Normative scores and clinical cut-offs of the Cyclothymic-Hypersensitive Temperament Questionnaire in adolescence

The Cyclothymic-Hypersensitive Temperament (CHT) is a multidimensional, transdiagnostic affective disposition characterized by mood instability, interpersonal sensitivity, heightened emotional reactivity and impulsive behaviors. The CHT Questionnaire (CHTQ) currently lacks of normative references and empirically derived thresholds.

Study 1 established age- and sex-adjusted normative scores and derived percentiles, tolerance limits, and Equivalent Score (ES)-based risk categories. Study 2 tested the clinical relevance of these norms in 196 adolescents with bipolar spectrum disorders and propensity score-matched controls, examining group differences, ES-based risk distributions, and disorder-specific thresholds.

In Study 1, regression analyses showed a significant age-by-sex interaction for Total and subscale scores. Age was positively associated with Total in females (R ² = 0.029) and negatively in males (R ² = 0.009). The same pattern emerged for Impulsiveness/Emotional Dysregulation (IED; females: R ² = 0.029; males: ns) and Moodiness/Hypersensitivity (MHS; R ² = 0.017 both sexes), supporting age- and sex-specific norms. Normative values and ES-based classifications enhanced score interpretability. Moderate- and high-risk thresholds were 15.32 and 17.24 for Total, 6.67 and 7.70 for IED, 9.80 and 10.87 for MHS. In Study 2, bipolar adolescents showed higher adjusted Total and IED than controls (Total: t = -3.33, p < 0.001, d = 0.34; IED: t = -4.42, p < 0.001, d = 0.45), with no MHS differences. Logistic regression showed Total (odds ratio [OR] = 1.08, p = 0.001) and IED (OR = 1.20, p < 0.001), but not MHS, predicted bipolar status. Receiver Operating Characteristic (ROC) analyses showed modest discrimination for Total (Area Under the Curve [AUC] = 0.61; cut-off = 13.50) and IED (AUC = 0.63; cut-off = 4.78), and chance-level performance for MHS.

Integrating age- and sex-adjusted norms with risk categories and clinical thresholds, the CHTQ may support developmentally informed early risk stratification and longitudinal monitoring.