Can Marijuana Make It Better? Prospective Effects of Marijuana and Temperament on Risk for Anxiety and Depression

Supplement

Supplemental Analyses with Marijuana Use Quantity

The main analyses reported in the text were conducted with marijuana use frequency, quantified as number of days marijuana was reported to have been used within the past 30 days on the

Time-Line Follow Back (TLFB; Sobell & Sobell, 1992). When a participant reported using marijuana, we also asked them to indicate the quantity of marijuana used. Because there are so many different ways to consume marijuana (e.g., joints, vaporizers, edibles), and because participants may differ in their accuracy in recalling quantity consumed, we use frequency in our main analyses. However, we repeated all analyses with marijuana use quantity. Two measures were used: total grams used over the past 30 days and average grams used on days used (total grams over past 30 days divided by total days of use).

The analyses with marijuana quantity revealed the same conclusions are the analyses reported in the main text. Results of those analyses are reported here. Table S1 shows correlations between the two marijuana use quantity measures and temperament, anxiety, and depression. Table S2 shows the full cross-lag regression models for total grams used in past 30 days. Table S3 shows the full cross-lag regression models for average grams on days used.

Separability of Harm Avoidance, Anxiety, and Depression

Prior to analyses reported in the main text, we conducted exploratory factor analysis to verify that harm avoidance (HA), anxiety, and depression were dissociable constructs. Although there are theoretical reasons to expect HA to be related to anxiety and depression (Hansenne et al., 1998; Jiang et al., 2003; Matsudaira et al., 2006; Manfredi et al., 2011), they are theoretically dissociable. HA is viewed as a stable aspect of temperament, whereas the anxiety and depression symptoms are meant to reflect more transient, clinically-significant, affective symptoms. In line with this characterization, the measures themselves focus on different time periods: HA is measured with items that ask participants how they usually or generally act and feel whereas the measures of anxiety and depression symptoms ask what participants have experienced in the past 6 months. Consistent with these assumed temporal stability differences, there was less change over the one-year measurement period in HA than anxiety and depression. The average change for temperament was 2.4% for HA whereas average change for anxiety was 7.2% and for depression it was 14.2%. Nevertheless, there is conceptual overlap between HA and anxiety and depression. In order to empirically assess the presumed theoretical differences between them, we conducted two separate factor analyses, with one including all HA and anxiety items and the second all HA and depression items.

For HA and anxiety, factor analysis with varimax rotation revealed 8 factors with eigenvalues greater than 1 that together accounted for 60% of the variance in responses. The full factor loadings are shown in Table S4. Critically, all anxiety items loaded most heavily on a single factor (factor 3). Only 2 of the 33 total HA items loaded most highly on this anxiety factor (“Usually I am more worried than most people that something might go wrong in the future” and “I never worry about terrible things that might happen in the future”). The remaining HA items were spread over the other 7 factors. Some of the HA subscales loaded very cleanly onto a single factor (e.g., items for HA subscale 3, which measures shyness with strangers, all loaded most highly on factor 1). For other HA subscales, individual items loaded on different factors.

The factor analysis for HA and depression revealed 10 factors with eigenvalues greater than 1, together accounting for 62% of the variance. The full factor loadings are shown in Table S5. Depression items were spread over 5 factors. The largest number of depression items loaded most heavily on factor

5, with 6 very canonical depression items loading most heavily on this factor (e.g., items about crying, feeling worthless, having little enjoyment, being depressed). Of importance, there were no HA items that loaded most heavily on this factor with the depression items. Three depression items dealing with sleep and energy loaded together on another factor; some HA items also dealing with energy loaded most heavily on this factor as well. The remaining depression items loaded most heavily on factors that either had no loadings from HA items, or only 1 HA item.

