Normative data and factorial structure of the Turkish version of the Temperament and Character Inventory

Temperament Profiles Associated with Internalizing Symptoms and Externalizing Behavior in Adolescents with ADHD

The current study investigated temperament profiles associated with internalizing symptoms and externalizing behavior in adolescents with ADHD. Participants were 121 adolescents (90 males) with ADHD, ranging in age from 13 to 18 years (M = 15.40, SD = 1.59). Emotional and behavioral ratings were obtained using the Strengths and Difficulties Questionnaire (SDQ) and temperament profiles were assessed by administering the Temperament and Character Inventory (TCI). Multivariate profile analyses and post hoc tests revealed that youth high in internalizing symptoms were significantly higher in harm avoidance and lower in self-directedness. Youth high in externalizing behavior were significantly lower in cooperativeness. No cognitive differences were observed across groups, but youth high in externalizing behavior had more ADHD symptoms and greater impairment in daily life. Findings reveal unique temperament factors associated with comorbid concerns, which may have implications for adapting and personalizing intervention efforts based on these different profiles within adolescents with ADHD.

Temperament and Character Profiles of Ankylosing Spondylitis Patients Compared With Major Depression Patients and Healthy Controls

BACKGROUND/OBJECTIVE

Depressive disorder is common in patients with ankylosing spondylitis (AS), who exhibit specific brain imaging abnormalities resembling those in major depression (MD). We compared temperament and character profiles between patients with AS and MD.

METHODS

The study involved 36 patients with AS, 40 with MD, and 36 healthy controls (HCs). The participants were age-, sex-, and education-matched. Depression, anxiety, temperament, and character were evaluated using the Temperament and Character Inventory and physician-rated Hamilton Depression and Anxiety Scales. Disease severity was assessed using the Bath Ankylosing Spondylitis Disease Activity, Radiology, Metrology, and Functionality Indexes; erythrocyte sedimentation rate; and C-reactive protein.

RESULTS

Depression and anxiety scores were highest in MD, lowest in HCs, and intermediate in AS (p < 0.001). Harm avoidance was significantly higher in MD and AS than HCs (p = 0.01). Reward dependency was lower (p = 0.011) and self-transcendence higher in AS only (p = 0.034). Bath Ankylosing Spondylitis Radiology Index was negatively correlated with depression (p = 0.020). Bath Ankylosing Spondylitis Radiology Index and Bath Ankylosing Spondylitis Metrology Index were negatively correlated with harm avoidance (p < 0.05). Disease duration was negatively correlated with self-transcendence (p = 0.027). Harm avoidance was correlated with depression score (p = 0.029). Patients under tumor necrosis factor α inhibitor treatment had lower cooperativeness score (p = 0.022).

CONCLUSIONS

Patients with AS had a specific Temperament and Character Inventory pattern. Harm avoidance was common in both AS and MD. In AS, harm avoidance and depression decreased in patients with progression, probably because progressive fusion of the spinal segments causes decrease in pain. Harm avoidance (fear of pain) seemed to be an acting factor for occurrence of depressive symptoms in AS.

Distinct temperament and character traits in patients with hyperemesis gravidarum

Hyperemesis gravidarum (HG) is an extreme form of vomiting during pregnancy and is characterized with excessive vomiting and nausea and ketonuria, electrolyte imbalance, dehydration and severe nurtition deficiency. The etiology of HG is considered as multifactorial. Altough there is a great interest to HG in terms of psychiatric conditions, there have been limited numbers of studies that researched personality traits in patients with HG. In present study, we aimed to compare temperament and character traits between pregnant women with and without HG by Temperament and Character Inventory. 48 pregnant women with HG and 64 healthy pregnant women were included to study. The HG groups and control group were compared in terms of temperament and character traits and anxiety levels. The temperament scores of novelty seeking, harm avoidance and reward dependence were found to be similar between groups while the score of persistence was significantly lower in HG group compared with control group (p = .021). All character scores in HG group as cooperativeness, self-directedness, and self-transcendence were significantly lower compared with control groups (respectively; p = .002, p = .018 and p = .029). The scores of STAI-1 was higher in HG group compared with control group (p = .027) whereas the score of STAI-2 was found to be similar between groups. Present study is the first to demonstrate different temperament and character traits in patients with HG. We argue that our results support the psychiatric background of HG; however further studies are needed to confirm our results.

