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• Re: Personality of young adults born preterm
  Dieter Wolke
  Published on: 22 March 2016
• Personality of young adults born preterm
  Gorm Greisen
  Published on: 22 March 2016

• Published on: 22 March 2016

  Re: Personality of young adults born preterm

  • Dieter Wolke
  • Other Contributors:
    • Peter Bartmann

  The correspondence by Greisen & Hansen (...) draws attention to their well conducted controlled study of the personality of very preterm born (VPT) adults in two cohorts in Denmark 1. Their study found like ours 2 higher neuroticism, lower extraversion but also higher agreeableness in adults born preterm compared to those born at term. They concluded in their paper that "overall, our study corroborates the picture of...

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  The correspondence by Greisen & Hansen (...) draws attention to their well conducted controlled study of the personality of very preterm born (VPT) adults in two cohorts in Denmark 1. Their study found like ours 2 higher neuroticism, lower extraversion but also higher agreeableness in adults born preterm compared to those born at term. They concluded in their paper that "overall, our study corroborates the picture of VPT individuals being less extraverted with increased neuroticism as adults and this finding seems remarkably consistent in the literature" 1, p. 7). We agree.

  However, the effect sizes of differences in individual personality traits were somewhat smaller than those found in our study. Greisen and Hansen emphasise that the effects sizes were smaller than the typical effect on IQ as a general measure of brain injury in very preterm infants. Again, we can agree as the effect sizes of differences in personality that we reported 2 are about half as large as those found by us in IQ between VPT and term controls 3. Indeed, we reported that IQ differences could not explain the differences in personality in adulthood between the groups 2. Thus, despite the remarkable consistency of findings and their pattern, what can explain differences in effect sizes? We rule out that it can be explained by the fact that our study was led by two psychologists, two statisticians and one neonatologist while most were neonatologists in the Danish study, respectively. Rather, across different outcomes whether IQ, personality or quality of life, the Danish studies indicate smaller differences between VPT and term controls than our whole population study in Bavaria or other studies in the UK. We may speculate that "Danes are smug" 4 with findings that over the last decades they are the happiest nation. They have lower income inequality, their rates of social exclusion in school such as bullying are lower 5 (a factor we found to impact on VPTs wellbeing in Germany and the UK 6) and they may thus do a better job of integrating VPT. Alternatively or additionally, we know from the Bavarian Longitudinal Study that high intensive respiratory care, i.e. ventilation, was more or less universally applied to all VPT in the mid 1980s, while many neonatal units in Denmark maintained a "Scandinavian model" of less invasive treatment with nasal CPAP treatment and "minimal handling "7. This has been shown to lead to less respiratory problems, likely less brain damage and better outcomes 8. Systematic comparisons of findings across countries are important to detect universal versus country or treatment specific effects of prematurity on long term outcome.

  Dieter Wolke Department of Psychology and Warwick Medical School Mental Health and Wellbeing Unit, University of Warwick, Coventry

  Peter Bartmann Department of Neonatology, University of Bonn Children's Hospital, Bonn

  1. Hertz CL, Mathiasen R, Hansen BM, et al. Personality in Adults Who Were Born Very Preterm. PLoS One 2013;8(6):e66881. 2. Eryigit-Madzwamuse S, Strauss V, Baumann N, et al. Personality of adults who were born very preterm. Archives of Disease in Childhood - Fetal and Neonatal Edition 2015. 3. Eryigit Madzwamuse S, Baumann N, Jaekel J, et al. Neuro-cognitive performance of very preterm or very low birth weight adults at 26 years. Journal of Child Psychology and Psychiatry 2015;56(8):857-64. 4. Christensen K, Herskind AM, Vaupel JW. Why Danes are smug: comparative study of life satisfaction in the European Union. BMJ : British Medical Journal 2006;333(7582):1289-91. 5. Elgar FJ, Craig W, Boyce W, et al. Income Inequality and School Bullying: Multilevel Study of Adolescents in 37 Countries. The Journal of adolescent health : official publication of the Society for Adolescent Medicine 2009;45(4):351-59. 6. Wolke D, Baumann N, Strauss V, et al. Bullying of Preterm Children and Emotional Problems at School Age: Cross-Culturally Invariant Effects. The Journal of Pediatrics (http://dx.doi.org/10.1016/j.jpeds.2015.02.055). 7. Verder H. Nasal CPAP has become an indispensable part of the primary treatment of newborns with respiratory distress syndrome. Acta P?diatrica 2007;96(4):482-84. 8. Wolke D. The preterm responses to the environment - long term effects? In: Cockburn F, ed. Advances in perinatal medicine. Carnforth: Parthenon Publishing, 1997:305-14.