One notable finding across the two factors analyses is the large number of factors with eigenvalues greater than one. We attribute this to the large number of items included when considering all HA and anxiety, or HA and depression items. We note that HA subscales did not always load onto a common subscale factor. However, we had no expectations that different aspects of HA would differentially relate to anxiety and depression. We were consequently not interested in the HA subscales and instead focused only on the overall HA score, which had high reliability (α = .93). More importantly, the factor analyses clearly support the conceptual separability between HA and anxiety and between HA and depression items. As noted, the evidence for this separation is particularly clear for HA and anxiety: all anxiety items load most strongly onto a single factor and only 2 of 33 HA items load most strongly on this factor. For depression, many very face valid depression items loaded most strongly on a single factor, and no HA items load most strongly on this factor. Based on these empirical considerations, as well as theoretical considerations (that temperament reflects stable trait characteristics whereas anxiety and depression measure more transient states) and measurement issues (the temperament scales ask about how one feels in general and the anxiety and depression items focus on the past 6 months), we treat HA, anxiety, and depression as distinct in our analyses. References

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Burlington, VT: University of Vermont, Research Center for Children, Youth, and Families.

Cloninger, C.R., Svrakic, D.M., & Przybeck, T.R. (1993). A psychobiological model of temperament and character. Archives of General Psychiatry, 50(12), 975-990.

Hansenne, M., Pitchot, W., Gonzalez Moreno, A., Machurot, P., & Ansseau, M. (1998). The tridimensional personality questionnaire (TPQ) and depression. European Psychiatry, 13(2), 101-103.

Jiang, N., Sato, T., Hara, T., Takedomi, Y., Ozaki, I., & Yamada, S. (2003). Correlations between trait anxiety, personality and fatigue: Study based on the Temperament and Character Inventory.

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Manfredi, C., Caselli, G., Rovetto, F., Rebecchi, D., Ruggiero, G.M., Sassaroli, S., & Spada, M.M.

(2011). Temperament and parental styles as predictors of ruminative brooding and worry. Personality and Individual Differences, 50(2), 186-191.

Matsudaira, T., & Kitamura, T. (2006). Personality traits as risk factors of depression and anxiety among Japanese students. Journal of Clinical Psychology, 62(1), 97-109.

Sobell, L. C., & Sobell, M. B. (1992). Timeline Follow-back: A technique for assessing self- reported ethanol consumption. In J. Allen & R. Z. Litten (Eds.), Measuring Alcohol Consumption:

Psychosocial and Biological Methods (pp. 41-72). Totowa, NJ: Humana Press. Table S1. Correlations of Marijuana Use Quantity with Temperament, Anxiety, and Depression.

Average Total Grams on Grams Days Used Harm Avoidance -0.02 0.02 Novelty Seeking 0.36** 0.34** Reward Dependence 0.00 -0.02 Year 1 Anxiety 0.09 0.11* Year 1 Depression 0.10 0.14* Year 2 Anxiety 0.02 0.05 Year 2 Depression 0.05 0.09

Note. *p < .05, **p < .001. Table S2. Full Regression Models with Total Grams of Marijuana Used in Past 30 Days

Harm Avoidance HA and Anxiety HA and Depression Model 1: DV = Anxiety β t p Model 1: DV = Depression β t p Year 1 0.62 12.94 <0.001 0.58 11.23 <0.001 Anxiety Year 1 Depression Year 1 HA 0.06 1.20 0.23 Year 1 HA 0.09 1.71 0.09 Marijuana -0.04 -1.08 0.28 -0.01 -0.29 0.78 Use Qunatity Marijuana Use Quantity Gender -0.10 -2.35 0.02 Gender 0.00 0.08 0.94 HA X -0.15 -3.75 <0.001 -0.09 -2.13 0.03 Marijuana Use HA X Marijuana Use Marijuana -0.02 -0.47 0.64 -0.03 -0.74 0.46 Use x Gender Marijuana Use x Gender HA X Gender 0.00 -0.01 >0.99 HA X Gender 0.01 0.16 0.88 HA X -0.01 -0.20 0.84 0.06 1.25 0.21 Marijuana Use X Gender HA X Marijuana Use x Gender

