A prospective study of stability and change over 2 years of affective temperaments in 14-18 year-old Italian high school students

Objective: It is generally accepted that temperament is not entirely stable , and that it changes with development, particularly in juvenile subjects a lso, some temperaments are believed to be inherently more unstable. There i s a great deal of current interest in Kraepelin a thesis that temperamental dysregulation in juvenile subjects represents the constitutional foundatio n from which the more florid episodes of manic-depressive illness arise; th e cyclothymic, hyperthymic, depressive and irritable temperaments under con sideration might represent the first observable phenotypes of the genetic d iathesis for bipolarity. The analyses on the temperamental attributes in ju venile subjects were undertaken within this theoretical framework. Method: We evaluated 206 Italian high school students (14-18 years old) by means of a semi-structured affective temperament interview (TEMPS-I) at TO and TI t wo years later. Age, sex and psychometric properties of TEMPS-I raw scale s core and weighted cut-off las specially weighted linear combination of item s) were used as predictive variables of stability. Results: Affective tempe raments had a low to moderate level of stability, reaching 60% in the case of subjects with dominant cyclothymic temperament. The stability of the dep ressive temperament was primarily related to its weighted cut-off. The stab ility of the hyperthymic temperament appeared related to male sex, young ag e, and total scale score. Male sex represented the best stability predictor for the cyclothymic temperament as well. The group of subjects with an uns table depressive temperament showed a change toward the dominant cyclothymi c temperament, whereas individuals with unstable hyperthymic temperamental traits moved on towards the dominant cyclothymic and depressive temperament s. The irritable construct was the least stable. Limitations: The infeasibi lity of a multiwave design represents the main limitation in evaluating the predictors of stability. Furthermore, in the present analyses, the size of the cyclothymic subsample was small. Conclusion: Our data indicate conside rable fluctuation and instability in depressive and hyperthymic temperament s in mid-adolescence. The cyclothymic temperament appears to be the most st able. Interestingly, cyclothymic moodiness appears more persistent in juven ile males; likewise persistent hyperthymic traits appear more of a "male" a ttribute. Clinical and Public Health Implications: We submit that these sex -relevant traits could be important in the risk of developing juvenile bipo larity. Literature review indicates that clinical studies, albeit on small samples, have already provided some support for this thesis. Larger studies on epidemiological samples could be more informative from a public health perspective. A user-friendly affective temperament questionnaire, which is under development, is critical for the methodology of such studies. Our stu dy indicates that the present version of the Akiskal-Malya questionnaire ca n be easily used post-pubertally. Age adjustment must be considered for you nger subjects. (C) 1998 Elsevier Science B.V. All rights reserved.