Temperament profiles, major depression, and response to treatment with SSRIs in psychiatric outpatients

Objective

The Temperament and Character Inventory (TCI) is commonly used in adult populations. Our aim was to explore: (1) if there are specific differences in temperament dimensions related to depression in comparison with general population, (2) if the treatment response during the acute phase of major depressive disorder (MDD) is predictable by TCI temperament dimensions.

Method

Temperament profiles in 98 MDD patients were compared with a Finnish community sample. The patients were treated with serotonin selective reuptake inhibitors (SSRIs) for 6weeks and their temperament profiles were assessed at baseline and endpoint. The harm avoidance (HA) and depression scores at baseline and endpoint were modelled with path analysis. For path modelling, we tested the relationships between different temperament dimensions and depression symptoms and other clinical variables with Mancova model.

Results

The HA scores were significantly higher in patients both at baseline and endpoint compared to the Northern Finland 1966 Birth Cohort (NFBC). The patients, and especially males, had slightly higher reward dependency (RD) scores. HA at endpoint explained moderately the Montgomery Åsberg Depression Rating Scale (MADRS) endpoint score. HA endpoint score was strongly explained by HA baseline score.

Conclusions

HA is associated with risk of and treatment response to depression.

Personality traits associated with blepharospasm: A comparison with healthy subjects, patients with facial hemispasm and patients with hyperhidrosis

The aim of this study is to explore the existence of specific personality traits related to patients with blepharospasm (BSP), treated with injections of botulinum neurotoxin (BTX). Sixteen patients with BSP, 22 with facial hemispasm (HFS), 20 with essential hyperhidrosis (EH) and 20 healthy controls (HCs) completed the Temperament and Character Inventory-Revised to explore personality traits based on Cloninger's Psychobiological Model. The results revealed that the four groups differed on the Harm Avoidance (HA) scale and fear of uncertainty subscale, as well as on Persistence (PS). On HA, BSP group did not differ from HCs, but had higher scores than HFS and EH groups. On PS scales, BSP and HFS patients did not differ between them but showed higher score than HCs and EH patients. Our findings suggested that a high level of Harm Avoidance and Persistence seem to be associated with BSP, when compared with any disorders treated with BTX. An evaluation of the personality traits might help the clinicians to early identify BSP patients at greater risk of developing psychopathological disturbances.

The relationship between childhood adversity and adult personality revealed by network analysis

BACKGROUND

Childhood adversity is known to influence personality development. Studies suggest that distinct types of childhood adversities have differential effects on personality dimensions. However, different types of adversity often co-occur, and personality dimensions are strongly interconnected.

OBJECTIVE

The aim of this study was to use a network approach to analyze the interrelationships between different types of childhood adversity and diverse personality dimensions integratively.

PARTICIPANTS AND SETTING

We used previously collected data on 142 alcohol dependent patients and 102 healthy controls.

METHODS

The participants completed the Interview for Traumatic Events in Childhood, the Parental Acceptance and Rejection Questionnaire and the Temperament and Character Inventory. Outcomes on the subscales of these instruments were included in the network analysis.

RESULTS

The resulting network showed strong connections between different types of childhood adversity, and between the different temperaments and characters of personality. Childhood adversity, mainly physical abuse and maternal rejection, was connected to most personality dimensions, except for reward dependence. Physical abuse showed the highest centrality measures, indicating a central, important role in the network.

CONCLUSIONS

These findings confirm that different types of childhood adverse experiences often co-occur, and suggest that specifically physical and emotional abuse, and maternal rejection might play a prominent role in shaping personality.

Indirect Associations of Anxiety Sensitivity with Tobacco, Alcohol, and Other Drug Use Problems Through Emotional Disorder Symptoms in Adolescents

Theoretically, anxiety sensitivity-fear of anxiety symptoms-enhances perception of and emotional reactivity to autonomic arousal and mental distress, thereby increasing negative affect and motivation to use substances for negative reinforcement. Because no prior study of adolescents has tested if anxiety sensitivity is indirectly associated with substance use problems through symptoms of emotional disorders (i.e., disorders involving high levels of negative affect), the current cross-sectional study examined this theoretical pathway. Participants included ninth-grade students from 10 different high schools in the Los Angeles metropolitan area (N = 3005; 54.3% female). Self-report measures of anxiety sensitivity, emotional disorder symptoms, tobacco dependence, and alcohol and other drug problems were administered. Controlling for sex, race/ethnicity, parental education, school, and impulsiveness, we tested the associations of anxiety sensitivity with tobacco, alcohol, and other drug use problems as well as the indirect effects of anxiety sensitivity on each domain of substance use problems through emotional disorder symptoms. Anxiety sensitivity was associated with more severe tobacco dependence and greater alcohol problems and other drug problems, and anxiety sensitivity further was indirectly associated with all three domains of substance use problems through emotional disorder symptoms. Current findings suggest that adolescents high in anxiety sensitivity tend to experience emotional disorder symptoms, which may increase risk for substance use problems. Interventions that target anxiety sensitivity and enhance negative-affect coping skills may assist in preventing and reducing adolescent substance use problems.