Model 2: DV = HA β t p Model 2: DV = HA β t p Year 1 HA 0.76 19.00 <0.001 Year 1 HA 0.78 19.59 <0.001 Year 1 0.04 0.89 0.37 0.01 0.14 0.89 Anxiety Year 1 Depression Marijuana -0.06 -1.79 0.08 Marijuana Use Quantity -0.06 -1.50 0.14 Use Quantity Gender -0.05 -1.35 0.18 Gender -0.05 -1.51 0.13 Anxiety X -0.05 -1.43 0.15 0.00 -0.05 0.96 Marijuana Use Depression X Marijuana Use Marijuana -0.01 -0.22 0.83 -0.01 -0.34 0.74 Use x Gender Marijuana Use x Gender Anxiety x -0.07 -2.18 0.03 -0.06 -1.70 0.09 Gender Depression X Gender Anxiety X -0.02 -0.69 0.49 0.03 0.84 0.40 Marijuana Use x Gender Depression X Marijuana Use X Gender Table S2, continued

Novelty Seeking NS and Anxiety NS and Depression Model 1: DV = Anxiety β t p Model 1: DV = Depression β t p Year 1 0.67 16.74 <0.001 0.65 14.90 <0.001 Anxiety Year 1 Depression Year 1 NS 0.02 0.51 0.61 Year 1 NS 0.04 0.83 0.41 Marijuana -0.16 -3.19 <0.01 -0.13 -2.48 0.01 Use Quantity Marijuana Use Quantity Gender -0.08 -1.85 0.07 Gender 0.04 0.78 0.43 NS X 0.19 4.06 <0.001 0.16 3.13 <0.01 Marijuana Use NS X Marijuana Use Marijuana 0.07 1.46 0.14 0.08 1.44 0.15 Use x Gender Marijuana Use x Gender NS X Gender -0.04 -0.91 0.36 NS X Gender -0.03 -0.73 0.47 NS X -0.07 -1.45 0.15 -0.12 -2.27 0.02 Marijuana Use X Gender NS X Marijuana Use x Gender

Model 2: DV = NS β t p Model 2: DV = NS β t p Year 1 NS 0.77 20.98 <0.001 Year 1 NS 0.76 20.95 <0.001 Year 1 0.06 1.70 0.09 0.06 1.71 0.09 Anxiety Year 1 Depression Marijuana 0.05 1.31 0.19 0.03 0.74 0.46 Use Quantity Marijuana Use Quantity Gender -0.05 -1.36 0.18 Gender -0.04 -1.06 0.29 Anxiety X -0.01 -0.16 0.87 -0.01 -0.12 0.90 Marijuana Use Depression X Marijuana Use Marijuana -0.03 -0.95 0.34 -0.02 -0.63 0.53 Use x Gender Marijuana Use x Gender Anxiety x -0.05 -1.59 0.11 -0.02 -0.65 0.51 Gender Depression X Gender Anxiety X 0.02 0.66 0.51 -0.03 -0.82 0.41 Marijuana Use x Gender Depression X Marijuana Use X Gender Table S2, continued

Reward Dependence RD and Anxiety RD and Depression Model 1: DV = Anxiety β t p Model 1: DV = Depression β t p Year 1 0.66 16.19 <0.001 0.63 14.49 <0.001 Anxiety Year 1 Depression Year 1 RD -0.05 -1.16 0.25 Year 1 RD -0.08 -1.91 0.06 Marijuana -0.04 -0.99 0.32 -0.02 -0.56 0.58 Use Quantity Marijuana Use Quantity Gender -0.12 -2.83 <0.01 Gender -0.02 -0.52 0.60 RD X -0.06 -1.50 0.14 -0.05 -1.10 0.27 Marijuana Use RD X Marijuana Use Marijuana 0.02 0.46 0.65 0.00 0.01 0.99 Use x Gender Marijuana Use x Gender RD X Gender -0.03 -0.65 0.52 RD X Gender -0.06 -1.39 0.17 RD X 0.04 0.88 0.38 0.06 1.34 0.18 Marijuana Use X Gender RD X Marijuana Use x Gender

