Child Personality and Temperament Types
I cannot provide a direct answer from Lewis and Dulcan's Child and Adolescent Psychiatry textbook, as the evidence provided does not contain content specifically from that source. However, I can describe the established dimensional framework for child temperament and personality based on the available research evidence.
Core Temperament Dimensions in Children
The most widely accepted dimensional model identifies five broadband personality dimensions that capture individual differences in children and adolescents: extraversion, emotional stability, agreeableness, conscientiousness, and openness/intellect 1.
Primary Temperament Constructs
Research has identified three fundamental temperament characteristics that emerge in early childhood and predict subsequent psychopathology:
- Reactivity (Emotionality/Neuroticism): Reflects the child's emotional responsiveness and intensity of reactions to environmental stimuli 2, 3
- Approach-Sociability: Captures the child's tendency to engage with novel situations and social interactions 3
- Persistence (Effortful Control): Represents the child's ability to regulate attention, inhibit impulses, and maintain goal-directed behavior 2, 3
Two-Factor Model of Childhood Psychopathology
Analysis of dimensional models for childhood psychopathology reveals two common broadband factors:
- Internalizing: Encompasses anxiety, depression, and withdrawal behaviors 1
- Externalizing: Includes aggressive, oppositional, and hyperactive-impulsive behaviors 1
Clinical Significance of Temperament Types
High-Risk Temperament Profile
Vulnerability to child psychopathology is determined by a temperament characterized by high levels of emotionality/neuroticism combined with low levels of effortful control 2. This combination creates risk through both reactive (high emotional intensity) and regulative (poor self-control) pathways.
Differential Predictions by Temperament Type
The temperament characteristics show distinct predictive patterns for specific disorders:
- High Reactivity: Uniquely predicts elevated symptom trajectories across all major domains—depression, anxiety, conduct disorder, and ADHD 3
- High Approach-Sociability: Predicts higher trajectories of conduct disorder and ADHD, but paradoxically predicts lower trajectories of anxiety 3
- High Persistence: Associated with lower trajectories of conduct disorder and ADHD 3
Developmental Considerations
Temperament Assessment Challenges in Young Children
Caution must be taken before applying adult diagnostic constructs to preschool children, as interpretation of temperamental difficulties versus psychiatric disorders is particularly challenging in this age group 4. The American Academy of Child and Adolescent Psychiatry emphasizes that highly volatile and reactive toddlers require assessment and intervention, but whether such youths have specific psychiatric disorders has not been established 4.
Temperament as Precursor to Personality Disorders
Temperamental traits that emerge early in childhood have predictive utility for later personality pathology 1, 5. The American Academy of Child and Adolescent Psychiatry notes that dysthymic, cyclothymic, or hyperthymic (irritable, driven) temperaments may presage eventual bipolar disorder 4.
Integration of Adaptive and Maladaptive Traits
A common dimensional model integrates both adaptive personality traits and maladaptive psychopathology dimensions, recognizing that temperament and personality exist on a continuum rather than as discrete categories 1. This dimensional conceptualization allows clinicians to:
- Identify early risk factors for psychopathology development 3
- Target interventions toward specific temperamental vulnerabilities 2
- Understand gene-environment interplay in developmental trajectories 5
Clinical Pitfall to Avoid
Do not confuse stable temperamental characteristics with acute psychiatric symptoms. For example, the American Academy of Child and Adolescent Psychiatry warns that premorbid psychiatric problems are common in early-onset bipolar disorder, especially difficulties with disruptive behavior disorders, irritability, and behavioral dyscontrol 4. However, temperamental difficulties must be distinguished from episodic mood disorders through careful longitudinal assessment 4.