Temporal course and structural relationships among dimensions of temperament and DSM-IV anxiety and mood disorder constructs.

The temporal stability and directional relations among dimensions of temperament (e.g., neuroticism) and selected Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) disorder constructs (depression, generalized anxiety disorder, social phobia) were examined in 606 outpatients with anxiety and mood disorders, assessed on 3 occasions over a 2-year period. Neuroticism/behavioral inhibition (N/BI) and behavioral activation/positive affect (BA/P) accounted for the cross-sectional covariance of the DSM-IV constructs. Although N/BI evidenced the most change of the constructs examined, initial levels of N/BI predicted less improvement in 2 of the 3 disorder constructs. Unlike the DSM-IV disorder constructs, the temporal stability of N/BI increased as a function of initial severity. Moreover, N/BI explained all the temporal covariation of the DSM-IV disorder constructs. The results are discussed in regard to conceptual models of temperament that define N/BI and BA/P as higher order dimensions accounting for the course and covariation of emotional disorder psychopathology.