Abstract
Neurodevelopmental disorders, such as autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD), express aberrant neurocognitive functions in social communication, flexibility and executive control from an early age, not seldom casting extensive consequences long into adulthood. They exist along a continuum from severe disorders to broader phenotypes or “shadow syndromes”. In recent years, several studies have assessed the relation between these conditions and associated personality traits in terms of Cloninger’s temperament and character model in both children and adults. The aim is to clarify to what extent neurodevelopmental challenges are associated with adult personality and elucidate the link between symptom severity and specific personality traits. Findings give support for specific temperaments (previously known as constitutions) with high Novelty Seeking in ADHD and low Reward Dependence with high Harm Avoidance in ASD, while low scores on the character dimensions of Self-Directedness and Cooperativeness are a shared feature of both disorders (and more so the more severe the disorder is). This replicates previous findings of the same character deficits across adult mental disorders, forming a common ground for mental health problems. This pattern is proposed to be a window of opportunity for treatment interventions aiming at enhancing agency, communion, resilience and well-being.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Akbas, N. B., Kilic, E. Z., Zahmacioglu, O., Atalay, H., & Goktuna, Z. (2015). Attention deficit and hyperactivity symptoms in a group of university students and relations with temperament and character profiles. Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 28(3), 265–268. https://doi.org/10.5350/DAJPN2015280309
Alabaf, S., Gillberg, C., Lundstrom, S., Lichtenstein, P., Kerekes, N., Rastam, M., & Anckarsater, H. (2019). Physical health in children with neurodevelopmental disorders. Journal of Autism and Developmental Disorders, 49(1), 83–95.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Washington, D.C.: American Psychiatric Association.
Anckarsater, H., Stahlberg, O., Larson, T., Hakansson, C., Jutblad, S. B., Niklasson, L., . . . Rastam, M. (2006). The impact of ADHD and autism spectrum disorders on temperament, character, and personality development. American Journal of Psychiatry, 163(7), 1239–1244. https://doi.org/10.1176/appi.ajp.163.7.1239
Anckarsater, H., Hofvander, B., Billstedt, E., Gillberg, I. C., Gillberg, C., Wentz, E., & Rastam, M. (2012). The sociocommunicative deficit subgroup in anorexia nervosa: Autism spectrum disorders and neurocognition in a community-based, longitudinal study. Psychological Medicine, 42(9), 1957–1567.
Baron-Cohen, S., Jolliffe, T., Mortimore, C., & Robertson, M. (1997). Another advanced test of theory of mind: Evidence from very high functioning adults with autism or asperger syndrome. Journal of Child Psychology and Psychiatry, 38(7), 813–822.
Baron-Cohen, S., Leslie, A. M., & Frith, U. (1985). Does the autistic child have a “theory of mind”? Cognition, 21(1), 37–46.
Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (2001). The autism-spectrum quotient (AQ): Evidence from Asperger syndrome/high-functioning autism, males and females, scientists and mathematicians. Journal of Autism and Developmental Disorders, 31(1), 5–17.
Brandstrom, S., Schlette, P., Przybeck, T. R., Lundberg, M., Forsgren, T., Sigvardsson, S., … Adolfsson, R. (1998). Swedish normative data on personality using the Temperament and Character Inventory. Comprehensive Psychiatry, 39(3), 122–128.
Caspi, A., Houts, R. M., Belsky, D. W., Goldman-Mellor, S. J., Harrington, H., Israel, S., … Moffitt, T. E. (2014). The p Factor: One general psychopathology factor in the structure of psychiatric disorders? Clinical Psychological Science, 2(2), 119–137.
Cho, S. C., Hwang, J. W., Lyoo, I. K., Yoo, H. J., Kin, B. N., & Kim, J. W. (2008). Patterns of temperament and character in a clinical sample of Korean children with attention-deficit hyperactivity disorder. Psychiatry and Clinical Neurosciences, 62(2), 160–166. https://doi.org/10.1111/j.1440-1819.2008.01749.x
Cho, S. C., Kim, B. N., Kim, J. W., Rohde, L. A., Hwang, J. W., Chungh, D. S., … Kim, H. W. (2009). Full syndrome and subthreshold attention-deficit/hyperactivity disorder in a Korean community sample: Comorbidity and temperament findings. European Child and Adolescent Psychiatry, 18(7), 447–457.
