Thesis (M.A.)--The University of North Carolina at Greensboro, 2008. / Directed by Rosemery Nelson-Gray; submitted to the Dept. of Psychology. Title from PDF t.p. (viewed Apr. 13, 2010). Includes bibliographical references (p. 32-42).

Thesis (M.A.)--The University of North Carolina at Greensboro, 2008. / Directed by Susan P. Keane; submitted to Dept. of Psychology. Title from PDF t.p. (viewed Apr. 13, 2010). Includes bibliographical references (p. 24-30).

Thesis (doctoral)--Rijksuniversiteit te Leiden, 1997. / Primarily in English; some parts in Dutch. Summaries in Dutch and English. Includes bibliographical references (p. 281-297).

Thesis (Ph. D.)--University of Oregon, 2005. / Typescript. Includes vita and abstract. Includes bibliographical references (leaves 109-115). Also available for download via the World Wide Web; free to University of Oregon users.

Thesis (Ph. D.)--Ohio State University, 2005. / Title from first page of PDF file. Document formatted into pages; contains xi, 82 p.; also includes graphics (some col.). Includes bibliographical references (p. 54-62). Available online via OhioLINK's ETD Center

Diversos estudos têm demonstrado associação entre o temperamento e os níveis de ansiedade pré-operatória em crianças. Entretanto, a natureza desta associação não é consenso. Como a maioria desses estudos utilizou o questionário EASI (emocionalidade, atividade, sociabilidade e impulsividade) como instrumento para mensurar o temperamento, o presente estudo examina em profundidade as propriedades psicométricas do mesmo utilizando a análise de Rasch, para determinar se o instrumento mede de forma adequada o temperamento de crianças. Além disso, outras análises são aplicadas para explorar novas estruturas fatoriais do instrumento original. A habilidade da nova versão do EASI para discriminar diferentes níveis de ansiedade no período préoperatório imediato em crianças também foi investigada. Trata-se de um estudo transversal, com amostra de conveniência, onde foram incluídas crianças entre dois e seis anos agendadas para procedimentos cirúrgicos eletivos ambulatoriais. Os cuidadores das crianças completaram um formulário sócio-demográfico, o questionário EASI e uma Escala Análogo-Visual (EAV) de 100mm. Também, a Escala de Ansiedade Pré-Operatória de Yale (mYPAS) foi aplicada imediatamente antes da administração da medicação préanestésica, pelo anestesista pediátrico. Uma vez que o escore médio de compreensão das questões, medido pela EAV, foi superior a 80mm, considerou-se que o nível de compreensão da versão traduzida do EASI foi adequado. O questionário foi respondido por 110 cuidadores. Os resultados da análise de Rasch evidenciaram que as quatro subescalas da estrutura original apresentam desempenho inadequado (especialmente baixo índice de classificação correta dos aspectos do temperamento). A análise de componentes principais gerou uma solução com dois fatores. O Fator 1 é composto de itens de atividade e impulsividade, e o Fator 2 é predominantemente composto por itens das sub-escalas de sociabilidade e atividade. As sub-escalas originais do EASI não se correlacionaram com os escores da mYPAS, à exceção da sociabilidade (r=-0,449; P <0,001). O Fator 1 apresentou correlação positiva (r=0,239; P =0,0034) com a mYPAS, enquanto o Fator 2 apresentou correlação negativa (r=-0,404, P <0,0001). A análise de Rasch indicou que o instrumento original teve poder de discriminação insuficiente. Dentre os dois fatores propostos, os doze itens que compõem o Fator 1 apresentam perfil estatístico adequado, com alto poder de discriminação e relevância clínica. O Fator 2 não tem poder de discriminação adequado no seu formato atual, e ainda necessita de ajustes. / Some studies have shown correlation between temperament and preoperative anxiety levels in children. However, the nature of the association is not consensual. As most of these studies have used the EASI (emotionality, activity, sociability and impulsivity) questionnaire as an instrument to assess temperament, the present study examines the psychometric properties of this questionnaire in depth using the Rasch analysis to determine whether it is suitable for measuring children’s temperament. In addition, further analyses are carried out to explore potentially new factorial structures of the original instrument. The ability to discriminate between different levels of a child’s anxiety in the immediate preoperative period was also examined. It is a cross-sectional study, with a convenience sample of children aged between 2 and 6 years, to be submitted to outpatient elective surgeries. Children’s caregivers completed a socio-demographic form, the EASI questionnaire and a 0-100mm Analogue-Visual Scale (VAS). In addition, the Yale Preoperative Anxiety Scale (mYPAS) was performed immediately prior to the administration of pre-anesthetic medication by the pediatric anesthetist. As the mean comprehension level of the EASI-questions on VAS score was above 80mm, the translation of EASI was considered adequate. The questionnaire was answered by 110 caregivers. Results from Rasch analysis showed that the four subscales have inadequate perfomance (especially low person separation indices). Principal component analysis yielded a two-factor solution. Factor 1 is composed of activity and impulsivity items, and factor 2 is predominantly composed of items from the sociability and activity subscales. The original EASI subscales did not correlate with m-YPAS scores, with exception of sociability (r=-0.449; P <0.001). Factor 1 had a positive correlation (r=0.239; P=0.0034) with m-YPAS, while factor 2 showed a negative correlation (r=-0.404, P <0.0001). Rasch analysis indicated that the original EASI instrument has insufficient separation power. The twelve items that compose Factor 1 show adequate fit statistics, high separation power, and clinical meaning. Factor 2 is not sufficiently powerful in its current state, and still requires refinements.

