Basic dimensions of temperament and their relation to anxiety and depression: A symptom-based perspective

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Abstract

We examine relations among neuroticism/negative emotionality (N/NE), extraversion/positive emotionality (E/PE), and the mood and anxiety disorders. We present data showing that E/PE correlates most strongly with anhedonia/depressed affect and social anxiety. Similarly, although N/NE is a general predictor of psychopathology, it correlates more substantially with subjective distress and dysphoria than with other types of dysfunction. Thus, it is most strongly related to disorders characterized by pervasive distress, moderately related to syndromes involving more limited forms of distress, and weakly related to disorders characterized primarily by behavioral avoidance. We demonstrate a similar pattern at the symptom level, examining the basic dimensions comprising PTSD, OCD, specific phobia, and depression. These systematic associations suggest a fundamental continuity between normal and abnormal psychological processes.

Introduction

For several decades, studies of personality and psychopathology commingled in the pages of the old Journal of Abnormal and Social Psychology, which published the best basic research in social, personality, and clinical psychology. This integrative forum made it extremely easy for psychologists to keep abreast of ongoing developments in all of these fields. Beginning in 1965, however, the content of the old Journal was split between two serials: research in abnormal behavior was retained for the renamed Journal of Abnormal Psychology, whereas articles on personality and interpersonal processes were redirected to the newly created Journal of Personality and Social Psychology. Although this reorganization had many desirable consequences, it had the unfortunate effect of creating a chasm between studies of normal and abnormal behavior; the fields began to move further and further apart, so that eventually there was little connection between them (Watson & Clark, 1994).

In the 1990s, however, there was a renaissance of interest in the links between personality and psychopathology (Watson & Clark, 1994), and research in this area has flourished ever since. This line of research is important for several reasons, of which we will briefly mention three here. First, research in this area has identified important real-world correlates for many personality constructs, thereby demonstrating their predictive validity (Clark and Watson, 1995, Watson, in press). Indeed, we subsequently present evidence establishing that traits are strongly and systematically linked to psychopathology. Second, this research can play a key role in addressing basic diagnostic and taxonomic issues in psychopathology. Specifically, it can help to identify potential sources of comorbidity and to explicate the etiological bases of disorders. For example, as we discuss later, the broad trait of neuroticism/negative emotionality plays a key role in the comorbidity between the mood and anxiety disorders. Third, this research helps to clarify the boundaries of these domains by addressing the issue of continuity versus discontinuity: That is, do many of the maladaptive characteristics seen in clinical disorders represent pathologically extreme manifestations of basic personality processes, or are they fundamentally distinct phenomena (e.g., Widiger & Clark, 2000)? It is noteworthy that evidence of continuity indicates that these two domains are inherently interconnected, such that neither can be fully understood without reference to the other. We will revisit this issue after reviewing the relevant evidence.

Section snippets

The “Big Two” dimensions of temperament

In this paper, we will focus on two broad dimensions of individual differences. The basic traits of neuroticism and extraversion have been included in virtually every prominent trait model developed during the 20th century, and are key components in both the Big Three and the Big Five structures (Clark and Watson, 1999, Watson et al., 1994). Accordingly, these traits comprise a basic “Big Two” of personality.

As our understanding of these traits has increased, it has become clear that they

The problem of comorbidity

In the remainder of this paper, we will examine how N/NE and E/PE are related to the mood disorders (which are characterized by prominent episodes of depression; American Psychiatric Association APA, 1994) and the anxiety disorders (which involve anxious mood and/or behavioral avoidance; APA, 1994). Interest in this topic has been stimulated by the key taxonomic problem of comorbidity. Comorbidity can be broadly defined as the co-occurrence of different disorders within the same individual (see

Earlier models

Why do we see such strong comorbidity between the mood and anxiety disorders? Drawing on extensive evidence from the basic mood literature, Watson, Clark, and Carey (1988) argued that these syndromes share a common component of general distress or negative affectivity. They further proposed that low levels of positive affectivity (i.e., anhedonia) were a specific feature of depression that distinguishes it from the anxiety disorders. Thus, in this two-factor model, general negative affectivity

SCID symptom analyses

We can further explicate the links between personality and psychopathology by taking a more refined and detailed approach that focuses on specific types of anxiety and depression symptoms. We will begin by reporting symptom results from two data sets that further establish the basic points that N/NE: (a) correlates more strongly with some types of psychopathology than others and (b) is a particularly strong predictor of distress and dysphoria.

The first data set involves the sample of Gulf War

Overview

Symptom heterogeneity is a prominent feature of many mood and anxiety disorders. Indeed, we subsequently review evidence indicating that several of these disorders can be decomposed into multiple distinct symptom groups. We can enhance our understanding of the links between personality and psychopathology by examining the specific symptom dimensions that comprise these disorders. We consider evidence related to four disorders: posttraumatic stress disorder (PTSD), obsessive compulsive disorder

Conclusion

We have reviewed extensive evidence establishing that E/PE and N/NE both have important links to psychopathology in general, and to the mood and anxiety disorders in particular. The former dimension shows relatively specific associations with psychopathology. Most notably, markers of E/PE are most strongly and consistently correlated with indicators of: (a) anhedonia/depressed affect (which are prominent features of major depression) and (b) social/interpersonal anxiety (the core symptom of

Acknowledgments

We thank Michael Chmielewski, Lee Anna Clark, Bradley N. Doebbeling, Jennifer Gringer Richards, Roman Kotov, and Michael O’Hara for their help in the preparation of the manuscript. This research was supported by NIMH Grant #1-R01-MH068472-1 to David Watson, and by Department of Defense Grant DAMD17-97-1 to Bradley N. Doebbeling.

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