gms | German Medical Science

GMS Psycho-Social-Medicine

Corporate journal of German scientific societies in psychosocial medicine

ISSN 1860-5214

Temperament and personality: the German version of the Adult Temperament Questionnaire (ATQ)

Temperament und Persönlichkeit: die deutsche Version des Erwachsenen-Temperament-Fragebogens (ATQ)

Research Article Special issue: Diagnostic instruments

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  • corresponding author Jörg Wiltink - Klinik für Psychosomatische Medizin und Psychotherapie, Johannes-Gutenberg-Universität Mainz, Mainz, Germany
  • Ute Vogelsang - Klinik für Psychosomatische Medizin und Psychotherapie, Johannes-Gutenberg-Universität Mainz, Mainz, Germany
  • Manfred E. Beutel - Klinik für Psychosomatische Medizin und Psychotherapie, Johannes-Gutenberg-Universität Mainz, Mainz, Germany

GMS Psychosoc Med 2006;3:Doc10

The electronic version of this article is the complete one and can be found online at:

Published: December 11, 2006

© 2006 Wiltink et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


The psychobiological orientation inherent in temperament concepts permits a close tie between temperament and the rapidly proliferating research areas of neurosciences and behavioural genetics. Based on developmental and psychobiological studies, the Adult Temperament Questionnaire (ATQ) by Rothbart measures self-regulatory processes in addition to constitutionally based individual reactivity. The purpose of this paper is to validate a German version of the short form of the ATQ with 77 items. 213 psychosomatic inpatients and outpatients and 116 control subjects took part in this study. The study included standardized measures of personality and symptoms. The German version reliably measures the four dimensions negative affect, extraversion, orienting sensitivity and effortful control; subscales were moderately correlated. We found a consistent pattern of correlation to personality (NEO-FFI) and interpersonal problems (IIP), negative affect strongly correlated with neuroticism; effortful control correlated with conscientiousness, orienting sensitivity with openness, and extraversion correlated with the corresponding scale of the NEO-FFI. According to our hypothesis, negative affect was positively correlated with higher distress and physical complaints, while effortful control was negatively correlated with them. When negative affect and effortful control were combined, effortful control had a moderating effect on distress. Clinical and non-clinical samples differed significantly on all dimensions; the ATQ appears to be suitable for differentiating subgroups of patients according to self-regulation.

Keywords: temperament, personality, Adult Temperament Questionnaire, validation


Die psychobiologische Orientierung von Temperamentkonzepten ermöglicht enge Verbindungen zu sich rasch entwickelnden Forschungsbereichen der Neurowissenschaften und Verhaltensgenetik. Auf der Grundlage von entwicklungs- und psychobiologischen Studien erfasst der Erwachsenen-Temperament-Fragebogen (ATQ) von Rothbart selbstregulatorische Prozesse zusätzlich zu konstitutioneller individueller Reaktivität. Ziel der Arbeit ist, die deutsche Version der Kurzform des ATQ mit 77 Items zu validieren. 213 ambulante und stationäre psychosomatische Patienten und 116 Vergleichspersonen nahmen an der Studie teil. Eingeschlossen wurden standardisierte Fragebögen zur Persönlichkeit, interpersonellen Beziehungen, körperlichen und psychischen Beschwerden. Die deutsche Version des ATQ erfasste die vier Dimensionen Negative Affektivität, Extraversion, Sensitivität für Reize und Willentliche Kontrolle zuverlässig; diese waren mäßig korreliert. Konsistente Muster von Korrelationen bestanden zu Persönlichkeit (NEO-FFI) und interpersonellen Problemen (IIP): Negative Affektivität korrelierte stark mit Neurotizismus, Willentliche Kontrolle mit Gewissenhaftigkeit, Sensitivität gegenüber Reizen mit Offenheit und Extraversion mit der gleichnamigen Skala des NEO-FFI. Entsprechend unserer Hypothesen fand sich ein positiver Zusammenhang zwischen Distress und körperlichen Beschwerden zu negativer Affektivität, und negative Korrelationen zu willentlicher Kontrolle. In Kombination mit negativer Affektivität hatte willentliche Kontrolle einen moderierenden Effekt auf Distress. Klinische und nichtklinische Stichproben unterschieden sich deutlich auf allen Dimensionen; die Ergebnisse legen eine Differenzierung von Subgruppen definierter Patientenkollektive nach selbstregulativen Fähigkeiten nahe.