Model 2: DV = RD β t p Model 2: DV = RD β t p Year 1 RD 0.76 22.76 <0.001 Year 1 RD 0.76 22.48 <0.001 Year 1 -0.02 -0.48 0.63 0.00 -0.03 0.98 Anxiety Year 1 Depression Marijuana 0.09 2.47 0.01 0.09 2.46 0.02 Use Quantity Marijuana Use Quantity Gender -0.13 -3.91 <0.001 Gender -0.14 -4.03 <0.001 Anxiety X -0.11 -3.31 <0.01 -0.02 -0.61 0.54 Marijuana Use Depression X Marijuana Use Marijuana -0.09 -2.54 0.01 -0.10 -2.55 0.01 Use x Gender Marijuana Use x Gender Anxiety x -0.01 -0.42 0.67 -0.02 -0.54 0.59 Gender Depression X Gender Anxiety X -0.03 -0.80 0.43 0.07 1.67 0.10 Marijuana Use x Gender Depression X Marijuana Use X Gender

Note. All regression coefficients are standardized. Table S3. Full Regression Models with Average Grams on Days Used

Harm Avoidance HA and Anxiety HA and Depression Model 1: DV = Model 1: DV = Anxiety t p Depression β t p 12.86 < 0.58 1 <0.001 0 1 . . 0 1 0 9 Year 1 Anxiety 1 Year 1 Depression -0.37 0 0.04 0 0.57 . . 7 5 Year 1 HA 2 Year 1 HA 7 -0.24 0 0.02 0 0.68 . . 8 Marijuana Use 4 Marijuana Use Quantity 1 Quantity 2 -2.40 0 -0.02 - 0.73 . 0 0 . 2 3 Gender Gender 4 -3.07 < -0.11 - 0.06 0 1 . . 0 HA X Marijuana 8 HA X Marijuana Use 1 Use 8 -0.59 0 -0.03 - 0.61 . 0 5 . 6 Marijuana Use x 5 Marijuana Use x Gender Gender 2 -0.30 0 0.05 0 0.39 . . 7 8 HA X Gender 6 HA X Gender 5 HA X Marijuana Use X Gender -0.36 0 HA X Marijuana 0.08 1 0.14 . . 7 5 2 Use x Gender 0

Model 2: DV = HA t p Model 2: DV = HA β t p 19.14 < 0.78 1 <0.001 0 9 . . 0 7 0 7 Year 1 HA 1 Year 1 HA 0.22 0 0.00 0 0.95 . . 8 0 Year 1 Anxiety 3 Year 1 Depression 6 -1.18 0 -0.04 - 0.30 . 1 2 . 4 Marijuana Use 0 Marijuana Use Quantity Quantity 3 -1.19 0 -0.06 - 0.17 . 1 2 . 4 3 Gender Gender 7 -1.38 0 0.00 - 0.93 . 0 1 . 7 Depression X 0 Anxiety X Marijuana Use Marijuana Use 9 -0.21 0 -0.01 - 0.76 . 0 8 . 4 Marijuana Use x 3 Marijuana Use x Gender Gender 1 -1.96 0 -0.03 - 0.46 . 0 0 . 5 Depression X 7 Anxiety x Gender Gender 4 -0.20 0 Depression X 0.05 0 0.33 . . 8 Marijuana Use X 9 Anxiety X Marijuana Use x Gender 4 Gender 8

Table S3, continued Novelty Seeking NS and Anxiety NS and Depression Model 1: DV = Model 1: DV = Anxiety t p Depression β t p 16.44 < 0.65 1 <0.001 0 4 . . 0 6 0 2 Year 1 Anxiety 1 Year 1 Depression 1.67 0 0.09 1 0.09 . . 1 7 Year 1 NS 0 Year 1 NS 2 -1.50 0 -0.06 - 0.25 . 1 1 . 4 Marijuana Use 1 Marijuana Use Quantity Quantity 6 -1.51 0 0.05 0 0.41 . . 1 8 Gender 3 Gender 3 3.10 < 0.13 2 0.01 0 . . 5 0 NS X Marijuana 2 NS X Marijuana Use 1 Use 0.48 0 0.05 0 0.36 . . 6 Marijuana Use x 9 Marijuana Use x Gender 3 Gender 2 -0.86 0 -0.07 - 0.17 . 1 3 . 9 3 NS X Gender NS X Gender 9 -0.63 0 -0.08 - 0.11 . 1 5 . 3 NS X Marijuana 6 NS X Marijuana Use X Gender Use x Gender 1

