Dominant Affective Temperaments and its variance among people with depression, bipolar disorder, and a non-clinical sample: Validation of the Affective Temperament Questionnaire (ATQ)

Julieta Martins Azevedo, Diogo Carreiras, Paula Castilho, Joana Rodrigues, António Macedo


Affective temperaments are frequently described as a biologically determined early emerging variation in emotional reactivity, with solid temporal stability. We aimed to analyse affective temperament variation and dominance while adapting and translating the Affective Temperament Questionnaire (ATQ) to European Portuguese in both clinical (Major Depressive Disorder – MDD and Bipolar Disorder – BD) and non-clinical samples. ATQ was administered to 42 subjects with MDD, 64 with BD and 411 non-clinical. A 3-factor model CFA was performed (comprising hyperthymic, cyclothymic and dysthymic temperaments), revealing good adjustment and acceptable internal consistency levels. ATQ subscales showed a general higher internal consistency in people with mood disorders. Support for convergent validity was found. BD and MDD presented higher prevalence in Cyclothymic and Dysthymic temperaments than non-clinical, although they did not differ significantly between them regarding the last one. Findings suggest ATQ is a valid and reliable self-report measure to assess affective temperaments in the Portuguese population and proved to be acceptable for either clinical or non-clinical samples. This measure can be applied to detect early vulnerability to affective disorders, which can be very helpful in clinical settings and primary care.


Affective temperament, ATQ, Bipolar disorder, Major depressive disorder, Confirmatory factor analysis, Psychometric properties.

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Akiskal, H. S. (1992). Delineating irritable and hyperthymic variants of the cyclothymic temperament. Journal of Affective Disorders, 6, 326-342.

Akiskal, H. S. (2000). Dysthymia, cyclothymia and related chronic subthreshold mood disorders. In M. Gelder, J. Lopez-Ibor, & N. Andreasen (Eds.), New Oxford textbook of psychiatry (pp. 736-749). Oxford University Press.

Akiskal, H. S. (2001). Dysthymia and cyclothymia in psychiatric practice a century after Kraepelin. Journal of Affective Disorders, 62, 17-31.

Akiskal, H. S., & Akiskal, K. K. (2005). TEMPS: Temperament evaluation of Memphis, Pisa, Paris and San Diego. Journal of Affective Disorders, 85, 1-2.

Akiskal, H. S., & Akiskal, K. K. (2007). In search of Aristotle: Temperament, human nature, melancholia, creativity and eminence. Journal of Affective Disorders, 100, 1-6.

Akiskal, H. S., Hantouche, E. G., & Allilaire, J. F. (2003). Bipolar II with and without cyclothymic temperament: “dark” and “sunny” expressions of soft bipolarity. Journal of Affective Disorders, 73, 49-57.

Akiskal, H. S., & Mallya, G. (1987). Criteria for the “soft” bipolar spectrum: Treatment implications. Psychopharmacology Bulletin, 23(1), 68-73.

Akiskal, H. S., Mendlowicz, M. V., Jean-Louis, G., Rapaport, M. H., Kelsoe, J. R., Gillin, J. C., & Smith, T. L. (2005). TEMPS-A: Validation of a short version of a self-rated instrument designed to measure variations in temperament. Journal of Affective Disorders, 85(1-2), 45-52.

Akiskal, H. S., & Pinto, O. (2000). The soft bipolar spectrum: Footnotes to Kraepelin on the interface of hypomania, temperament and depression. In A. Marneros & J. Angst (Eds.), Bipolar disorders (pp. 37-62). Springer. https:/

Akiskal, H. S., Placidi, G. F., Maremmani, I., Signoretta, S., Liguori, A., Gervasi, R., Mallya, G., & Puzantian, V. R. (1998). TEMPS-I: Delineating the most discriminant traits of the cyclothymic, depressive, hyperthymic and irritable temperaments in a nonpatient population. Journal of Affective Disorders, 51, 7-19.

Akiskal, K. K., & Akiskal, H. S. (2005). The theoretical underpinnings of affective temperaments: Implications for evolutionary foundations of bipolar disorder and human nature. Journal of Affective Disorders, 85, 231-239.

Altman, E., Hedeker, D., Peterson, J., & Davis, J. (1997). The Altman Self-Rating Mania Scale. Biological Psychiatry, 42, 948-955.

Arbuckle, J. (2015). IBM SPSS and AMOS 22 User Guide. IBM.

Azevedo, J., Martins, J., Carvalho, C., Pereira, A. T., Macedo, A., & Castilho, P. (2020). The clinical interview for bipolar disorder. Coimbra.

Byrne, B. M. (2010). Structural equation modeling with Amos: Basic concepts, applications, and programming (2nd ed.). Taylor and Francis Group.