Schlüsselwörter: Temperament, Persönlichkeit, Erwachsenen-Temperament-Fragebogen, Validierung


Temperament describes comprehensive, emotional and behavioral dispositions that are largely regarded to be biologically anchored and stable. Together with aspects of socialization, these dispositions ultimately contribute to personality, behavior, and even psychological disorders. The Greek-Roman typology describing characteristics of temperament in relation to bodily liquids and their proportions when mixed has had an enduring influence, above all on psychopathological developmental concepts [1].

The current renaissance of temperament concepts is likely linked to their psychobiological orientation that suggests connections to the rapidly proliferating research areas of behavioral genetics, neurosciences and developmental psychobiology. The observation of differential susceptibility to conditioning [2] underlies the concept of introversion and extraversion [3]. Accordingly, introverted individuals were more easily excitable and consequently preferred lower stimulation than extroverted whose cortices were less prone to excitement, thus leading them to prefer higher levels of stimulation. Gray defined personality in terms of three different systems of reactivity in relation to stimulus constellations [4]: (1) The Behavioral Inhibition System (BIS) comprises a network of the hippocampus, subiculum, septum and related structures. It reacts to conditioned stimuli for punishment or non-reward, to the unknown and to anxiety-provoking stimuli. Ongoing behavior is inhibited and attention to external stimulus is heightened. This system underlies negative affect, anxiety, sadness, and frustration. (2) The Behavioral Approach System (BAS) is based on the interplay between (basolateral, centromedial) central regions of the amygdala, the hypothalamus (ventromedial), the central gray matter and central somatic and motor regions of the brain stem. The BAS reacts to stimuli for reward and non-punishment. Behavior for approaching a goal is increased. It forms the foundation for positive affects (joy, enjoyment, satisfaction). (3) The less well differentiated fight-flight system is activated by unconditioned, aversive or threatening stimuli and triggers fight or flight behavior [5], [6]. It is assumed that the innate interplay of these systems is responsible for inter-individual differences in temperament [7].

In their model, Cloninger et al. define temperament as automatic and stable emotional reactions that are determined in part by genetic disposition [8]. Character, in contrast, covers self-concepts, goals, values, intentions, and meanings in life that are consciously accessible and influence intentions and attitudes. Cloninger associates implicit learning processes with temperament (conveyed through the limbic system and basal ganglia) and explicit learning, on the other hand, with character mediated through structures of the neocortex or hippocampus. The Temperament and Character Inventory (TCI) is increasingly implemented in clinical groups to measure temperament characteristics (e.g. personality disorders; [9]). The inventory includes four temperament scales (novelty seeking, harm avoidance, reward dependence, persistence) and three character scales (self-directedness, cooperativeness, self-transcendence). However, with 240 items, the questionnaire is very time-consuming; the distinction between temperament and character, explicit and implicit information processing, and their association with the brain structures mentioned above are not always clear.

Far-reaching consensus has been reached over the past years for the lexically and factor-analytically derived five-factor model for describing personality. In addition to the higher-order factors neuroticism and extraversion [3], it contains the dimensions conscientiousness, openness and agreeableness. McCrae et al. have recently described these higher-order personality characteristics along the lines of temperament as “endogenous dispositions that follow intrinsic paths of development essentially independent of environmental influences” [10]. They account for these initially surprising conclusions as follows: “Studies on heritability, limited parental influence, structural invariance across cultures and species, and temporal stability all point to the notion that personality traits are more expressions of human biology than products of life experience.” (p. 177). More recent studies on gene typing of defined collectives have shown, consistent with studies on twins and adopted children, that up to 50% of the variance in broadly defined personality traits (“The Big Five”) and temperament traits [8] are influenced by genetic features [11].