Relationship of self-transcendence traits with in vivo dopamine D2/3 receptor availability and functional connectivity: An [18 F]fallypride PET and fMRI study

Genetic research has implicated dopamine neurotransmission in the expression of the self-transcendence trait in humans. However, molecular imaging of dopaminergic markers is undocumented in relation to this personality trait. In this multimodal imaging study, we first investigated the relationship between the self-transcendence trait and in vivo dopamine D_2/3 receptor availability using [¹⁸ F]fallypride positron emission tomography (PET). We next conducted seed-based functional connectivity analyses using resting-state functional magnetic resonance imaging (rs-fMRI) data with regions derived from the PET analysis as seeds to explore the functional significance of D_2/3 receptor availability foci associated with the self-transcendence trait. Twenty-one healthy subjects underwent high-resolution PET with [¹⁸ F]fallypride and a subset of 18 subjects also completed 3-Tesla rs-fMRI. The Temperament and Character Inventory was used to measure the self-transcendence trait. A voxel-based whole brain analysis revealed that the [¹⁸ F]fallypride binding potential (BP_ND ) within the cluster of the left insula was significantly positively correlated with self-transcendence trait scores. A region-of-interest analysis also showed a significant positive correlation between self-transcendence and [¹⁸ F]fallypride BP_ND in the left insula. The exploratory [¹⁸ F]fallypride BP_ND seed-based rs-fMRI analysis showed that the functional connectivity from the left insula seed to the prefrontal cortices (including the inferior frontal region) was negatively associated with self-transcendence trait scores. The results of the present study suggest that D_2/3 receptor-mediated neurotransmission in the left insula may constitute a significant neurobiological factor in the self-transcendence trait. The negative associations between BP_ND seed-based functional connectivity and self-transcendence trait scores may suggest reduced prefrontal control in this personality trait.

Temperament and character differences of patients with polycystic ovary syndrome

AIM

There is an unclear relationship between Polycystic Ovary Syndrome and psychiatric disorders including anxiety and depression. We aimed to evaluate temperamental and personal characteristics of patients with PCOS.

METHODS

Fifty patients with PCOS and 41 healthy controls were included in the study. Hormonal and demographic characteristics were recorded after gynecologic and psychiatric evaluation. Socio-demographical Data Form, Beck Depression Inventory, Beck Anxiety Inventory and the Cloninger's Temperament and Character Inventory were performed for all participants.

RESULTS

Patients with Policystic Ovary Syndrome had significantly higher depression and anxiety scores when compared to the controls (p < 0.05). There were no significant difference in any of the subdimensions neither for temperament nor for character between patient and control groups (p > 0.05). Testosteron levels and the degree of hirsutism, LH/FSH ratio and body mass index of the patients did not have significant correlations with depression or anxiety scores or any of the Cloninger subdimentions (p > 0.05). However, there was a negative correlation between age and novelty seeking and age and reward dependence (r:-0.33, p:0.018; r:-0.295, p:0.037, respectively).

CONCLUSIONS

This preliminary study showed no significant difference between patients and healthy controls regarding temperament and character. Patients had higher anxiety and depression scores. Further research is needed to enlighten this subject.

Temperament and Character Traits of Parents of Children With ADHD

OBJECTIVE

This study investigates the relationship between ADHD and the personalities of parents of children with ADHD.

METHOD

Personality traits of parents of children with ADHD (study group; n = 135) and parents of children without ADHD (control group; n = 122) were compared. Psychiatric comorbidities were excluded with Structured Clinical Interview for DSM-IV Axis I Disorders, Clinical Version [SCID-I-CV]. Personality is assessed with Temperament and Character Inventory, and inattention (IA) and hyperactivity (HI) are assessed with Turgay Scale.