Made available in DSpace on 2015-07-22T20:50:52Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-09-29 / Objetivo: Realização de dois estudos com crianças e adolescentes, visando identificar transtornos psiquiátricos em filhos de pais com transtorno bipolar tipo I, e avaliar traços de temperamento e caráter em pacientes com transtorno depressivo maior. Métodos: Estudo 1: O estudo envolveu uma série de casos composta por 35 crianças e adolescentes (20 meninos/15 meninas) de seis a 17 anos (média de idade: 12,5±2,9 anos). Todos os participantes foram avaliados através da entrevista diagnóstica The Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime Version (K-SADS-PL). A história psiquiátrica familiar e os dados sociodemográficos também foram investigados. Estudo 2: Estudo caso-controle envolvendo 41 crianças e adolescentes (8–17 anos) com depressão maior pareadas por idade e sexo com 40 controles saudáveis. Todos os participantes foram avaliados pela entrevista diagnóstica K-SADS-PL. Os traços de temperamento e caráter foram avaliados através das versões para pais e para crianças do instrumento The Junior Temperament and Character Inventory (JTCI), e a gravidade da depressão através da escala Children’s Depression Rating Scale (CDRS). Resultados: Estudo 1: Pelo menos um diagnóstico psiquiátrico foi identificado em 71,4% da amostra. Altas taxas de transtornos específicos foram observadas: transtornos de humor (28,6%), transtornos disruptivos (incluindo transtorno de déficit de atenção e hiperatividade/TDAH) (40,0%) e transtornos de ansiedade (20,0%). A taxa de transtornos de humor comórbidos com TDAH (17,2%) foi maior do que a presença transtornos de humor isolados (11,4%). Psicopatologia foi frequentemente encontrada em parentes de segundo grau dos participantes (71,4%). Estudo 2: Os pacientes com depressão maior tiveram escores significativamente mais altos nas dimensões esquiva ao dano e busca por novidades, e escores mais baixos em dependência de gratificação, persistência, auto-direcionamento e cooperatividade em comparação aos controles saudáveis. A comorbidade com transtornos disruptivos influenciou praticamente todas as dimensões de temperamento e caráter, em geral aumentando as diferenças entre as médias de escores de casos e controles. Além disso, estar deprimido no momento da avaliação não influenciou os resultados, com exceção da dimensão dependência de gratificação de acordo com as informações fornecidas pelos pais. Conclusões: Filhos de bipolares constituem grupo de risco para desenvolver transtornos psiquiátricos, especialmente transtornos de humor e disruptivos. Crianças e adolescentes com transtorno depressivo maior têm um perfil de temperamento e caráter que difere de controles saudáveis, apontando para características estadoindependentes das dimensões esquiva ao dano e auto-direcionamento. / Purpose: To conduct two studies with children and adolescents, aiming to identify psychiatric disorders in the offspring of bipolar parents type I, and to evaluate temperament and character traits in patients with major depressive disorder (MDD). Methods: Study 1: The study involved a case series comprising 35 children and adolescents (20 males/15 females) aged 6 to 17 years (mean age: 12.5±2.9 years). All participants were assessed using the diagnostic interview The Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime Version (K-SADS- PL). Psychiatric family history and demographics were also evaluated. Study 2: A case-control study comprising 41 MDD children and adolescents (8-17 years) matched by gender and age to 40 healthy controls (HC). All participants were diagnostically assessed with the K-SADS-PL. Temperament and character traits were measured by the parent and child versions of The Junior Temperament and Character Inventory (JTCI), and depression severity by The Children’s Depression Rating Scale - Revised (CDRS-R). Results: Study 1: At least one psychiatric disorder was identified in 71.4% of the sample. High rates of specific disorders were noted: mood disorders (28.6%), disruptive behaviour disorders (including attention deficit hyperactivity disorder/ADHD) (40.0%) and anxiety disorders (20.0%). The rate of mood disorders comorbid with disruptive behaviour disorders (17.2%) was higher than the rate of pure mood disorders (11.4%). Presence of psychopathology was commonly reported in second-degree relatives of the offspring (71.4%). Study 2: MDD subjects had significantly higher scores on harm avoidance and novelty seeking dimensions, and lower scores on reward dependence, persistence, self-directedness and cooperativeness compared with HC. Comorbidity with disruptive behaviour disorders exerted influence on almost all dimensions of temperament and character, in general increasing the mean score differences between MDD and HC subjects. Moreover, being currently depressed did not influence the results, except for reward dependence according to parent data. Conclusions: Bipolar offspring are at high risk for developing psychiatric disorders, especially mood and disruptive behaviour disorders. MDD children and adolescents have a different temperament and character profile compared to HC subjects, pointing towards trait-like characteristics of the dimensions harm avoidance and self-directedness. / TEDE / BV UNIFESP: Teses e dissertações