Model 2: DV = NS t p Model 2: DV = NS β t p 21.23 < 0.77 2 <0.001 0 1 . . 0 1 0 6 Year 1 NS 1 Year 1 NS 1.67 0 0.08 1 0.11 . . 1 6 Year 1 Anxiety 0 Year 1 Depression 0 0.95 0 0.03 0 0.45 . . 3 Marijuana Use 7 Marijuana Use Quantity 4 Quantity 6 -1.27 0 -0.03 - 0.49 . 0 2 . 1 6 Gender Gender 9 0.47 0 0.02 0 0.68 . . 6 Depression X 4 Anxiety X Marijuana Use 4 Marijuana Use 1 -0.20 0 0.01 0 0.78 . . 8 Marijuana Use x 2 Marijuana Use x Gender 4 Gender 8 -1.08 0 -0.03 - 0.59 . 0 2 . 8 Depression X 5 Anxiety x Gender Gender 4 0.87 0 0.00 - 0.97 . Depression X 0 3 . 9 Marijuana Use X 0 Anxiety X Marijuana Use x Gender Gender 4 Table S3, continued

Reward Dependence RD and Anxiety RD and Depression S i g Model 1: DV = Model 1: DV = Anxiety t . Depression β t Sig. 16.03 < 0.63 1 <0.001 0 4 . . 0 2 0 8 Year 1 Anxiety 1 Year 1 Depression -1.76 0 -0.13 - 0.02 . 2 0 . 8 3 Year 1 RD Year 1 RD 4 -0.47 0 0.00 - 0.92 . 0 6 . 4 Marijuana Use 1 Marijuana Use Quantity Quantity 0 -2.25 0 -0.01 - 0.81 . 0 0 . 3 2 Gender Gender 4 -1.50 0 -0.08 - 0.15 . 1 1 . 3 RD X Marijuana 4 RD X Marijuana Use Use 4 0.27 0 0.02 0 0.71 . . 7 Marijuana Use x 3 Marijuana Use x Gender 9 Gender 7 RD X Gender -0.01 0 RD X Gender -0.04 - 0.52 . 0 9 . 9 6 4 0.82 0 0.04 0 0.45 . . 4 RD X Marijuana 7 RD X Marijuana Use X Gender 1 Use x Gender 6

Model 2: DV = RD t p Model 2: DV = RD β t p 22.23 < 0.76 2 <0.001 0 2 . . 0 3 0 7 Year 1 RD 1 Year 1 RD -1.23 0 -0.01 - 0.86 . 0 2 . 2 1 Year 1 Anxiety Year 1 Depression 8 2.35 0 0.10 2 0.01 . . 0 Marijuana Use 7 Marijuana Use Quantity 2 Quantity 4 -4.19 < -0.20 - <0.001 0 4 . . 0 3 0 9 Gender 1 Gender -1.58 0 -0.01 - 0.86 . 0 1 . 1 Depression X 1 Anxiety X Marijuana Use Marijuana Use 8 -1.71 0 -0.09 - 0.06 . 1 0 . 9 Marijuana Use x 9 Marijuana Use x Gender Gender 2 -0.38 0 0.04 0 0.35 . . 7 Depression X 9 Anxiety x Gender 1 Gender 3 Anxiety X Marijuana Use x Gender -0.13 0 Depression X 0.10 2 0.04 . . 9 Marijuana Use X 0 0 Gender 8

Note. All regression coefficients are standardized. Table S4. Factor loadings from factor analysis of all harm avoidance and anxiety items.