Cloninger, C. R. (1986). A unified biosocial theory of personality and its role in the development of anxiety states. Psychiatric Developments, 4(3), 167–226.
Cloninger, C. R., & Cloninger, K. M. (2011). Person-centered therapeutics. International Journal of Person Centered Medicine, 1(1), 43–52.
Cloninger, C. R., Svrakic, D. M., & Przybeck, T. R. (1993). A psychobiological model of temperament and character. Archives of General Psychiatry, 50(12), 975–990.
Costa, P. T., Jr., & McCrae, R. R. (1992). Four ways five factors are basic. Personality and Individual Differences, 13(6), 653–665.
Davidsson, M., Hult, N., Gillberg, C., Sarneo, C., Gillberg, C., & Billstedt, E. (2017). Anxiety and depression in adolescents with ADHD and autism spectrum disorders: Correlation between parent- and self-reports and with attention and adaptive functioning. Nordic Journal of Psychiatry, 71(8), 614–620.
Donfrancesco, R., Di Trani, M., Porfirio, M. C., Giana, G., Miano, S., & Andriola, E. (2015). Might the temperament be a bias in clinical study on attention-deficit hyperactivity disorder (ADHD)?: Novelty Seeking dimension as a core feature of ADHD. Psychiatry Research, 227(2–3), 333–338. https://doi.org/10.1016/j.psychres.2015.02.014
Eysenck, H. J. (1971). Readings in extraversion-introversion: Theoretical and methodological issues (Vol. 1). London, UK: Staples.
Fernell, E., & Gillberg, C. (2010). Autism spectrum disorder diagnoses in Stockholm preschoolers. Research in Developmental Disabilities, 31(3), 680–685.
Fresan, A., Leon-Ortiz, P., Robles-Garcia, R., Azcarraga, M., Guizar, D., Reyes-Madrigal, F., … de la Fuente-Sandoval, C. (2015). Personality features in ultra-high risk for psychosis: A comparative study with schizophrenia and control subjects using the Temperament and Character Inventory-Revised (TCI-R). Journal of Psychiatric Research, 61, 168–173.
Fried, R., Hirshfeld-Becker, D., Petty, C., Batchelder, H., & Biederman, J. (2015). How informative is the CANTAB to assess executive functioning in children with ADHD? A controlled study. Journal of Attention Disorders, 19(6), 468–475.
Garcia, D., Lester, N., Cloninger, K. M., & Cloninger, C. R. (2017). Temperament and Character Inventory (TCI). In V. Ziegler-Hill & T. K. Shackelford (Eds.), Encyclopedia of personality and individual differences. Cham, Switzerlan: Springer International.
Gillberg, C. (2010). The ESSENCE in child psychiatry: Early symptomatic syndromes eliciting neurodevelopmental clinical examinations. Research in Developmental Disabilities, 31(6), 1543–1551.
Gillberg, C., Lundstrom, S., Fernell, E., Nilsson, G., & Neville, B. (2017). Febrile seizures and epilepsy: Association with autism and other neurodevelopmental disorders in the child and adolescent twin study in Sweden. Pediatric Neurology, 74, 80–86 e2.
Gomez, R., Woodworth, R., Waugh, M., & Corr, P. J. (2012). Attention-deficit/hyperactivity disorder symptoms in an adult sample: Associations with Cloninger’s temperament and character dimensions. Personality and Individual Differences, 52(3), 290–294. https://doi.org/10.1016/j.paid.2011.10.015
Gutierrez, F., Sangorrin, J., Martin-Santos, R., Torres, X., & Torrens, M. (2002). Measuring the core features of personality disorders in substance abusers using the Temperament and Character Inventory (TCI). Journal of Personality Disorders, 16(4), 344–359.
