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Personality and temperament

What is personality and temperament in bipolar disorder?

Personality and temperament are inter-related and are thought to be relatively stable over time. Temperament is a basic inherited style and refers to aspects like emotions, sensitivity, introversion, and extraversion, while personality refers to characteristics like behaviours, feelings, and thoughts.

One of the main personality/temperament models is the Five-Factor Model which includes five traits of; 1) neuroticism: vulnerability to emotional instability and self-consciousness, 2) extraversion: predisposition towards sociability, assertiveness, and social interaction, 3) openness: cognitive disposition to new experiences, creativity, and aesthetics, 4) agreeableness: tendency towards being sympathetic, trusting, and altruistic, and 5) conscientiousness: tendency towards dutifulness and competence.

Impulsivity was originally thought to be part of the extraversion construct but is now viewed as a separate personality construct. It involves a predisposition towards unplanned reactions to internal or external stimuli, without regard to the consequences. Impulsivity is a major feature in a variety of psychiatric disorders.

What is the evidence for personality and temperament?

Compared to controls

Moderate to high quality evidence finds large increases in harm avoidance, highs and lows, depression, irritability, and anxiousness, and large decreases in self-directedness and excessive positive mood in people with bipolar disorder. There were medium-sized increases in self-transcendence and medium-sized decreases in cooperativeness and excessive positive mood. There were small increases in novelty seeking and small decreases in reward dependence.

Medium-sized increases were found in impulsivity on tasks assessing response inhibition, delayed gratification, attention, decision making, and risk-taking in people with bipolar disorder. During remission of the disorder, increased impulsivity was found in non-planning, motor, and general cognitive domains.

In first-degree relatives of people with bipolar disorder, there were large effects of more highs and lows, irritability, and anxiousness, and medium-sized effects of more harm avoidance and less self-directedness than in controls.

Compared to first-degree relatives

Moderate to high quality evidence suggests large effects of more harm avoidance, highs and lows, irritability, and anxiousness, and less self-directedness in people with bipolar disorder than in first-degree relatives. There were also medium-sized effects of less cooperativeness, and more novelty seeking and self-transcendence in people with bipolar disorder.

Compared to bipolar disorder II

Moderate to high quality evidence suggests a small effect of more depression in people with bipolar disorder I.

Compared to other psychiatric illnesses

Moderate to high quality evidence suggests medium-sized effects of more novelty seeking, highs and lows, irritability, and excessive positive mood in people with bipolar disorder than in people with major depression. There was also more self-transcendence, more rumination on positive mood states, and less harm avoidance in people with bipolar disorder.

Compared to people with borderline personality disorder, moderate quality evidence suggests large effects of less depression, irritability, and anxiousness, and a medium-sized effect of more excessive positive mood in people with bipolar disorder.

February 2022

Image: ©Marek Uliasz – stock.adobe.com

Last updated at: 6:04 pm, 16th February 2022
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Fact Sheet Technical Commentary
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