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Book Forum: MOOD DISORDERS   |    
Mood and Temperament
JOHN C. MARKOWITZ, M.D.
Am J Psychiatry 2001;158:507-508. doi:10.1176/appi.ajp.158.3.507
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New York, N.Y.

By David Watson. New York, Guilford Publications, 2000, 340 pp., $40.00.

Funny how we ignore what surrounds us. Just as the "clinician’s illusion" leads us to recall our sickest patients as the norm (1), psychiatric training encourages a reflex conceptualization of mood within a pathological context. David Watson, a psychology professor, writes about the ubiquitous affect we often forget: normal, euthymic mood.

Mood and Temperament requires clinicians to rethink moods as brief, not lingering, and positive, with only intermittent negativity, in an ongoing, undulating "stream of affect." Neither money (beyond subsistence level), marriage, children, education, nor social status correlates with self-reported happiness—a highly subjective construct—although religion apparently elevates. Objective factors matter less than an individual’s emotional "set point" of expectations and social comparisons. Women suffer more mood and anxiety disorders than men, but in general populations there are few differences between the sexes in mood. People—at least the students Watson has long studied—feel mildly good until some upsetting event briefly evokes negative affect. Is that how you feel?

Watson establishes constructs of positive and negative affect comprising more specific emotions such as joviality, self-assurance, fear, sadness, guilt, and hostility. Life events tend to have quotidian severity—student examinations, not deaths—and "depression" is an affective dimension comparable to anger, not a syndrome. In Watson’s quasibiopsychosocial model, temperament and mood interact with environment, endogenous and sociocultural rhythms, and individual variability. Temperament dominates, however. Life seems reducible to positive and negative affect, a one-note (or two-note) symphony.

Regarding life events, Watson debunks the idea that weather affects mood, dismisses as illusory the perceptions of night owls (some people feel most serene at night but not at their peak positive affect) and "blue" Mondays, but finds evidence for "Sunday blahs." He finds affect stable over years, situations (solitary versus social), stress levels, and social roles. (But is it dispositional stability or systematic subjective bias if subjects self-report consistent moods?)

Reviewing five-factor (neuroticism, extraversion, openness to experience, agreeableness, conscientiousness) personality models like the NEO Personality Inventory, Watson links four of the five factors to affect. Individual differences in negative and positive affectivity are the central cores of neuroticism and extraversion and provide the unifying "glue" that forms these "higher-order dispositions" (p. 203). He considers whether the relationship between affect and personality is instrumental (e.g., extraverted behaviors yield good events and good moods) or temperamental (negative affect produces introverted behavior). His welter of correlations, however, cannot unscramble this chicken-or-egg question. Would that Watson had transcended dichotomous correlations, since the interaction of instrumental and temperamental factors presumably is complex.

The glaucomatous scope of the lone chapter on psychopathology may indicate the distance between normative psychology and psychiatry. This text on mood omits DSM definitions of mood disorders. Concentrating on his pet negative and positive affect models, Watson argues for merging DSM diagnoses, oblivious to treatment differences among major depression, generalized anxiety disorder, and borderline personality disorder. Despite its jacket blurb trumpeting a "comprehensive framework" for understanding mood, this book contains little physiology, neuroanatomy, or psychopathology. An inadequate, unbiological discussion of diurnal and premenstrual mood cycles cites mostly 1970s and 1980s references. Although mentioning "hormonal secretions" in passing (p. 122), Watson depends on subjective self-assessment. He discusses serenity but not serotonin, neuroticism but not norepinephrine.

The book hangs, for better and worse, on Watson’s two decades of normative data. He has researched on campus productively but largely limits himself to that corpus, from the campus. Deeming the life events literature unwieldy to summarize (p. 63), for example, he emphasizes his own data, reliant on self-reported mood ratings of (euthymic) psychology students, exhaustively describing several studies where one would suffice. He insufficiently discusses the generalizability and limits of convenience samples and self-assessment data. The psychiatric reader may hanker for greater breadth.

Watson belabors academic disputes of doubtful general interest, including hair-splitting mood classifications. In a book heavy in intercorrelations of affects and graphs of their temporal shifts, Watson often seems to write for competing research colleagues. Alternatively, the reader can imagine himself or herself a student in Watson’s undergraduate class, sitting through impersonal, theoretical, lengthy, and often repetitive lectures, delivered in a clear but monotonic first-person narrative under Watson’s intrusive "I." This may provoke negative affect.

Cohen P, Cohen J: The clinician’s illusion. Arch Gen Psychiatry 1984; 41:1178–  1182
 
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References

Cohen P, Cohen J: The clinician’s illusion. Arch Gen Psychiatry 1984; 41:1178–  1182
 
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