Hansenne, M., Reggers, J., Pinto, E., Kjiri, K., Ajamier, A., & Ansseau, M. (1999). Temperament and Character Inventory (TCI) and depression. Journal of Psychiatric Research, 33(1), 31–36.
Happe, F. G. (1994). An advanced test of theory of mind: Understanding of story characters’ thoughts and feelings by able autistic, mentally handicapped, and normal children and adults. Journal of Autism and Developmental Disorders, 24(2), 129–154.
He, J. A., Antshel, K. M., Biederman, J., & Faraone, S. V. (2015). Do personality traits predict functional impairment and quality of life in adult ADHD? A controlled study. Journal of Attention Disorders, 23(1), 12–21.
Heath, A. C., Cloninger, C. R., & Martin, N. G. (1994). Testing a model for the genetic structure of personality: A comparison of the personality systems of Cloninger and Eysenck. Journal of Personality and Social Psychology, 66(4), 762–775.
Homberg, J. R., Kyzar, E. J., Scattoni, M. L., Norton, W. H., Pittman, J., Gaikwad, S., … Kalueff, A. V. (2016). Genetic and environmental modulation of neurodevelopmental disorders: Translational insights from labs to beds. Brain Research Bulletin, 125, 79–91.
Insel, T., Cuthbert, B., Garvey, M., Heinssen, R., Pine, D. S., Quinn, K., … Wang, P. (2010). Research domain criteria (RDoC): Toward a new classification framework for research on mental disorders. American Journal of Psychiatry, 167(7), 748–751.
Instanes, J. T., Haavik, J., & Halmoy, A. (2016). Personality traits and comorbidity in adults with ADHD. Journal of Attention Disorders, 20(10), 845–854.
Josefsson, K., Cloninger, C. R., Hintsanen, M., Jokela, M., Pulkki-Raback, L., & Keltikangas-Jarvinen, L. (2011). Associations of personality profiles with various aspects of well-being: A population-based study. Journal of Affective Disorders, 133(1–2), 265–273.
Kadak, M. T., Demirel, O. F., Gokalp, B., Erdogdu, Z., & Demirel, A. (2015). Relationship between temperament, character and the autistic trait in parents of children with autistic spectrum disorder. International Journal of Psychiatry in Clinical Practice, 19(3), 216–220. https://doi.org/10.3109/13651501.2015.1050401
Kerekes, N., Brandstrom, S., Lundstrom, S., Rastam, M., Nilsson, T., & Anckarsater, H. (2013). ADHD, autism spectrum disorder, temperament, and character: Phenotypical associations and etiology in a Swedish childhood twin study. Comprehensive Psychiatry, 54(8), 1140–1147.
Kim, K. M., Nam, S., Kim, S. Y., Lee, S. M., Choi, J. W., Kang, T., & Kim, J. W. (2017). Psychopathological, temperamental, and characteristic factors in adults with remaining childhood attention-deficit hyperactivity symptoms. International Journal of Psychiatry in Clinical Practice, 21(3), 236–241. https://doi.org/10.1080/13651501.2017.1297835
Kotov, R., Krueger, R. F., Watson, D., Achenbach, T. M., Althoff, R. R., Bagby, R. M., … Zimmerman, M. (2017). The Hierarchical Taxonomy of Psychopathology (HiTOP): A dimensional alternative to traditional nosologies. Journal of Abnormal Psychology, 126(4), 454–477.
Kuiper, M. J., Brandsma, R., Lunsing, R. J., Eggink, H., Ter Horst, H. J., Bos, A. F., & Sival, D. A. (2018). The neurological phenotype of developmental motor patterns during early childhood. Brain and Behavior. 2019;9:e01153.
Kunihira, Y., Senju, A., Dairoku, H., Wakabayashi, A., & Hasegawa, T. (2006). ‘Autistic’ traits in non-autistic Japanese populations: Relationships with personality traits and cognitive ability. Journal of Autism and Developmental Disorders, 36(4), 553–566.