RESULTS

Harm avoidance and persistence scores were higher, and self-directedness (SD) scores were lower in the study group than the control group. Being in ADHD group predicted lower SD scores. Positive correlations were found between harm avoidance and IA and HI, and between persistence and HI. Negative correlations were found between SD and both IA and HI.

CONCLUSION

Our data suggest that there is relationship between ADHD in children's and parents' personalities. Common etiologic properties and personalized psychoeducation and treatment options for families should be discussed.

Age and Sex Differences in Temperament and Character Dimensions in a French Nonclinical Population

Abstract. The authors examined age and sex trends on the seven dimensions and 25 facets assessed by the Temperament and Character Inventory (TCI) collected between 2006 and 2014. This cross-sectional study sought to better understand personality differences according to age and sex cohorts in a French nonclinical community sample (1,181 participants). Our results show significant differences in age groups in Novelty Seeking, Reward Dependence, Harm Avoidance, and Self-Transcendence. Women scored higher than men in Harm Avoidance, Reward Dependence, and Cooperativeness. Men between 18 and 29 years old reported higher Novelty Seeking whereas older women had higher Harm Avoidance. Among all the dimensions of the TCI, only Self-Directedness presents a consistent Gender × Age interaction. Our study confirmed that there were personality-specific features in men and women. In addition, there were personality changes with age in both temperament and character dimensions. Our research highlighted the need to take into account both age and gender of subjects in the future analyses and interpretations of findings from the temperament and character inventories.

Distinct temperament and character profiles in first onset vitiligo but not in alopecia areata

Alopecia areata (AA) and vitiligo (V) are diseases that are correlated with psychiatric disorders before, during and after diagnosis. The Temperament and Character Inventory (TCI) is a well-established approach for investigating personality traits in various psychosomatic diseases. The aim of this study is to compare and investigate the differences in the TCI between patients with first onset AA, patients with V and healthy controls (HC). Participants in the study included 42 patients with first onset AA, 50 adult patients with V and 60 HC who had no history or diagnoses of psychiatric or dermatological disorders. All participants were assessed with the TCI and the Dermatology Life Quality Index (DLQI). Among the temperament traits, the extravagance, disorderliness and total novelty-seeking scores were lower, and the worry and pessimism scores were higher in patients with V compared with patients with AA and the HC. The mean score of the enlightened second nature and the total self-directedness score of the character traits were higher in patients with V compared with patients with AA and the HC group. In the AA group, there was a negative correlation only between the reward dependence total score and the DLQI score. This study suggests that patients with first onset V have a distinct temperament, such as being unenthusiastic and unemotional, and character profiles, such as worry and pessimism, independent of their psychiatric comorbidities, and patients with AA do not have a different personality from the non-affected population.

Temperament and character dimensions assessed in general population, in individuals with psychoactive substance dependence and in young male conscripts

BACKGROUND

In this work we consider Cloninger's psychobiological model, which measures two dimensions of personality: character and temperament. Temperament refers to the biological basis of personality and its characteristics, while character refers to an individual's attitudes towards own self, towards humanity and as part of the universe.

METHODS

The Temperament and Character Inventory-Revised-140 (TCI-R-140) was administered to 3 divergent samples: a general population sample, a sample of male conscripts and a sample of individuals attending a substance abuse rehabilitation programme. Score differences among the three samples were assessed controlling for age and gender and reliability coefficients are reported. The latent structure was studied in all samples, using exploratory and confirmatory factor analysis methods (EFA and CFA respectively).

RESULTS

The proposed structure was partially replicated via EFA. CFA however indicated less than satisfactory fit, as in previously reported results. To improve the fit, the path diagram was augmented to account for multiple factor complexity, as suggested by the EFA results in all samples. While retaining the original seven-factor structure, the augmented model provided adequate fit. The consistency of the inventory was satisfactory in all samples. Evidence for the construct validity was found in relation to aggression.

CONCLUSIONS

This is the first study to conclude in adequate fit, after allowing for the indicators to load on more than one factor within each dimension. While cross-national differences apply, our results were similar (when comparable) with previously reported ones in the literature.

Standardization and normative data of the Greek version of the temperament and character inventory (TCI)

BACKGROUND

Robert Cloninger's psychobiological model of temperament and character is a dimensional approach to personality assessment and gave birth to the temperament and character inventory (TCI). The aim of the present report is to examine the psychometric properties of the Greek version of the TCI, and to replicate its postulated structure and provide preliminary normative data for the Greek population.