Rothbart and Bates ([12], p. 109) define temperament in an integrative concept as “constitutionally based individual differences in emotional, motor, and attentional reactivity and self-regulation”. Temperament is regarded as the result of biological evolution, as affective, motivational systems that are activated under circumstances of newness, sudden or intense stimulation or danger. In addition to the concept of reactivity to stimulation underlying most temperament models (characterized by features such as start, duration, and intensity of affective reactions, differences in excitability or tendency to over-stimulation) Posner and Rothbart add the ability of self-regulation which helps modulate the reactivity [13]. This concept is founded above all on studies in developmental psychology and developmental biology and emanates from the domains of affects, activation and attention. With their Adult Temperament Questionnaire, ATQ, Rothbart’s work group has presented a questionnaire that measures the temperament traits of negative affect, extraversion, orienting sensitivity, and effortful control [14]:

Negative affect measures heightened sensitivity to a broad spectrum of negative stimuli; thus persons with heightened negative affect experience a broad span of negative affects such as fear, anxiety and sadness, depression and aggravation, and frustration [15]. Effortful control measures the ability to focus attention and shift to desired channels. This makes it possible, for instance, to perform an act even in the presence of strong avoidance tendencies. Extraversion/surgency measures sociability, pleasure from social interaction, enjoyment of intense stimulation, and positive emotionality. Orienting sensitivity (also called “cognitive sensitivity”) measures the ability to be conscious of a neutral or emotional stimulation of low intensity from the surroundings, or a spontaneous idea not directly related to an association with the surrounding environment.

In neurobiological terms, the temperament concept [14] is based on the work of Gray [4], Posner [13] and Panksepp [16]. Accordingly, the authors regard the behavior-inhibition system [4] and the rage-anger system as underlying negative affect. Extraversion is based on the approach system [4] which is oriented to reward, active, seeks stimulation and is linked to positive affect. The dimension orienting sensitivity is based on Posner’s theory of the posterior attention network [13]. This network serves to “orient” or focus attention on relevant places and serves to register new things. Structures involved here are the upper parietal lobe (effortful direction of attention) and the transition to the temporal cortex that enables attention to be pulled away from former objects (e.g. contra-lateral neglect after lesions). Even if the interplay is not yet fully understood, the colliculus superior (mid brain), thalamus (pulvinar) and frontal areas of the visual cortex coordinate the shift in attention and its attachment to a new object. The frontal attention network underlies effortful control. This aids in selecting competing or conflicting information or recognizing errors. The operative structures are the front part of the cingulate gyrus (anterior cingulate, AC), which is an interface between the cortex and limbic system, parts of the dorsolateral prefrontal cortex (working memory) and the basal ganglia.

Rothbart et al. [14] emphasize that the underlying psychobiological systems are not mature at birth, and therefore their development is influenced throughout maturity and by experience. For instance, a series of studies have shown that the maturity of attention functions takes place in well-defined stages. Thus, between the ages of 4-6 months an infant develops the ability to turn away its gaze and devote its attention to a new object. This also enables the inhibition of distress through distraction. At 12 months, the small child develops the ability to resolve conflicts between simultaneously active reaction tendencies, e.g. to reach beyond the field of vision. At 30 months it is able to solve spatial conflict tasks, and at 39-41 months it can actively inhibit reactions (“go/no-go tasks”). The performance on the tasks mentioned correlates with the corresponding parental assessment of the child’s temperament, ability to delay reward and extent of brain structures (e.g. the volume of the right anterior cingulate).

The validity of the ATQ was supported by correlations with the NEO-FFI. The authors assumed [14], [17] that fundamental temperament traits underlie global personality traits, as measured by the NEO-FFI. Hypotheses about the connections between the scales of the ATQ and the NEO-FFI were verified in college students. Thus effortful control can be regarded as an attention trait that underlies conscientiousness, while orienting sensitivity underlies openness. The inclination to distress is viewed as a central feature of neuroticism and a reward and incentive system as a core feature of extraversion.

The authors of the test showed that negative affect and effortful control are negatively correlated in children. They interpret this as possible evidence that better effortful control makes it possible to regulate negative affects. An initial clinical study on the Adult Temperament Questionnaire (ATQ) shows that patients with borderline personality disorders with high negative affect and low effortful control (compared to healthy controls) also have deficits in cognitive control (so-called attention network test). As predicted, there existed a negative correlation between effortful control and conflict resolution on the Attention Network Test [18], [19], [20], [21]. We found – albeit in a small sample – that obese patients with a binge eating disorder differed from those without binge eating in terms of higher negative affect and poorer cognitive control [22].