Larsson, H., Anckarsater, H., Rastam, M., Chang, Z., & Lichtenstein, P. (2012). Childhood attention-deficit hyperactivity disorder as an extreme of a continuous trait: A quantitative genetic study of 8,500 twin pairs. Journal of Child Psychology and Psychiatry, 53(1), 73–80.
Little, L. M., Dean, E., Tomchek, S., & Dunn, W. (2018). Sensory processing patterns in autism, attention deficit hyperactivity disorder, and typical development. Physical and Occupational Therapy in Pediatrics, 38(3), 243–254.
Lundstrom, S., Chang, Z., Rastam, M., Gillberg, C., Larsson, H., Anckarsater, H., & Lichtenstein, P. (2012). Autism spectrum disorders and autistic like traits: Similar etiology in the extreme end and the normal variation. Archives of General Psychiatry, 69(1), 46–52.
Lynn, D. E., Lubke, G., Yang, M., McCracken, J. T., McGough, J. J., Ishii, J., . . . Smalley, S. L. (2005). Temperament and character profiles and the dopamine D4 receptor gene in ADHD. American Journal of Psychiatry, 162(5), 906–913. https://doi.org/10.1176/appi.ajp.162.5.906
Magnavita, J. J. (2004). Handbook of personality disorders: Theory and practice. Hoboken, NJ: Wiley.
Manouilenko, I., Eriksson, J. M., Humble, M. B., & Bejerot, S. (2014). Minor physical anomalies in adults with autism spectrum disorder and healthy controls. Autism Research and Treatment, 2014, 743482.
Matsuura, N., Ishitobi, M., Arai, S., Kawamura, K., Asano, M., Inohara, K., … Kosaka, H. (2014). Distinguishing between autism spectrum disorder and attention deficit hyperactivity disorder by using behavioral checklists, cognitive assessments, and neuropsychological test battery. Asian Journal of Psychiatry, 12, 50–57.
Melegari, M. G., Nanni, V., Lucidi, F., Russo, P. M., Donfrancesco, R., & Cloninger, C. R. (2015). Temperamental and character profiles of preschool children with ODD, ADHD, and anxiety disorders. Comprehensive Psychiatry, 58, 94–101. https://doi.org/10.1016/j.comppsych.2015.01.001
Merwood, A., Asherson, P., & Larsson, H. (2013). Genetic associations between the ADHD symptom dimensions and Cloninger’s temperament dimensions in adult twins. European Neuropsychopharmacology, 23(6), 416–425.
Müller, D. J., Chiesa, A., Mandelli, L., Luca, V. D., Ronchi, D. D., Jain, U., . . . Kennedy, J. L. (2010). Correlation of a set of gene variants, life events and personality features on adult ADHD severity. Journal of Psychiatry Research, 44(9), 598–604. https://doi.org/10.1016/j.jpsychires.2009.11.011
Nyden, A., Niklasson, L., Stahlberg, O., Anckarsater, H., Wentz, E., Rastam, M., & Gillberg, C. (2010). Adults with autism spectrum disorders and ADHD neuropsychological aspects. Research in Developmental Disabilities, 31(6), 1659–1668.
Park, H., Suh, B. S., Lee, H. K., & Lee, K. (2016). Temperament and characteristics related to attention deficit/hyperactivity disorder symptoms. Comprehensive Psychiatry, 70, 112–117.
Perroud, N., Hasler, R., Golay, N., Zimmermann, J., Prada, P., Nicastro, R., . . . Baud, P. (2016). Personality profiles in adults with attention deficit hyperactivity disorder (ADHD). BMC Psychiatry, 16, 199. https://doi.org/10.1186/s12888-016-0906-6
Pettersson, E., Larsson, H., & Lichtenstein, P. (2016). Common psychiatric disorders share the same genetic origin: A multivariate sibling study of the Swedish population. Molecular Psychiatry, 21(5), 717–721.
