The impact of ADHD and autism spectrum disorders on temperament, character, and personality development.
OBJECTIVE
The authors describe personality development and disorders in relation to symptoms of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders.


METHODS
Consecutive adults referred for neuropsychiatric investigation (N=240) were assessed for current and lifetime ADHD and autism spectrum disorders and completed the Temperament and Character Inventory. In a subgroup of subjects (N=174), presence of axis II personality disorders was also assessed with the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II).


RESULTS
Patients with ADHD reported high novelty seeking and high harm avoidance. Patients with autism spectrum disorders reported low novelty seeking, low reward dependence, and high harm avoidance. Character scores (self-directedness and cooperativeness) were extremely low among subjects with neuropsychiatric disorders, indicating a high overall prevalence of personality disorders, which was confirmed with the SCID-II. Cluster B personality disorders were more common in subjects with ADHD, while cluster A and C disorders were more common in those with autism spectrum disorders. The overlap between DSM-IV personality disorder categories was high, and they seem less clinically useful in this context.


CONCLUSIONS
ADHD and autism spectrum disorders are associated with specific temperament configurations and an increased risk of personality disorders and deficits in character maturation.
Anckarsäter
Henrik
H
Malmö University Hospital, Forensic Psychiatric Clinic, Sege Park 8A, S-205 02 Malmö, Sweden. henrik.anckarsater@skane.se
Stahlberg
Ola
O
Larson
Tomas
T
Hakansson
Catrin
C
Jutblad
Sig-Britt
SB
Niklasson
Lena
L
Nydén
Agneta
A
Wentz
Elisabet
E
Westergren
Stefan
S
Cloninger
C Robert
CR
Gillberg
Christopher
C
Rastam
Maria
M
D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D001321:Autistic Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D002605:Character; D015331:Cohort Studies; D015897:Comorbidity; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005106:Exploratory Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010553:Personality Development; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D010555:Personality Inventory / Q000706:statistics & numerical data*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D013694:Temperament