Component

1 2 3 4 5 6 7 8

HA Subscale 1 (Anticipatory Worry) confident everything will go well (R) .106 .336 .206 .356 .044 .462 .074 -.383 worried about things going wrong .250 .488 .498 .229 .052 .188 .016 .119 get over embarrassment quickly (R) .314 .200 .265 .187 .108 .205 .429 -.070 relaxed and care-free (R) .078 .392 .293 .289 .019 .364 .130 -.319 stop what I'm doing because of worry .119 .713 .130 -.006 .068 .095 .212 .111 things go wrong unless I'm careful .077 .259 .202 -.044 .185 .233 .033 .632 stop what I'm doing because I'm worried .111 .696 .105 .061 .139 .179 .073 .286 I will have good luck (R) .106 .013 .044 -.063 .161 .780 -.052 .081 all will turn out well (R) .179 .307 .033 .145 .108 .658 .040 -.231 never worry about terrible things in the future (R) .119 .154 .573 .184 -.053 .237 .098 .059 usually have good luck (R) .031 .074 .101 .026 .065 .683 .184 .262

HA Subscale 2 (Fear of Uncertainty) tense and worried in unfamiliar situations .381 .572 .304 .160 .116 .103 -.024 -.101 more reserved and controlled than most (R) .080 .158 .169 .638 .020 .075 .229 -.219 tense and worried when others aren't .355 .585 .256 .205 .174 .029 .050 -.083 confident I can do things most others find dangerous (R) .077 .035 .027 .728 .034 .068 .103 -.130 tense and worried doing something new .311 .587 .191 .169 .197 .075 .161 -.083 prefer something risky (R) .149 .084 -.003 .814 .149 -.025 .009 .148 prefer risks over staying quiet and inactive (R) .194 .085 .051 .792 .214 .014 -.028 .103

HA Subscale 3 (Shyness with Strangers) avoid meeting strangers because I lack confidence .758 .268 .072 -.056 .162 .080 -.011 .035 more shy than most people .833 .187 .041 .078 .083 -.062 -.045 .048 confident and sure of myself in social situations (R) .622 .283 .055 .092 .123 .332 .137 -.017 not shy with strangers (R) .845 .054 .063 .063 .084 .066 .060 -.045 Table S4, continued.

relaxed and outgoing when meeting strangers (R) .721 .058 .026 .202 .073 .078 .162 -.012 stay away from social situations .643 .276 -.044 .118 .083 .032 -.178 .131 confident and relaxed meeting strangers (R) .587 .002 .191 .213 .054 .130 .359 -.098

HA Subscale 4 (Fatigability) less energy and get tired quickly .152 .210 .194 .061 .752 .068 .086 .095 more energetic and tire less quickly than others (R) .228 .023 .143 .275 .696 .162 .120 -.065 recover quickly from illness/stress (R) .045 .140 .140 .119 .143 .101 .774 -.052 usually confident and energetic than most (R) .310 .175 .063 .218 .435 .215 .406 -.146 tense, tired due to changes .172 .695 .174 .052 .095 .064 .179 -.001 often need naps or extra rest periods -.008 .149 .231 .136 .602 -.083 .172 .152 need extra rest, support, reassurance to recover from -.018 .337 .044 .024 .311 -.050 .656 .209 illness usually can stay "on the go" all day (R) .221 .123 -.025 .089 .671 .241 .064 .060

Anxiety worry about future .069 .084 .534 -.002 -.122 .364 .131 .158 afraid of certain animals, situations, or places .008 .112 .477 .221 .152 -.100 .074 -.099 nervous or tense .173 .301 .610 -.005 .268 .084 .071 -.105 too fearful or anxious .130 .445 .454 .004 .243 .039 .004 -.117 heart pounding or racing -.038 .196 .422 -.205 .410 -.039 .120 -.221 worry about my family -.076 .018 .650 -.052 .118 -.036 .019 .126 worry a lot .110 .416 .638 .040 .203 .088 .078 .040

Note. R indicates reserves scored item. All items are shortened and paraphrased. See Temperament and Character Inventory (Cloninger, Svrakic,

& Przybeck, 1993) and Achenbach System of Empirically Based Assessment Adult Self-report (Achenbach & Rescorla, 2003) for full items.

Table S5. Factor loadings from factor analysis of all harm avoidance and depression items.