With the growing number of children who receive a diagnosis of Autism Spectrum Disorder (ASD), there is an increasing need to identify risk markers that will allow for earlier diagnosis of this disorder. Since no single atypical behavior has been found that is shared by all 12-month-old infants who are later diagnosed with ASD, it is likely that a constellation of markers combine in a way that is more predictive of outcome at this age. Establishing a Cumulative Risk Index (CRI) is one way to investigate which combination of early risk markers is most predictive of later ASD diagnostic outcome. Temperament is one construct of behavior that could act as an early risk marker for ASD and therefore, could add predictive power to a CRI for this disorder. Temperament is defined as a "behavioral style" that includes individual differences in reactivity and self-regulation and emphasizes emotional, attentional and activity related characteristics. Another important aspect of temperament is that it exerts bidirectional influences upon the social environment. Therefore, the study of temperament could provide a method for understanding how children with ASD influence and are influenced by the environment of a testing session. Though important information has been collected about early temperament in children with ASD, much of the data is limited due to its dependence on retrospective and parent-report measures. One measure that allows for direct assessment of temperament during a controlled testing session is the Infant Behavior Record (IBR). The purpose of this study is to investigate early temperament in ASD by using the IBR as an assessment of temperament behaviors in high-risk 12-month old infants. Through this, we hope to reveal group differences in IBR scores, establish a relationship between temperament scores and cognitive test performance, and increase predictive value of the CRI when IBR scores are included. For this study, a revised version of the IBR was filled out while watching video record of the administration of the Mullen Scales of Early Learning (MSEL) at an infant's 12-month lab visit. Scores for the IBR reflected the examiner's impressions of the infant's orientation to objects and people and emotional state. Through using the IBR to study task orientation (TO), affect/extraversion (AE) and activity level (AL) in high-risk infants, this study found that only decreased AE behaviors distinguished high-risk infants who went on to develop ASD (HRA+ASD) from high-risk infants who did not receive an ASD diagnosis (HRA-ASD) (p=.08). To determine the relationship of temperament and cognitive assessment performance, IBR scores were compared to MSEL scores. This study found that across all participants, TO and AE behaviors were positively correlated with MSEL scores (AE rs=.27, p<.001; TO rs=.37, p<.001). This relationship remained true for both the high-risk (AE rs=.20, p<.001; TO rs=.23, p<.001) and the low risk groups (AE rs=.32, p<.001; TO rs=.54, p<.001), as well as for the HRA-ASD infants (AE, trend, p=.057; rs=.24, p<.001; TO rs=.459, p<.001), and the low-risk infants who did not go on to receive a diagnosis of ASD (AE rs=.35, p<.001; TO rs=.47, p<.001). The only group in this study that was found to have no correlations between temperament scores and MSEL scores was HRA+ASD. Since only AE behaviors distinguished HRA+ASD infants, this was the only IBR factor added to a pilot model of the CRI. This study found that the inclusion of AE to a pilot model of the CRI did not add significant predictive value to the model (p=.15). Through using the IBR to investigate temperament in HRA infants, the findings of this study suggest that there are some important differences in temperament behaviors for HRA+ASD infants. Specifically, reduced AE behaviors seem to distinguish the HRA+ASD infants from the other outcome groups. Also, this study found that increased TO and AE behaviors were associated with better performance on a cognitive assessment for all groups except HRA+ASD. These two findings are important, as they differentiate this outcome group from all others, suggesting that there may be a different set of mechanisms employed during a testing session for HRA+ASD infants. This study also found that AE risk did not contribute predictive value to a CRI for this disorder. Taken together these findings suggest that though temperament profiles appear to differ in HRA+ASD infants during the first year of life, this construct of behavior is not a valuable early behavioral risk marker for identifying ASD.