Peyre, H., Speranza, M., Cortese, S., Wohl, M., & Purper-Ouakil, D. (2015). Do ADHD children with and without child behavior checklist-dysregulation profile have different clinical characteristics, cognitive features, and treatment outcomes? Journal of Attention Disorders, 19(1), 63–71. https://doi.org/10.1177/1087054712452135
Picardi, A., Fagnani, C., Medda, E., Toccaceli, V., Brambilla, P., & Stazi, M. A. (2015). Genetic and environmental influences underlying the relationship between autistic traits and temperament and character dimensions in adulthood. Comprehensive Psychiatry, 58, 178–188.
Piltz, A. (1978). Medeltidens lärda värld (The scholarly world of the Middle Ages) (p. 41). Stockholm, Sweden: Camina.
Plomin, R. (2018). Blueprint: How DNA makes us who we are. Cambridge, MA: MIT Press.
Purper-Ouakil, D., Lepagnol-Bestel, A. M., Grosbellet, E., Gorwood, P., & Simonneau, M. (2010). Neurobiology of attention deficit/hyperactivity disorder. Medicíne/Sciences, 26(5), 487–496. https://doi.org/10.1051/medsci/2010265487.
Rastam, M., Taljemark, J., Tajnia, A., Lundstrom, S., Gustafsson, P., Lichtenstein, P., … Kerekes, N. (2013). Eating problems and overlap with ADHD and autism spectrum disorders in a nationwide twin study of 9- and 12-year-old children. The Scientific World Journal, 2013, 315429.
Romine, C. B., Lee, D., Wolfe, M. E., Homack, S., George, C., & Riccio, C. A. (2004). Wisconsin card sorting test with children: A meta-analytic study of sensitivity and specificity. Archives of Clinical Neuropsychology, 19(8), 1027–1041.
Rydell, M., Lundstrom, S., Gillberg, C., Lichtenstein, P., & Larsson, H. (2018). Has the attention deficit hyperactivity disorder phenotype become more common in children between 2004 and 2014? Trends over 10 years from a Swedish general population sample. Journal of Child Psychology and Psychiatry, 59(8), 863–871.
Salgado, C. A., Bau, C. H., Grevet, E. H., Fischer, A. G., Victor, M. M., Kalil, K. L., … Belmonte-de-Abreu, P. (2009). Inattention and hyperactivity dimensions of ADHD are associated with different personality profiles. Psychopathology, 42(2), 108–112.
Shapiro, L. (2015). Understanding OCD: Skills to control the conscience and outsmart obsessive compulsive disorder. Santa Barbara, CA: Praeger.
Shephard, E., Bedford, R., Milosavljevic, B., Gliga, T., Jones, E. J. H., Pickles, A., … Team, B. (2018). Early developmental pathways to childhood symptoms of attention-deficit hyperactivity disorder, anxiety and autism spectrum disorder. Journal of Child Psychology and Psychiatry. https://doi.org/10.1111/jcpp.12947.
Sizoo, B., van den Brink, W., Gorissen van Eenige, M., & van der Gaag, R. J. (2009). Personality characteristics of adults with autism spectrum disorders or attention deficit hyperactivity disorder with and without substance use disorders. The Journal of Nervous and Mental Disease, 197(6), 450–454. https://doi.org/10.1097/NMD.0b013e3181a61dd0
Sizoo, B. B., van der Gaag, R. J., & van den Brink, W. (2015). Temperament and character as endophenotype in adults with autism spectrum disorders or attention deficit/hyperactivity disorder. Autism, 19(4), 400–408. https://doi.org/10.1177/1362361314522352
Sjobring, H. (1973). Personality structure and development. A model and its application. (1973/01/01 ed., Vol. 244). Copenhagen, Denmark: Munksgaard.
Soderstrom, H., Rastam, M., & Gillberg, C. (2002). Temperament and character in adults with Asperger syndrome. Autism, 6(3), 287–297. https://doi.org/10.1177/1362361302006003006
Spittle, A. J., FitzGerald, T., Mentiplay, B., Williams, J., & Licari, M. (2018). Motor impairments in children: More than just the clumsy child. Journal of Paediatrics and Child Health, 54(10), 1131–1135.