As the method appears promising for clinical application and has yet to be translated into German, this study presents the validation of a German version of the short form ATQ based on non-clinical and clinical samples, implementing standardized self-rating measures of personality, social relationships, psychological and physical complaints. We began with three hypotheses: (1) The pattern of correlation between the scales of the ATQ and the NEO-FFI reported by the authors of the test can be replicated in a healthy comparative sample and patients with psychological and psychosomatic disorders; (2) patients experiencing greater distress from symptoms also have higher negative affect; (3) patients differ substantially from controls in terms of higher negative affect and lower effortful control; (4) effortful control moderates the connection between negative affect and distress.


Study participants

213 patients took part in the study (172 psychosomatic outpatients, 41 psychosomatic inpatients). The average age of the primarily female patients (69.5%) was 37.9 years (18-82 years). 41.8% were married, 43.2% single; 15% divorced, separated or widowed. 40.1% were employed full time, 18.9% part time; 7.1% were unemployed; altogether 34% were not employed (undergoing training, housewives, retired). The diagnoses included primarily affective disorders (ICD-10: F32-34), followed by adaptive disorders (F43: 26.8%); anxiety disorders (F41: 12.2%), somatoform (F45: 11.7%) and phobic disorders (F40: 5.6%). 15% had a personality disorder in addition.

The study included 116 comparative persons, predominantly (N=66) medical students and their relatives. At N=78 (67.2%), the proportion of women corresponded to that of the patient sample. The average age was 31.7 years (18-62 years).

Measurement procedures

The Adult Temperament Questionnaire (ATQ)

The short form of the ATQ with 77 items was translated into German and then independently translated back into English. Minor discrepancies between the two versions were discussed extensively and corrections were undertaken collaboratively by the two translators. The four scales, each containing 15 to 26 items, are comprised of 3 to 4 subscales each (see Table 1 [Tab. 1] and Table 2 [Tab. 2]). The questions were presented as 7-scale Likert items with responses ranging from “not at all applicable” to “completely applicable”. Mainly students and their relatives were recruited as the comparative sample. Since we were additionally interested in appropriateness for clinical groups, the questionnaire was also administered to 213 patients currently undergoing inpatient and outpatient psychosomatic-psychotherapeutic treatment.

Additional questionnaires

Due to the postulated congruence with the five-factor model of personality [4], we performed a validation using the NEO-FFI [23], the German version of the NEO Five-Factor Inventory by Costa and McCrae which was filled out by all study participants. The questionnaire method uses a factor analytic construct to provide a reliable measure of the underlying personality dimensions (“Big Five”) neuroticism (e.g. nervous, anxious, sad, insecure), extraversion (sociable, active, talkative, jovial), openness for new experiences (curious, creative, imaginative), agreeableness (altruistic, compassionate, understanding) and conscientiousness (orderly, reliable, punctual, ambitious). The following questionnaires were only administered to patients: The Symptom Check List (SCL-90-R; [24]) is a standard instrument for measuring subjective impairment from psychological and physical symptoms, with 90 items on nine subscales (see Table 3 [Tab. 3]). The global score (GSI) is a reliable measure of the current symptoms [25]. The Giessen Complaint List (GBB-24; [26]) is at present the best studied, age and sex-normed questionnaire in German for measuring general physical complaints [27]. The German version of the Inventory of Interpersonal Problems (IIP-D; [28]) measures self-perceived difficulties with other persons. It includes desired patterns difficult to achieve when dealing with other persons (“I find it hard to trust other people”) and undesired patterns that individuals do “too often” (“I fight too much with others”). 64 items are grouped on 8 scales (8 items each): autocratic-dominant, quarrelsome-competitive, distant-cold, introverted-socially avoiding, insecure-submissive, exploitable-compliant, nurturing-friendly, expressive-importunate (see Table 3 [Tab. 3]).


We carried out the analysis using SPSS (version 10.0) with the usual parametric (AN(C)OVA, Pearson correlation) and non-parametric procedures. In order to test the influence of effortful control on the connection between negative affect and psychological distress, patients were divided according to the median split into groups of high or low negative affect and high or low effortful control. Sumscores of psychological, physical, and interpersonal distress were compared between the groups by analysis of variance.


