title: The impact of ADHD and autism spectrum disorders on temperament, character, and personality development.
abstract: 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.
authors.affiliation: Malmö University Hospital, Forensic Psychiatric Clinic, Sege Park 8A, S-205 02 Malmö, Sweden. henrik.anckarsater@skane.se
authors.forename: Henrik
authors.initials: H
authors.lastname: Anckarsäter
authors.forename: Ola
authors.initials: O
authors.lastname: Stahlberg
authors.forename: Tomas
authors.initials: T
authors.lastname: Larson
authors.forename: Catrin
authors.initials: C
authors.lastname: Hakansson
authors.forename: Sig-Britt
authors.initials: SB
authors.lastname: Jutblad
authors.forename: Lena
authors.initials: L
authors.lastname: Niklasson
authors.forename: Agneta
authors.initials: A
authors.lastname: Nydén
authors.forename: Elisabet
authors.initials: E
authors.lastname: Wentz
authors.forename: Stefan
authors.initials: S
authors.lastname: Westergren
authors.forename: C Robert
authors.initials: CR
authors.lastname: Cloninger
authors.forename: Christopher
authors.initials: C
authors.lastname: Gillberg
authors.forename: Maria
authors.initials: M
authors.lastname: Rastam
mesh_terms: 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