Boateng, G. O., Neilands, T. B., Frongillo, E. A., Melgar-Quiñonez, H. R., & Young, S. L. (2018). Best practices for developing and validating scales for health, social, and behavioral research: A primer. Frontiers in Public Health, 6, 1-18.

Cassano, G. B., Rucci, P., Frank, E., Fagiolini, A., Dell’Osso, L., Shear, M. K., & Kupfer, D. J. (2004). The mood spectrum in unipolar and bipolar disorder: Arguments for a unitary approach. The American Journal of Psychiatry, 161, 1264-1269.

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates, Publishers.

Figueira, M. L., Caeiro, L., Ferro, A., Severino, L., Duarte, P. M., Abreu, M., Akiskal, H. S., & Akiskal, K. K. (2008). Validation of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A): Portuguese-Lisbon version. Journal of Affective Disorders.

Galinha, I. C., & Pais-Ribeiro, J. (2005). Contribuição para o estudo da versão portuguesa da Positive and Negative Affect Schedule (PANAS): II – Estudo psicométrico. Análise Psicológica, 23, 219-227.

Gonda, X., Vázquez, G. H., Akiskal, K. K., & Akiskal, H. S. (2011). From putative genes to temperament and culture: Cultural characteristics of the distribution of dominant affective temperaments in national studies. Journal of Affective Disorders, 131, 45-51.

Greenwood, T. A. (2020). Creativity and bipolar disorder: A shared genetic vulnerability. Annual Review of Clinical Psychology, 16, 239-264.

Hair, J. F., Anderson, R. E., Tatham, R. L., & Black, W. C. (2010). Multivariate data analysis with readings (4th ed.). Prentice Hall.

Hantouche, E. G., Allilaire, J. F., & Akiska, H. S. (2002). Construct validity of affective temperament questionnaire: Data from the National French Study “EPIDEP”. European Psychiatry, 17, 108s-108s.

Harnic, D., Pompili, M., Mazza, M., Innamorati, M., Di Nicola, M., Catalano, V., Bruschi, A., Del Bono, D., Forte, A., Lester, D., Girardi, P., Bria, P., & Janiri, L. (2013). Affective temperaments and psychopathological dimensions of personality in bipolar and cyclothymic patients. Behavioral Medicine, 39, 17-23.

Iliceto, P., Pompili, M., Lester, D., Gonda, X., Niolu, C., Girardi, N., Rihmer, Z., Candilera, G., & Girardi, P. (2011). Relationship between temperament, depression, anxiety, and hopelessness in adolescents: A structural equation model. Depression Research and Treatment, 160175.

Innamorati, M., Rihmer, Z., Akiskal, H., Gonda, X., Erbuto, D., Murri, M. B., Perugi, G., Amore, M., Girardi, P., & Pompili, M. (2015). Cyclothymic temperament rather than polarity is associated with hopelessness and suicidality in hospitalized patients with mood disorders. Journal of Affective Disorders, 170, 161-165.

Joyce, P. R., Light, K. J., Rowe, S. L., Cloninger, C. R., & Kennedy, M. A. (2010). Self-mutilation and suicide attempts: Relationships to bipolar disorder, borderline personality disorder, temperament and character. Australian & New Zealand Journal of Psychiatry, 44(3), 250-257.

Kraepelin, E. (1921). Manic-depressive insanity and paranoia. E&S Levingstone.

Light, K. J., Joyce, P. R., & Frampton, C. M. A. (2009). Description and validation of the Affective Temperament Questionnaire. Comprehensive Psychiatry, 50, 477-484.

Mendlowicz, M. V., Akiskal, H. S., Kelsoe, J. R., Rapaport, M. H., Jean-Louis, G., & Gillin, J. C. (2005). Temperament in the clinical differentiation of depressed bipolar and unipolar major depressive patients. Journal of Affective Disorders, 84, 219-223.

Mitchell, P. B., & Malhi, G. S. (2004). Bipolar depression: phenomenological overview and clinical characteristics. Bipolar Disorders, 6, 530-539.

Morvan, Y., Tibaoui, F., Bourdel, M. C., Lôo, H., Akiskal, K. K., Akiskal, H. S., & Krebs, M. O. (2011). Confirmation of the factorial structure of temperamental autoquestionnaire TEMPS-A in non-clinical young adults and relation to current state of anxiety, depression and to schizotypal traits. Journal of Affective Disorders, 131(1-3), 37-44.

Pais-Ribeiro, J., Silva, I., Ferreira, T., Martins, A., Meneses, R., & Baltar, M. (2007). Validation study of a Portuguese version of the Hospital Anxiety and Depression Scale. Psychology, Health & Medicine, 12, 225-237.

Palagini, L., Miniati, M., Caruso, D., Massa, L., Novi, M., Pardini, F., Salarpi, G., Pini, S., Marazziti, D., Etain, B., & Riemann, D. (2020). Association between affective temperaments and mood features in bipolar disorder II: The role of insomnia and chronobiological rhythms desynchronization. Journal of Affective Disorders, 266, 263-272.