Still, G. F. (1902). Some abnormal psychical conditions in children. Lancet, 1, 1008–1012.
Svrakic, D. M., Whitehead, C., Przybeck, T. R., & Cloninger, C. R. (1993). Differential diagnosis of personality disorders by the seven-factor model of temperament and character. Archives of General Psychiatry, 50(12), 991–999.
Taljemark, J., Rastam, M., Lichtenstein, P., Anckarsater, H., & Kerekes, N. (2017). The coexistence of psychiatric and gastrointestinal problems in children with restrictive eating in a nationwide Swedish twin study. Journal of Eating Disorders, 5(25), 1–11.
Taylor, M. J., Martin, J., Lu, Y., Brikell, I., Lundstrom, S., Larsson, H., & Lichtenstein, P. (2018). Association of Genetic Risk Factors for psychiatric disorders and traits of these disorders in a Swedish population twin sample. JAMA Psychiatry, 76, 280. https://doi.org/10.1001/jamapsychiatry.2018.3652
Tillman, R., Geller, B., Craney, J. L., Bolhofner, K., Williams, M., Zimerman, B., . . . Beringer, L. (2003). Temperament and character factors in a prepubertal and early adolescent bipolar disorder phenotype compared to attention deficit hyperactive and normal controls. Journal of Child and Adolescent Psychopharmacology, 13(4), 531–543. https://doi.org/10.1089/104454603322724922
Westwood, H., & Tchanturia, K. (2017). Autism spectrum disorder in anorexia nervosa: An updated literature review. Current Psychiatry Reports, 19(7), 41.
Whitehouse, A. J., Cooper, M. N., Bebbington, K., Alvares, G., Lin, A., Wray, J., & Glasson, E. J. (2017). Evidence of a reduction over time in the behavioral severity of autistic disorder diagnoses. Autism Research, 10(1), 179–187.
Wing, L. (1981). Language, social, and cognitive impairments in autism and severe mental retardation. Journal of Autism and Developmental Disorders, 11(1), 31–44.
Wolff, S. (1991). ‘Schizoid’ personality in childhood and adult life. I: The vagaries of diagnostic labelling. British Journal of Psychiatry, 159(5), 615–620.
Yoo, H. J., Kim, M., Ha, J. H., Chung, A., Sim, M. E., Kim, S. J., & Lyoo, I. K. (2006). Biogenetic temperament and character and attention deficit hyperactivity disorder in Korean children. Psychopathology, 39(1), 25–31. https://doi.org/10.1159/000089660
Yoo, H. J., Ha, J. H., Yu, J., Park, D. H., & Ryu, S. H. (2016). Influence of temperaments in Attention Deficit Hyperactivity Disorder symptoms among preschool children. Neuropsychiatry, 6(3), 75–79. https://doi.org/10.4172/Neuropsychiatry.1000123
Zwir, I., Arnedo, J., Del-Val, C., Pilkki-Råback, L., Konte, B., Yang, S. S., … Cloninger, C. R. (2018a). Uncovering the complex genetics of human character. Molecular Psychiatry. https://doi.org/10.1038/s41380-018-0263-6.
Zwir, I., Arnedo, J., Del-Val, C., Pilkki-Råback, L., Konte, B., Yang, S. S., … Cloninger, C. R. (2018b). Uncovering the complex genetics of human temperament. Molecular Psychiatry. https://doi.org/10.1038/s41380-018-0264-5.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Nilsson, T., Ståhlberg, O., Råstam, M., Garcia, D., Anckarsäter, H. (2019). Temperament and Character in Childhood-Onset Neurodevelopmental Disorders (Autism Spectrum Disorders and ADHD). In: Garcia, D., Archer, T., Kostrzewa, R.M. (eds) Personality and Brain Disorders. Contemporary Clinical Neuroscience. Springer, Cham. https://doi.org/10.1007/978-3-319-90065-0_6
Download citation
DOI: https://doi.org/10.1007/978-3-319-90065-0_6
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-90064-3
Online ISBN: 978-3-319-90065-0
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)