METHODS

The study sample included 734 subjects from the general Greek population (436 females; 59.4 % and 298 males; 40.6 %). Their mean age was 40.80 ± 11.48 years (range 25-67 years). The mean age for females was 39.43 ± 10.87 years (range 25-65 years), while the mean age for males was 42.82 ± 12.06 years (range 25-67 years). Descriptive statistics tables concerning age, gender and occupational status distribution in the sample were created. The analysis included the calculation of Cronbach's alpha, factor analysis with promax rotation and the calculation of Pearson correlation coefficients between the subscales scores. Analysis of Covariance with age as covariate and t test and Cohen's d as post hoc tests was used to search for differences in subscales scores between males and females.

RESULTS

The overall psychometric properties of the Greek version of the TCI proved to be satisfactory, with acceptable consistencies of the subscales. The factor analysis of temperament identified four factors which together explained 58.56 % of total variance, while the factor analysis of the three-factor solution of the character explained 52.24 % of total variance. The TCI scales correlate significantly but weakly between each other and with age.

DISCUSSION

The Greek version of the TCI exhibits psychometric properties similar to its original English counterpart and to other national translations and it is suitable for use in research and clinical practice.

Evaluation of temperament and character features as risk factors for depressive symptoms in patients with restless legs syndrome

BACKGROUND AND PURPOSE

Restless legs syndrome (RLS) is a common sleep-related movement disorder that is frequently associated with psychological disturbances. Personality traits are of considerable importance with respect to coping with chronic illness and disease vulnerability. This study assessed the temperament and character traits of RLS patients using an approach that involves the psychobiological model of personality.

METHODS

The personality features of 65 newly diagnosed and untreated RLS patients with no neurological or psychiatric diseases and 109 healthy controls were determined using the Temperament and Character Inventory and compared using covariance analyses. The International RLS Study Group Severity Scale was used to assess the severity of the RLS symptoms, and the Beck Depression Inventory was used to assess the presence and severity of depressive symptoms.

RESULTS

RLS patients scored significantly higher than healthy controls on the temperament dimension of harm avoidance (HA, p=0.02) and significantly lower on self-directedness (SD, p=0.001). No significant difference was observed in terms of the temperament dimension of novelty seeking (p=0.435). HA scores were significantly correlated with the BDI score but not with the RLS severity or duration.

CONCLUSIONS

High HA and low SD scores are the main characterizing personality features of RLS patients. These personality dimensions may be among the factors predisposing patients to development of the depressive symptoms that are frequently associated with RLS.

Temperament and character in remitted and symptomatic patients with schizophrenia: modulation by the COMT Val158Met genotype

While research on remission in schizophrenia has gained attention, personality characteristics associated with remission in schizophrenia have been under-studied. A functional valine-to-methionine (Val158Met) polymorphism in the catechol-O-methyltransferase (COMT) gene is shown to modify clinical presentation of schizophrenia despite weak or no association with the disorder itself. Studies also report that this polymorphism can affect personality traits. We aimed to examine personality traits of remitted patients with schizophrenia as compared to symptomatic patients and healthy controls and to investigate whether the COMT Val158Met polymorphism influences their personality. Scores on the Temperament and Character Inventory were compared between 34 remitted outpatients with schizophrenia, age- and sex-matched 72 symptomatic outpatients with schizophrenia, and matched 247 healthy individuals. The effect of COMT Val158Met polymorphism on personality was examined in each group. The analysis of covariance, controlling for confounding variables, revealed that compared to healthy controls, symptomatic patients exhibited a pervasively altered personality profile whereas remitted patients showed alterations in more limited personality dimensions and demonstrated normal levels of novelty-seeking, reward dependence and cooperativeness. The two-way analysis of covariance, with genotype and sex as between-subject factors and confounders as covariates, revealed that Met carriers demonstrated significantly lower reward dependence and cooperativeness than Val homozygotes in symptomatic patients; while no significant genotype effect was found in remitted patients or in healthy individuals. These findings indicate that remitted patients with schizophrenia have a relatively adaptive personality profile compared to symptomatic patients. The COMT Val158Met polymorphism might have a modulating effect on the relationship between personality and remission.

Predictors of suicide in patients with conversion disorder

OBJECTIVE

Previous studies have shown that the ratio of suicide attempts is between 19.6 and 34.2% in patients with conversion disorder (CD), yet few studies have addressed this issue. The present study compared demographic and clinical variables and predictors of suicide attempts in patients with CD.