Component

1 3 4 6 7 9 10

HA Subscale 1 (Anticipa tory Worry) confident everything will go well (R) .478 .052 .283 .485 .003 .129 -.334 worried about things going wrong .633 .157 .169 .149 -.012 .027 .119 get over embarrassment quickly (R) .292 .040 .198 .214 .367 .183 .053 relaxed and care-free (R) .535 .036 .227 .361 .086 .096 -.218 stop what I'm doing because of worry .669 .043 -.001 .036 .194 .048 .219 things go wrong unless I'm careful .225 .230 -.039 .159 .054 -.010 .652 stop what I'm doing because I'm worried .677 .170 .033 .111 .018 .045 .345 I will have good luck (R) .010 .095 -.016 .779 -.037 -.062 .169 all will turn out well (R) .345 .116 .092 .657 .029 .053 -.215 never worry about terrible things in the future (R) .403 .069 .098 .182 -.009 .208 .050 usually have good luck (R) .064 .068 .031 .666 .199 .040 .385

HA Subscale 2 (Fear of Uncertai nty) tense and worried in unfamiliar situations .646 .134 .107 .058 .008 .021 -.021 more reserved and controlled than most (R) .293 -.014 .608 .047 .101 .389 -.105 tense and worried when others aren't .651 .182 .167 .010 .078 -.054 -.001 confident I can do things most others find .126 -.050 .723 .072 .034 .209 -.049 dangerous (R) tense and worried doing something new .630 .166 .149 .050 .140 .062 -.027 prefer something risky (R) .075 .115 .842 -.009 .060 -.178 .060 prefer risks over staying quiet and inactive (R) .092 .186 .804 .055 .044 -.149 .025

HA Subscale 3 (Shyness with Strangers ) avoid meeting strangers because I lack confidence .255 .107 -.049 .070 -.011 .073 .071 more shy than most people .198 .083 .071 -.056 -.051 -.013 .049 confident and sure of myself in social situations .274 .072 .098 .315 .101 .108 .070 (R) not shy with strangers (R) .132 .082 .050 .074 .001 .072 -.018 Table S5, continue d.

relaxed and outgoing when meeting strangers (R) .073 .078 .203 .061 .121 .050 -.026 stay away from social situations .226 .057 .144 .025 -.123 -.201 .052 confident and relaxed meeting strangers (R) .097 .055 .176 .137 .348 .107 -.069

HA Subscale 4 (Fatigabil ity) less energy and get tired quickly .227 .734 .087 .065 .066 .097 .075 more energetic and tire less quickly than others .120 .621 .316 .160 .029 .256 -.106 (R) recover quickly from illness/stress (R) .188 .100 .133 .131 .687 .338 -.060 usually confident and energetic than most (R) .232 .372 .252 .224 .271 .314 -.128 tense, tired due to changes .662 .094 .044 .054 .241 -.094 .048 often need naps or extra rest periods .229 .694 .084 -.101 .190 .091 .075 need extra rest, support, reassurance to recover .270 .317 .055 -.025 .701 -.060 .127 from illness usually can stay "on the go" all day (R) .092 .504 .174 .220 .090 .098 .149

Depressi on cry a lot -.021 .134 .192 -.053 .236 -.067 -.112 don't eat as well as I should -.054 .216 -.016 -.005 .137 .628 .029 feel worthless .185 .096 .073 .043 .002 .172 .064 feel too guilty .316 -.002 .024 -.101 .080 .186 .056 tired without good reason .031 .715 -.049 .057 -.071 .009 -.003 little that I enjoy .057 .156 -.120 .072 .030 .001 .060 sleep more than most .042 .555 -.090 .014 .332 -.148 .050 trouble making decisions .358 .085 .042 .048 -.067 .424 .442 trouble sleeping .040 .231 -.027 .081 -.059 -.055 .060 low energy .066 .681 .026 .087 -.004 .105 .139 unhappy, sad, or depressed .183 .213 .028 .210 .042 -.007 .105 can't succeed .324 .032 -.142 .201 .037 .154 .051

Note. R indicates reserves scored item. All items are shortened and paraphrased. See Temperament and Character Inventory (Cloninger, Svrakic,

& Przybeck, 1993) and Achenbach System of Empirically Based Assessment Adult Self-report (Achenbach & Rescorla, 2003) for full items.