  Conflict of Interest:

  None declared

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  Conflict of Interest:
  None declared.

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• Published on: 22 March 2016

  Personality of young adults born preterm

  • Gorm Greisen, Professor
  • Other Contributors:
    • Bo M?lholm Hansen

  We read with interest the article by Eryigit-Madzwamuse et al (1) on the personality of young adults who were born preterm. We would like to draw the attention of the journal's readers to our recent work in the same field (2) with some important similarities and some interesting differences.

  We also studied approximately 200 cases and 200 controls and also assessed the 'big five' personality traits (neuroticism...

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  We read with interest the article by Eryigit-Madzwamuse et al (1) on the personality of young adults who were born preterm. We would like to draw the attention of the journal's readers to our recent work in the same field (2) with some important similarities and some interesting differences.

  We also studied approximately 200 cases and 200 controls and also assessed the 'big five' personality traits (neuroticism, extraversion, agreeableness, openness, and conscientiousness). Our cases were more preterm at birth (28 vs. 30 weeks), and in spite of this, the estimates of effect sizes expressed as population standard deviation (Cohen's d) were smaller for neuroticism (0.28 vs. 0.54) and for extraversion (0.30 vs. 0.45) while the effect size was similar for agreeableness (0.25 vs. 0.24).

  These differences may have led to a very different focus of the discussion section in the two articles. Eryigit-Madzwamuse et al used factor analysis (including a scale on autistic features) to build a concept of a 'socially withdrawn personality' and propose bullying in school as a link between the early neurodevelopmental impairments to the abnormalities of adult personality. We, on the other side, concluded that the effect sizes were smaller than the typical effect on IQ as a general measure of brain injury in very preterm infants. Also, the increased agreeableness could be the result of upbringing by adults appreciating the small miracle of survival. The increased agreeableness could help explain that the deficits in education, income, and family-building are surprisingly small (3).

  Were the differences in effect size due to differences in Bavarian and Danish culture as regards upbringing of children? Or was the difference in focus rather a question of seeing the glass as half empty or half full? Did it come from the fact that the authors were mainly psychologists or neonatologists, respectively?

  Yours, sincerely

  Gorm Greisen Department of Neonatology, Rigshospitalet, Copenhagen Denmark

  Bo M?lholm Hansen Department of Paediatrics, Herlev Hospital, Copenhagen, Denmark

  References 1. Eryigit-Madzwamuse S, Strauss V, Baumann N, Bartmann, Wolke D. Personality in adults who were born very preterm. Arch Dis Child Fetal Neonatal Ed 2015;100:F524-529. 2. Hertz CL, Mathiasen R, Hansen BM, Mortensen EL, Greisen G. Personality in Adults Who Were Born Very Preterm. PLoS ONE 2013; 8(6): e66881. doi:10.1371/journal.pone.0066881 3. Mathiasen R, Nybo-Andersen AM, Hansen BM, Greisen G. Social integration at the age of 30 years of individuals born before 33 weeks of gestation. Acta Paediatrica, 2007;120:96: 85.

  Conflict of Interest:

  None declared

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  Conflict of Interest:
  None declared.

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