Internal consistency and correlations of the Adult Temperament Questionnaire (ATQ)

Table 1 [Tab. 1] shows the items of the short form ATQ and their scales and subscales. Table 2 [Tab. 2] shows the scales and subscales along with definitions of the scales and example items. The internal consistency of our sample was compared with the scores reported by the authors of the test.

As the table shows, the scales were reliable. Cronbach alpha of the entire sample was between .72 and .84 and as such was good, comparable with the results of the authors of the test. Only the reliability of orienting sensitivity was somewhat lower than that found by the test authors. With regard to internal consistency, no systematic differences occurred between patients and students, therefore they are presented together.

Table 3 [Tab. 3] shows the inter-correlations of the subscales of the ATQ and correlations with the NEO-FFI, the SCL-90R, GBB and IIP.

As the table shows, the inter-correlations of the scales were moderately high. Negative affect (NA) had a negative correlation to the same extent with effortful control as with extraversion; there was low correlation with orienting sensitivity. Significant but low correlation was found between effortful control (EC) and extraversion (ES) as well as between extraversion and orienting sensitivity (OS); orienting sensitivity and effortful control showed no correlation

In accordance with the findings of Rothbart et al. [14], negative affect correlated most strongly with neuroticism; there was also low negative correlation with extraversion, conscientiousness, and agreeableness. Effortful control (EC) had the strongest positive correlation with conscientiousness, followed by agreeableness and extraversion; there was a negative connection with neuroticism. Extraversion correlated most strongly with extraversion (NEO-FFI), less with openness; there was also a significant negative correlation with neuroticism. Orienting sensitivity correlated highly positively with openness and had a lower positive correlation with extraversion.

Negative affect was accompanied by high symptom pressure (GSI) and physical complaints (GBB); effortful control, in contrast, correlated negatively and highly significantly with all complaints measured. We found similar outcomes for extraversion (with the exception of gastric complaints). Orienting sensitivity did not correlate with complaints.

Interpersonal problems were reported equally as frequently with increased negative affect. This occurred above all in insecure and introverted, socially avoiding demeanor with overall distress from interpersonal difficulties; few had an autocratic and quarrelsome demeanor. Effortful control accompanied a nurturing and minimally exploitable demeanor and overall low level of interpersonal problems. Increased extraversion expressed itself with few overall problems, through greater expression, autocratic-dominant demeanor, and little introverted-avoiding, insecure or distant demeanor. Orienting sensitivity was accompanied by increased caring and expression, little social avoidance or quarrelsomeness.

In addition, the following factors influencing the scores on the four scales were tested: patient status, sex, age.

Figure 1 (a-d) [Fig. 1] shows the influence of patient status and sex on the scores for the four subscales. Two-factorial analyses of variances were performed for sex and group status (patients vs. controls). Age was controlled as covariate; the means shown are age-corrected. As the figure shows, the patients had highly significant greater negative affect and lower effortful control and extraversion, also a tendency to reduced orienting sensitivity. Women reported significantly higher scores of negative affect and a tendency for greater orienting sensitivity as compared to men.

Relationship between distress, negative affect and effortful control

Starting from the hypothesis that effortful control moderates the connection between negative affect and distress, patients were divided along the median split into high and low negative affect and effortful control. We performed analyses of variances followed by a Scheffé test. The results (see Figure 2 [Fig. 2]) showed that effortful control exerts a moderating effect: patients who complained most about distress had high negative affect and low effortful control, followed by high negative affect and high effortful control. Patients with lower distress had low negative affect but low effortful control. Patients with the lowest distress reported high effortful control and low negative affect. This was true for the psychological distress GSI (SCL-90R), physical complaints (GBB), and interpersonal problems (IIP).


The Adult Temperament Questionnaire (ATQ) represents a promising, reliable, and valid questionnaire in German language that differentiates the four dimensions of temperament (“negative affect”, “effortful control”, “extraversion” and “orienting sensitivity”). The original four scales of the ATQ were replicated in the German translation.