Introdução: O estudo da personalidade apresenta uma influência crescente no entendimento da heterogeneidade de transtornos psiquiátricos. O temperamento em particular parece contribuir para a grande variabilidade do TDAH. Tal associação é examinada neste estudo, fazendo parte de um projeto mais amplo que envolve desde as bases genéticas até a comorbidade e resposta a tratamento do TDAH. Artigo: Este estudo examina escores nas dimensões de temperamento do TCI em subtipos de TDAH em adultos. Cento e quarenta e seis pacientes (66 mulheres e 80 homens) foram recrutados através de informação na imprensa acerca de manifestações do TDAH para um programa de pesquisa. Os diagnósticos de TDAH foram realizados pelo DSM-IV e a avaliação do temperamento teve por base o TCI. Os pacientes foram divididos em dois subtipos de TDAH: desatento (N=52) e hiperativo/combinado (N=92). Os escores de temperamento foram então avaliados em análises de variância de dois fatores (sexo e subtipo), com correção para a idade. Os pacientes do subtipo hiperativo/combinado apresentaram escores mais altos em procura de novidades (P=0,033), enquanto os desatentos, uma tendência não significativa para escores maiores em dependência de premiação (P=0,064). Nas comparações entre os sexos, as mulheres apresentaram escores maiores em esquiva ao dano (P=0,029) e dependência de premiação (P=0,010). Foi observada uma interação significativa entre o sexo e o subtipo sobre os escores de persistência. Enquanto entre os homens o subtipo hiperativo/combinado mostrou-se associado a escores mais altos em persistência, o inverso foi observado no sexo feminino. Este estudo sugere que a avaliação do temperamento pode contribuir na compreensão da heterogeneidade clínica do TDAH. Discussão e conclusões: Os achados deste estudo são coerentes com a literatura examinada, apontando para o papel de variações do temperamento na heterogeneidade do TDAH. / Introduction: Current research on personality assessment presents a growing influence on the understanding of the clinical heterogeneity of psychiatric disorders. Specifically, temperament seems to contribute to the large ADHD variability. Such association is analyzed here as part of a larger project encompassing from genetics to comorbidity and response to treatment in ADHD. Article: This study aims to evaluate temperament dimension scores of TCI in ADHD subtypes in adult subjects. One hundred forty six patients (66 females and 80 males) were self referred by press information on ADHD symptoms. The diagnosis of ADHD was confirmed using DSM-IV criteria and temperament was assessed with the TCI. Patients were separated in two ADHD subtype groups: inattentive (N=52) and hyperactive/combined ones (N=92). Temperament scores were measured by two factors ANOVA analysis (gender and subtype), with age correction. Hyperactive/combined patients scored higher in novelty seeking (P=0.033) while inattentive presented a nonsignificant trend towards higher scores in reward dependence (P=0.064). Comparing genders, females showed higher scores in harm avoidance (P=0.029) and reward dependence (P=0.010). A significant interaction between gender and subtypes was observed in persistence scores. While combined/hyperactive males presented higher persistence scores, the opposite was observed among females. This study suggests that temperament assessment can contribute to the understanding of the clinical heterogeneity in ADHD. Discussion and conclusions: The results of this investigation are coherent with the current literature, pointing towards the role of temperament variability on the heterogeneity of ADHD.

The problem of this study was to determine if differences in attitudes and temperament traits would create a separation between a group of mothers of children who have learning disabilities and a group of mothers of children who do not have learning disabilities. The purpose of the investigation was to determine if differences between the two groups would warrant programmatic changes in parent education and development of new counseling approaches for mothers of children with learning disabilities within the schools. Findings indicated that neither the analysis of maternal attitudes nor the analysis of temperament traits contributed to a distinct separation of the two groups. The scores for all participants were within normal limits, with the mean scores of mothers of children with learning disabilities being slightly higher on all scales of both instruments. The two groups were found to separate on variables of age of mother and sex and age of the child. Groups also separated when all variables were viewed simultaneously; three temperament trait variables (Restraint, Objectivity, Emotional Stability) in combination with sex and age of the child created this distinct separation. Due to the procedures utilized in sample selection, significant separations based on demographic data may not present an accurate picture of group differences. Therefore, it was concluded that programmatic changes in parent education and new counseling approaches for mothers of children with learning disabilities was not warranted. On the basis of these findings, school counselors interested in assisting mothers of children with learning disabilities might consider utilizing any of the present parent education programs or counseling approaches now available. Providing opportunities for mothers to become involved within the school setting might help both mother and child in adjusting to the child's learning environment. Further research is recommended to explore how relationships between positive maternal attitudes and temperament traits are related to learning disabilities exhibited by the child.