The assessment of cyclothymic-hypersensitive temperament in youth with mood disorders and attention deficit hyperactivity disorder.

BACKGROUND: Cyclothymic-hypersensitive temperament (CHT) has been related to both depression and bipolarity, as well as to suicidality. Recently, a psychometrically sound way of assessment has been validated in youth (Cyclothymic-Hypersensitive Temperament Questionnaire, CHTQ), but data on clinical populations are still scant. Aim of our study is to further explore the structure and other psychometric properties of the revised version of CHTQ and its clinical implications in clinical samples. METHODS: The study is based on a dataset of patients with unipolar depression, bipolar disorder and attention deficit and hyperactivity disorder (ADHD) (243 patients, 135 males, mean age 14.22 ± 2.16 years, age range 9-18 years), compared to a community sample of adolescents (398 subjects, 95 boys, mean age 15.47 ± 1.96 years, age range 10-18 years) RESULTS: The two-correlated factor structure of CHT has been confirmed, with a moodiness/hypersensitiveness factor, correlated with internalizing symptoms, and an impulsiveness/emotional dysregulation factor, correlated with externalizing symptoms. All CHTQ scores correlate with global functioning. CHTQ total scores discriminate patients from healthy controls. Only CHTQ impulsiveness/emotional dysregulation subscale score is higher in bipolar patients, compared to unipolar depression and ADHD, whereas neither CHTQ moodiness/hypersensitiveness subscale score nor CHTQ total score discriminate between clinical groups. LIMITATION: Data on current mood states are unavailable. Patients were recruited in a third level clinic. The unipolar depression group is relatively small. CONCLUSION: CHT may be a rapid and reliable screening and diagnostic tool in the clinical practice with youth, exploring the cyclothymic dimension in different psychiatric disorders.

Cyclothymic-hypersensitive temperament in youths: Refining the structure, the way of assessment and the clinical significance in the youth population.

BACKGROUND: Although a better understanding of the prodromes of affective disorders in youth has important clinical and research implications, empirical data are still unconclusive. Cyclothymic-hypersensitive temperament (CHT) has been linked to both depression and bipolarity, as well as to suicidality. Its conceptualization is still debated, as well as a comprehensive, psychometrically sound way of assessment. METHODS: factor structure, reliability, measurement invariance, convergent and divergent validity of the previously published CHT questionnaire (a youth version derived from Temperament Evaluation in Memphis Pisa and San Diego (TEMPS) was assessed in a school-based sample of 2959 students aged from 10 to 14 years (mean age = 11.8 ± 0.97 years). Furthermore, accuracy, sensitivity and specificity were calculated for a new cut-off score related to the presence of general psychopathology symptoms. RESULTS: CHT is better conceptualized in a two-correlated factors model, a moodiness/hypersensitiveness factor, more associated with internalizing symptoms, and an impulsiveness/emotional dysregulation factor, more associated with externalizing symptoms. The revised 22-items version of the CHT questionnaire with a cut-off score of 15 for females and 17 for males results accurate, sensitive and specific enough for the recognition of cyclothymic adolescents with clinical symptoms. LIMITATION: the cross sectional design and the self-report nature of the measures limit the findings. DISCUSSION: Cyclothymic-hypersensitive temperament is a relevant concept in the realm of affective disorder and can be reliably assessed in youths. It may describe youths with the coexistence of both internalizing and externalizing symptoms that can be difficult to diagnose with a DSM perspective.

Epidemiological pattern of bullying using a multi-assessment approach: Results from the Bullying and Youth Mental Health Naples Study (BYMHNS).

BACKGROUND: Bullying is a widespread phenomenon that has captured attention from mental health researchers. Several studies have assessed bullying prevalence with some methodological concerns. OBJECTIVES: Preliminary, we analyzed the psychometric properties of two bullying scales for victimization (the multidimensional peer victimization scale - MPVS) and for perpetration (the bully subscale of the Illinois bully scale - IBS-B); then, we estimated bullying prevalence; finally, we evaluated the effect of gender and classroom on the phenomenon. PARTICIPANTS AND SETTING: 2959 students from the metropolitan city of Naples constituted the sample. METHODS: Data collection was obtained using a multi-assessment approach that included both single-item questions and intensity scales in order to compare the two methods. RESULTS: The two scales resulted valid and showed good reliability. The MPVS displayed a 1-factor second order model. The IBS-B had a mono-factorial structure. Both showed full invariance for gender and classroom. Prevalence of victimization was 37% whereas that for perpetration was 21%. As expected we obtained several bullying prevalence results depending on the specificity of questions and in particular repetitiveness of episodes. There was a good correspondence between results of single-item questions and multi-item scales. Finally results demonstrated several differences for gender and classroom attended. CONCLUSION: In this epidemiological study the multi-assessment approach identified different but complementary features of bullying phenomena. The use of the two measurement approaches allowed us to obtain more precise and exhaustive information on bullying prevalence and compare it with previous findings.