Mood distinction for a non-clinical population addressed at risk for cyclothymic temperament [Elektronische Ressource] / Brian Lee Pheasant

Brian Pheasant

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• Gesundheit

Informations

• Publié par: eberhard_karls_universitat_tubingen
• Publié le: 01 janvier 2004
• Nombre de lectures: 14
• Langue: English

Extrait

Brian Lee Pheasant




Mood distinction for a non-clinical population addressed
at risk for cyclothymic temperament











Dissertation
zur
Erlangung des akademischen Grades
Doktor der Sozialwissenschaften
in der Fakultät
für Sozial- und Verhaltenswissenschaften
der Eberhard-Karls-Universität Tübingen









2004
















Gedruckt mit Genehmigung der
Fakultät für Sozial- und Verhaltenswissenschaften
der Universität Tübingen






Hauptberichterstatter: Prof. Dr. M. Hautzinger

Mitberichterstatter: Dr. P. Pössel

Dekan: Prof. Dr. A. Boeckh

Tag der mündlichen Prüfung: 19. Juli 2004


















Buchbinderei Schulz GmbH, Mainz


















For Helga and Bill










































II

Table of Contents

1. Cyclothymic temperament and bipolar mood disorders - 1

brief history, contemporary thinking and findings

1.1. Introduction 1


1.2. A description of affective temperament 2

1.2.1. What precisely is cyclothymic temperament? 4
1.2.2. Moods as a pivotal role in cyclothymia 8

1.3. Research methods involved in high-risk research 10

1.3.1. Biological high-risk research 11
1.3.1.1. The role of genetics in bipolar mood disorders 11

1.3.2. Psychometric high-risk research 16
1.3.2.1. Psychometric inventories used to identify bipolar mood disorders 18

1.4. Research objectives of current doctoral dissertation 21

2. Methods 24

2.1. Subject screening group from 1997 24

2.1.1. Control and risk groups for the diary 25
2.1.1.1. Control Group 27
2.1.1.2. Cyclothymic Temperament 28
2.1.1.3. Depressed Temperam 29

2.2. Measures 29

2.2.1. General Behavior Inventory (GBI) 29
2.2.2. Diary 35
2.2.2.1. Activation 37
2.2.2.2. Anger 37
2.2.2.3. Depression 38
2.2.2.4. Elevated, positive mood 38
2.2.2.5. Excitement
2.2.2.6. Extroversion 39
2.2.2.7. General Inactivity

2.3. Interview process 40

2.4. Evaluation procedures 43

III

3. Result 46

3.1. Screening subjects groups 46

3.1.1. Differences amongst control, cyclothymic and depressed 46
temperament

3.2. The seven mood categories 48

3.3. Variations in mood 55

3.4. Work, sleep, conflict situations, alcohol intake and drug 58
consumption

4. Discusion 68

4.1. The seven mood categories 68

4.2. Variations in mood 72

4.3. Wo 73
consumption

4.4 Closing comments 77

5. Overview of Dissertation 79

References

Appendix



















Cyclothymic Temperament & Bipolar Mood Disorders - Brief history, contemporary
thinking and findings

1.1. Introduction
A deviation from what is known as “normal” and “typical” human behaviour has prompted a
keen interest amongst many individuals throughout the course of history and time. The
ancient Greeks were some of the first to concern themselves with human behaviour and made
reference to melancholia as having a biological origin (Goodwin & Jamison, 1990;
Marneros, 2001). Hippocrates and his followers supported the notion that melancholia
serves as a form of “madness” and a condition “associated with an aversion to food,
despondency, sleeplessness, irritability, and restlessness” (Jackson, 1986). This same group
held the belief that a form of mental conflict and/or disorder was not the result of
“supernatural or magical forces” (Goodwin & Jamison, 1990). In one of the first references
to the existence of alternating forms of behaviour consisting of depression and mania
nd(Roccatagliata, 1986), it was Aretaeus of Cappadocia (2 century A.D.) who contended that
“mania was an end-stage of melancholia” (Goodwin & Jamison, 1990; Angst & Marneros,
2001). Despite a long period of research dormancy concerning the behavioural aspects of
thmania and melancholia, this topic once again resurfaced in the 16 century in which leading
physicians proposed mania and melancholia as one entity (a compounded disorder). Further
thsupport for this argument was later expressed at the end of the 18 century. It was said that
mania and melancholia remained as a constant disorder consisting of two sides of a coin, i.e.,
one associated with “audaciousness and fury,” the other half with “sadness and fear”
(Jamison, 1993).

Kraepelin (1921) proclaimed the term manic-depressive illness, comprising of mixed states,
suggesting a coexistence between manic and depressive symptoms, also known as an

affective illness. In a further attempt to solidify the understanding of an affective illness, a
thdeparture from the traditional medical disease model preferred by Europeans in the 20
century was made by Adolf Meyer (Meyer, 1950-1952). Although his views concerning
manic-depressive illness did not drastically deviate from those of Kraepelin, his approach
created an alternative understanding to the complexities of this issue. Not only seen as a
positive diversion in the traditional portrayal of manic-depressive illness, this construct (and
comprehension of such) could also apply to other forms of psychological disorders. Meyer
(1950-1952) asserted that psychopathology develops through the individual’s biological and
psychological characteristics, as well as biological and genetic factors being susceptible to
specific psychological and social influences (Goodwin & Jamison, 1990).

1.2. A description of affective temperament
Temperament within the context of human behaviour can be summarized as a specific,
relatively constant manner reflecting feelings, expressions, interactions with other
individuals, and the reaction to comments and events (Hofstätter, 1986). Secondly,
temperaments “emerge as broader, more general dispositional constructs that subsume
various emotional traits, along with other associated cognitive and behavioural
characteristics,” (Watson, 2000). It is also known that the constructs of temperament are
partially heritable and as such already present at the birth of an individual (Buss & Plomin,
1984; Watson, 2000). The spectrum of temperament, when placed into the context of an
affective temperament emphasizes the various dispositions closely affiliated with the
biological characteristics of drive, affect, and emotion (Akiskal, 1996).

Kraepelin (1921) as well as Kretschmer (1936) emphasized the necessity of an affective
temperament in supporting the manic-depressive issue. The link serving as a pivotal

importance in the long chain of manic-depressive dispositions (Goodwin & Jamison, 1990),
is exemplified by the four temperament types suggested by Kraepelin (1921): 1) a depressive
temperament characterized by gloomy and emotional stress, 2) a manic temperament
portrayed as “superficial, desultory, incoherent and accompanied by a mood which is
permanently exalted, careless and confident,” 3) an irritable temperament seen as a less
subtle form of the manic temperament, and 4) a cyclothymic temperament sized up as a
“frequent, more or less regular fluctuation of the psychic state to the manic or to the
depressive side.” Further, it was Kraepelin who stated that manic and depressive episodes
develop and/or originate from an already existing affective temperament supplying the basis
for the cyclical development of a disorder (Goodwin & Jamison, 1990).

Akiskal (1981 & 1994c) also supports Kraepelin’s “classical” view, i.e., the 4 temperament
types serving as the subclinical foundation for the possible development of an affective
disorder. Since the existence of a “cyclothymic temperament” is seen as a risk factor for the
development of an affective disorder (e.g., Bipolar Disorder II), (Akiskal & Akiskal, 1992) it
is this reason why the term and its significance play such a pivotal role in the current
doctoral dissertation. Secondly, since the current study does not include patients from a
hospital already diagnosed with “cyclothymia” or “cyclothymic diso