The fact that a consistent pattern was found of correlations to personality traits and interpersonal problems speaks for the validity of the scales. Congruent to the findings of the test authors [14], negative affect corresponded most highly with neuroticism (NEO-FFI); we also found negative, low correlations to extraversion, conscientiousness, and agreeableness. Effortful control (EC) correlated most strongly positively with conscientiousness, followed by agreeableness and extraversion; a negative connection existed with neuroticism. Extraversion correlated most strongly with the corresponding scale on the NEO-FFI, less with openness; we also found a significant negative correlation to neuroticism. Orienting sensitivity correlated highly positively with openness; positively but low with extraversion (NEO-FFI).

In accordance with our hypothesis, negative affect accompanied high distress (GSI) and physical complaints (GBB); effortful control, on the other hand, was correlated highly significantly negative with all complaints measured. We found comparable outcomes for extraversion (with the exception of gastric complaints). No correlation existed between orienting sensitivity and complaints.

Negative affect accompanied interpersonal problems (IIP), above all an insecure and introverted demeanor but reduced autocratic and quarrelsome bearing. Effortful control occurred with few interpersonal problems, a caring and little exploitable demeanor. Increased extraversion expressed itself in few overall problems, higher expressivity, autocratic demeanor, but low interest, insecure or distant demeanor. Orienting sensitivity occurred with increased caring, expressivity, low interest and little quarrelsomeness.

As postulated, the most distinct correlations existed in our sample between negative affect and the two dimensions effortful control and extraversion. The other scales were largely independent of each other. A higher negative affect in women as compared to men might correspond to a generally higher rating by women of their symptoms. As expected, the scale scores of patients for negative affect were distinctly higher than those of the comparative group; their effortful control, on the other hand, was distinctly lower. This is in accord with the first clinical findings in borderline personality disorders [18], [19], [20], [21] and our findings in patients with obesity with psychological comorbidity [22].

When we combined negative affect and effortful control, we found, congruent to our hypothesis, effortful control to have a moderating effect: Patients with the greatest distress had high negative affect and low effortful control, followed by high negative affect and high effortful control. Patients with low distress scores had lower negative affect, but lower effortful control. Patients reporting the lowest distress had high effortful control and low negative affect. This was true for psychological distress GSI (SCL-90R), physical complaints (GBB) and interpersonal problems (IIP). These findings speak for the validity of the model which aims to measure both reactive and regulative dimensions of temperament.

The traits of the "Big Five" have frequently been criticized because they lack a dynamic perspective [29]. Temperament concepts describe functional models of differential reactivity and responsiveness to internal and external stimuli. Individual differences in the reaction of basal psychobiological functions, for instance appetitive (BAS) or defensive systems (e.g. BIS) are linked to physiological systems and functions (neural networks, transmitter systems, etc.). These concepts are augmented in the temperament model presented here by self-regulative systems tied to attention functions that are well characterized in the neuro-sciences. Thus, effortful control, for instance, possesses the ability to inhibit prepotent positive (extraversion) and negative (negative affect) reactions and execute sub-dominant reaction tendencies, while orienting sensitivity facilitates perception of peripheral stimuli that have emotional relevance. Therefore, reactive and effortful features of attention processes can be related dynamically to the activation or suppression of positive and negative emotionality. Numerous examples in the scientific literature also speak for the negative correlation between negative affect and effortful control, as has been shown, for instance, in the STROOP test for emotions where negative semantic information can impair executive processes; attention disorders have been described as disturbances of anxiety disorders and depression [15].

In the present cross-sectional study, attention functions were not measured independently in the psychological screening. Due to the heterogeneity of the sample, specific subgroups (e.g. borderline personality disorders) cannot be reliably separated. Nevertheless, our findings on the interaction between effortful control and negative affect suggest that future, prospective studies – analogue to Posner et al. [18], [19], [20], [21] – could more clearly characterize subgroups in the Adult Temperament Questionnaire along diagnostic categories reflecting self-regulative functions and potential prognostic factors.


Conflicts of interest: none declared.

Acknowledgement: We express our gratitude to Professor Mary Rothbart and Dr. David Evans, University of Oregon, for providing us with the original version of the ATQ and for their helpful comments on previous versions of this paper.


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