 2 3 4 5 6 7
Cautious
21
Impulsive, I act before I think
1 2 3 4 5 6 7
I think before I act
22
Careless
1 2 3 4 5 6 7
Careful
23
I enjoy taking risks
1 2 3 4 5 6 7
I avoid taking risks
24
I rarely feel guilty
1 2 3 4 5 6 7
I blame myself easily
25
I deal with rejection well
1 2 3 4 5 6 7
I deal with rejection poorly
26
I deal with criticism well
1 2 3 4 5 6 7
I’m sensitive to criticism
27
I hardly ever get hurt emotionally
1 2 3 4 5 6 7
I easily get hurt emotionally
28
I find it easy to overcome traumas
1 2 3 4 5 6 7
I find it difficult to overcome traumas
29
I deal well with stress
1 2 3 4 5 6 7
I am sensitive to stress
30
I deal with pressure well
1 2 3 4 5 6 7
I perform poorly under pressure
31
I have a high tolerance for frustration
1 2 3 4 5 6 7
I have a low tolerance for frustration
32
I blame others for my mistakes
1 2 3 4 5 6 7
I take responsibility for my mistakes
33
I try to run away from my problems
1 2 3 4 5 6 7
I face my problems
34
I hope my problems solve themselves
1 2 3 4 5 6 7
I try to solve my problems
35
I let my personal problems pile up
1 2 3 4 5 6 7
I handle my personal problems as soon as I can
36
It is difficult for me to handle my conflicts with people
1 2 3 4 5 6 7
I easily handle my conflicts with people
37
I have trouble finding solutions
1 2 3 4 5 6 7
I find solutions easily
38
I tend to repeat my mistakes
1 2 3 4 5 6 7
I learn from my mistakes
39
Suffering has made me more fragile
1 2 3 4 5 6 7
Suffering has made me stronger
40
It is hard for me to pay attention
1 2 3 4 5 6 7
It is easy for me to pay attention
41
Distracted
1 2 3 4 5 6 7
Focused
42
I plan my activities poorly
1 2 3 4 5 6 7
I plan my activities well
43
I fail to finish tasks I have begun
1 2 3 4 5 6 7
I finish tasks, even when they are long and difficult
44
Disorganized
1 2 3 4 5 6 7
Organized
45
Undisciplined
1 2 3 4 5 6 7
Disciplined
46
Irresponsible
1 2 3 4 5 6 7
Responsible
47
Negligent
1 2 3 4 5 6 7
Perfectionist
48
My desires are weak
1 2 3 4 5 6 7
I have strong desires
49
I am tempered in terms of what I like
1 2 3 4 5 6 7
I indulge in what I like
50
I am able to resist temptations
1 2 3 4 5 6 7
I easily give in to temptations
51
I manage to control myself when I really want something
1 2 3 4 5 6 7
I can do “crazy” things when I really want something
52
In peace
1 2 3 4 5 6 7
Anxious
53
Relaxed
1 2 3 4 5 6 7
Tense
54
Serene
1 2 3 4 5 6 7
Apprehensive
55
I rarely feel troubled
1 2 3 4 5 6 7
I often feel troubled
56
Turbulent
1 2 3 4 5 6 7
Balanced
57
Unstable
1 2 3 4 5 6 7
Stable
58
Unpredictable
1 2 3 4 5 6 7
Predictable
59
Oscillating
1 2 3 4 5 6 7
Steady
60
Scoring: Volition (1–8), Anger (9–16), Fear (17–20), Caution (21–24), Emotional Sensitivity (25–32), Coping (33–40), Control (41–48), Desire (49–52), Anxiety (53–56), Stability (57–60)
-
2.
Affective Temperament section—For each description below, please check the alternative that best corresponds to you (check only one alternative).
-
(A)
I have a tendency towards melancholy and sadness; I see little fun and joy in things; I tend to put myself down; I don’t like changes; I prefer to listen than to talk.
Nothing like me
Exactly like me
-
(B)
I am a big worrier and very careful; I often feel insecure and apprehensive; I am afraid that bad things will happen; I try to avoid risky situations; I am always alert and vigilant.
Nothing like me
Exactly like me
-
(C)
I have little initiative; I often drift away from what others are saying or doing; I often fail to finish what I have started; I tend to be passive and a bit slow.
Nothing like me
Exactly like me
-
(D)
My mood is unpredictable and unstable (highs and lows), changes quickly or in a way that is disproportionate to the facts; I have periods of high energy, enthusiasm, and agility that alternate with other phases of sluggishness, loss of interest, and discouragement.
Nothing like me
Exactly like me
-
(E)
I am tense and uneasy, with a strong tendency to feel agitated, anxious, and irritated at the same time.
Nothing like me
Exactly like me
-
(F)
I am restless, disorganized, and easily distracted; sometimes I am hasty or inconvenient and only realize it when it is too late; I quickly lose interest; I often fail to do what I should and finish what I have started.
Nothing like me
Exactly like me
-
(G)
I’m dedicated, demanding, detail oriented, inflexible, and a perfectionist; I need to be in control of things; I don’t deal well with uncertainty and mistakes.
Nothing like me
Exactly like me
-
(H)
My mood is balanced and predictable; I usually have mood changes only when there is a clear reason; I am usually in good spirits; and, in general, I feel good about myself.
Nothing like me
Exactly like me
-
(I)
I am always in good spirits; I am very confident and I have fun easily; I love novelties; I do many things without getting tired; I pursue what I want until I get it; I have a strong tendency to leadership.
Nothing like me
Exactly like me
-
(J)
I’m very frank, direct, and determined, but also angry, explosive, and suspicious.
Nothing like me
Exactly like me
-
(K)
I am restless, active, spontaneous, and distracted; I often rush and act carelessly; it is very common for me to leave things to the last minute; when I get irritated, I get over it quickly.
Nothing like me
Exactly like me
-
(L)
I am expansive, fast, talkative, and intense; I have many ideas and I am easily distracted; I am hasty, explosive, and impatient; I take risks when overconfident or excited; I overindulge in things I enjoy; I do not like routines and rules.
Nothing like me
Exactly like me
-
(A)
-
3.
Choose the description (from A to K) from question 2 above that best describes you (only one alternative). Please read carefully those that describe you best before choosing your answer.
A
B
C
D
E
F
G
H
I
J
K
L
Affective temperament types in order: (A) Depressive; (B) Anxious; (C) Apathetic; (D) Cyclothymic; (E) Dysphoric; (F) Volatile; (G) Obsessive; (H) Euthymic; (I) Hyperthymic; (J) Irritable; (K) Disinhibited; (L) Euphoric
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Lara, D.R., Ottoni, G.L., Bisol, L.W., de Carvalho, H.W. (2015). The Integration of Mood, Behavior, and Temperament in Mood Spectrum Disorders. In: Choi-Kain, L., Gunderson, J. (eds) Borderline Personality and Mood Disorders. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1314-5_8
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