Research report
The relation between affective temperament and resilience in depression: A controlled study

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Abstract

Background

The aim of this study was to investigate the presence of a relationship between affective temperament and resilience in patients with major depressive disorder (MDD) diagnosis, and to examine whether this relationship, if present, differs from healthy individuals.

Methods

In line with this purpose, 100 cases with major depressive disorder diagnosis who were in their remission period were evaluated consecutively in their regular outpatient control interviews. The control group consisted of 100 healthy individuals without any history of psychiatric admission and treatment, matched with the depressive group in terms of age and sex. Diagnostic interviews were conducted with SCID-I, affective temperament and resilience were evaluated with TEMPS-A (Evaluation of Temperament Memphis, Pisa, Paris and San Diego-Auto questionnaire) and The Resilience Scale for Adults (RSA)—Turkish version, respectively.

Results

We observed a strong relationship between resilience and hyperthymic temperament both in depressive and healthy individuals. There was an inverse relation between psychological resilience and irritable and anxious temperament in both groups. A negative correlation was observed between irritable temperament and family cohesion in depressive disorder group, while in healthy individuals a strong correlation was observed between family cohesion and depressive and anxious temperament, and a weak correlation between family cohesion and hyperthymic temperament.

Limitations

The measurements of temperament and resilience were estimated depending on the patient's statement.

Conclusion

There is a strong relationship between hyperthymic temperament and psychological resilience in MDD. The relationship between the type of affective temperament and the family cohesion sub-dimension of psychological resilience differs from that of healthy individuals.

Introduction

Genetic and environmental factors play an important role in the etiology of major depressive disorder. Affective temperament describes the attitudes and behavior of the individual based on the constitutional, genetic and biological factors (Akiskal and Akiskal, 2005a). Individual's affective temperament is one of the variables determining the risk for depression. Akiskal suggested that affective temperament constitutes the basis of mood disorders and described five major affective temperament types: depressive, hyperthymic, cyclothymic, irritable, and anxious (Akiskal and Akiskal, 2005b). Studies conducted within this area suggested that a considerable number of depressive patients have a depressive and anxious temperament (as cited by Angst, 2000). There is a continuity between poles, and there is an association between hyperthymic qualities and good prognosis (Kesebir et al., 2005, Rihmer et al., 2010).

In 1970s researchers observed that some individuals could be able to pass through the normal developmental stages against adverse circumstances, and they started to investigate the neurobiological determinants as well as the psychological determinants in these individuals (Feder et al., 2009, Fadardi et al., 2010, Amico et al., 2011). Resilience has positive effects on neural plasticity and executive functions (Masten, 2001, Buckner et al., 2003, Cicchetti and Blender, 2006, Simeon et al., 2007). Psychological resilience can be described as the ability for adaptation of the individual to adverse environmental conditions (Basım and Çetin, 2011), and is determined by the personal characteristics, familial cohesion and support, and external support systems. The measurement instrument which was developed to assess psychological resilience, (Friborg et al., 2003) examines personal strength, structured style, social competence, family cohesion and social resources sub-dimensions. Personal strength sub-dimension is further divided into two as perception of self and perception of future (Friborg et al., 2005).

We think that the relationship between temperament and resilience is important in psychosomatic diseases and even in somatic diseases. Such that, in asthmatic children, self-esteem was determined to be the predictor of resilience (Lima et al., 2010). The aim of this study was to investigate whether there is a relationship between affective temperament and psychological resilience in depressive patients and if there is a relationship, to determine if this relation differs from that of healthy individuals.

Section snippets

Study sample

Of the individuals who admitted to the outpatient clinic of Erenköy Psychiatry Education and Research Hospital between January 2012 and March 2012 for their regular follow-up assessment and who were being followed regularly for at least 1 year, those who have been diagnosed as major depressive disorder (MDD) and are in remission were recruited to the study. The study sample consisted of 100 consecutive patients (57 females and 43 males) aged between 17 and 77 years of age (mean 32.7±13.2) who

Affective temperament and psychological resilience in MDD and HC groups

The depressive (p=0.012), cyclothymic (p=0.025), irritable (p=0.039), anxious temperament scores (p=0.018) of the depressive disorder cases were higher and psychological resilience (p=0.001) and hyperthymic temperament scores (p<0.001) were lower than those of healthy individuals (Table 1). In depressive disorder cases, the scores from perception of self (p<0.001), perception of future (p=0.042), structural style (p=0.001), and social competence sub-dimensions (p=0.033) of the psychological

Discussion

In this study, the relationship of affective temperament with resilience was compared between depressive and healthy individuals for the first time. In the depression group, the scores for depressive, cyclothymic, irritable, anxious temperaments were higher than those of healthy individuals. Premorbid depressive and anxious temperament in depression is a finding which has been repeated many times (Akiskal and Pinto, 2000). In Akdeniz et al.’s (2004) study similar to our findings, cyclothymic

Limitations

There are methodological difficulties in measuring the temperament and resilience. It is not very simple to differentiate state and trait characteristics between affective temperament and mood disorder. In this study even though the patients were evaluated in the ‘remission’ period according to DSM-IV, it is difficult to distinguish this ‘relative’ remission period from sub-threshold or sub-syndromal forms. Another limitation of this study is that the measurements of temperament and resilience

Role of funding source

No funding source was present for the study.

Conflict of interest

The authors declare no conflict of interest.

Acknowledgment

No acknowledgement is present for the study.

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