Perugi, G., Hantouche, E., Vannucchi, G., & Pinto, O. (2015). Cyclothymia reloaded: A reappraisal of the most misconceived affective disorder. Journal of Affective Disorders, 183, 119-133.

Peterson, R. A. (1994). A meta-analysis of cronbach’s alpha. Journal of Consumer Research, 21, 381-391.

Pini, S., Cassano, G. B., Simonini, E., Savino, M., Russo, A., & Montgomery, S. A. (1997). Prevalence of anxiety disorders comorbidity in bipolar depression, unipolar depression and dysthymia. Journal of Affective Disorders, 42(2-3), 145-153.

Placidi, G. F., Dell’Osso, L., & Akiskal, H. S. (1993). Recurrent mood disorders: New perspective in therapy (1st ed.). Springer-Verlag.

Pompili, M., Baldessarini, R. J., Inammorati, M., Vázquez, G. H., Rihmer, Z., Gonda, X., Forte, A., Lamis, D. A., Erbuto, D., Serafini, G., Fiorillo, A., Amore, M., & Girardi, P. (2018). Temperaments in psychotic and major affective disorders. Journal of Affective Disorders, 225, 195-200.

Pompili, M., Pennica, A., Serafini, G., Battuello, M., Innamorati, M., Teti, E., Girardi, N., Amore, M., Lamis, D. A., Aceti, A., & Girardi, P. (2013). Depression and affective temperaments are associated with poor health-related quality of life in patients with HIV infection. Journal of Psychiatric Practice, 19, 109-117.

Pompili, M., Rihmer, Z., Innamorati, M., Lester, D., Girardi, P., & Tatarelli, R. (2009). Assessment and treatment of suicide risk in bipolar disorders. Expert Review of Neurotherapeutics, 9, 109-136.

Rettew, D., & McKee, L. (2005). Temperament and its role in developmental psychopathology. Harvard Review of Psychiatry, 13, 14-27.

Rihmer, Z., Akiskal, K. K., Rihmer, A., & Akiskal, H. S. (2010). Current research on affective temperaments. Current Opinion in Psychiatry, 23, 12-18.

Rodrigues, J., Azevedo, J., & Castilho, P. (2018). Uncovering affective temperaments: Validation Study of the ATQ in a Portuguese non-clinical sample [Dissertação de Mestrado, Faculdade de Psicologia e de Ciências da Educação, Universidade de Coimbra]. Repositório Científico da Universidade de Coimbra.

Sajatovic, M., Chen, P., & Young, R. C. (2015). Rating scales in bipolar disorder. In Mauricio Tohen, Charles L. Bowden, Andrew A. Nierenberg, & John R. Geddes (Eds.), Clinical trial design challenges in mood disorders (pp. 105-136). Elsevier Inc.

Shansis, F., Berlim, M. T., Mattevi, B., Maldonado, G., Izquierdo, I., & Fleck, M. (2003). Desenvolvimento da versão em português da Escala Administrada pelo Clínico para Avaliação de Mania (EACA-M): “Escala de Mania de Altman”. Revista de Psiquiatria do Rio Grande do Sul, 25, 412-424.

Shingala, M. C., & Rajyaguru, A. (2015). Comparison of post hoc tests for unequal variance. International Journal of New Technologies in Science and Engineering, 2(5), 22-33.

Sousa, V. D., & Rojjanasrirat, W. (2011). Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: A clear and user-friendly guideline. Journal of Evaluation in Clinical Practice, 17, 268-274.

Stevens, J. (2002). Applied multivariate statistics for the social sciences (4th ed.). Lawrence Erlbaum Associates.

Upton, G., & Cook, I. (2008). A dictionary of statistics. Oxford University Press.

Vázquez, G. H., & Gonda, X. (2013). Affective temperaments and mood disorders: A review of current knowledge. Current Psychiatry Reviews, 9, 21-32.

Vázquez, G. H., Tondo, L., Mazzarini, L., & Gonda, X. (2012). Affective temperaments in general population: A review and combined analysis from national studies. Journal of Affective Disorders, 139(1), 18-22.

Walsh, M. A., Brown, L. H., Barrantes-Vidal, N., & Kwapil, T. R. (2013). The expression of affective temperaments in daily life. Journal of Affective Disorders, 145, 179-186.

Walsh, M. A., Royal, A. M., Barrantes-Vidal, N., & Kwapil, T. R. (2012). The association of affective temperaments with impairment and psychopathology in a young adult sample. Journal of Affective Disorders, 141, 373-381.

Watson, D., Clark, L., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063-1070.

Zigmond, A. S., & Snaith, P. R. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361-370.



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