METHODS

A total of 100 consecutive patients were recruited and divided into groups according to their history of suicide attempts. Socio-demographic variables such as economic status, age, gender, educational level, marital status, clinical variables such as the presence of psychiatric disorder in family, substance abuse, risky alcohol use, age of onset, subtype of CD, number of hospitalization were recorded. Participants also completed the Childhood Trauma Questionnaire (CTQ-28), Temperament and Character Inventory (TCI), Toronto Alexithymia Scale (TAS-20), Dissociative Experiences Scale (DES), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI).

RESULTS

Suicide attempters had a higher rate of risky alcohol use, more hospitalizations, and higher mean scores on the BAI, BDI, DES/DES-taxon, TAS-total and CTQ-total than did non-suicide attempters or healthy control (NHC). Patients with CD had a higher harm-avoidance and a lower self-directedness rather than NHC. Risky alcohol use, number of hospitalizations, and mean DES-taxon and emotional abuse scores were independent predictors of suicide attempts.

CONCLUSION

Our findings indicate that clinicians should be aware of the prediction of suicide in patients with CD who show dissociation and risky alcohol use. Moreover, a history of childhood emotional abuse should be considered in the management of CD. The fact that clinical variables distinguished between suicide attempters and non-attempters suggests that a history of suicide attempts may be used to clarify the heterogeneous nature of CD.

A latent profile analysis of schizotypy, temperament and character in a nonclinical population: association with neurocognition

Schizotypy is conceptualized as a latent personality construct that confers liability for schizophrenia, while it is also suggested that schizotypy can relate to certain favorable aspects. Investigating individual-level interactions between schizotypy and broader personality characteristics might give a clue to this question. We aimed to identify homogeneous classes of individuals based on schizotypy, temperament and character and to validate this classification using comprehensive neurocognitive data. We studied 455 nonclinical adults using the Schizotypal Personality Questionnaire, the Temperament and Character Inventory, and an array of neuropsychological tests. A latent profile analysis (LPA) of schizotypy, temperament and character was conducted, and cognitive performance was compared as a function of latent class membership. LPA provided a 3-class solution. Of the sample, 15% was classified into a "high-positive-schizotypy/adaptive" group characterized by high cognitive-perceptual but low interpersonal schizotypy, together with low harm avoidance and high self-directedness, cooperativeness and self-transcendence; 18% was classified into a "high-schizotypy/maladaptive" group characterized by overall high schizotypy, together with high harm avoidance and low self-directedness and cooperativeness; and 67% was classified into a "low-schizotypy/adaptive" group characterized by overall low schizotypy, together with intermediate-to-low harm avoidance, high self-directedness and intermediate-to-high cooperativeness. Overall cognitive performance of the high-positive-schizotypy/adaptive group was comparable to that of the low-schizotypy/adaptive group and superior to that of the high-schizotypy/maladaptive group. The present LPA clearly defines a group of individuals who have adaptive personality traits and intact neuropsychological functions despite high positive schizotypy, suggesting that there may be complex, nonlinear relationships between schizotypal traits and psychopathology.

Temperament and character profiles of male COPD patients

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a respiratory disorder, and is characterized by persistent airflow obstruction. These patients are exposed to severe physical limitations and substantial psychosocial trouble. The aims of this study were to determine the temperament and character profiles of personality in patients with COPD and to compare the results with those of healthy controls.

METHODS

Thirty-nine male COPD patients and 67 age- and gender-matched healthy controls completed the self-administered 240-item temperament and character inventory (TCI) and 14-item hospital anxiety and depression scale. The relationships between temperament and character personality profiles and clinical factors such as severity of COPD, anxiety, and depression were evaluated.

RESULTS

COPD patients had significantly higher mean scores of Harm avoidance and lower mean score of Self-directedness than those of healthy controls. In the COPD patients, the anxiety score was significantly higher (P=0.03) and the depression score was found to be insignificantly higher than that of control group. The TCI profiles were not correlated with the severity of COPD. In COPD patients, Self-directedness and Cooperativeness traits of TCI character negatively correlated with anxiety, but any of traits did not correlate with depression.

CONCLUSIONS

The present study defined the Harm avoidance score was higher and Self-directedness was lower in COPD patients and the COPD severity did not correlate with any of the personality trait. We suggest that during evaluation of COPD patients for treatment, personality trait should also be considered in clinical practice.

Assessment of temperament and character profile with anxiety and depression in patients with acne

BACKGROUND

Acne is the most common skin disease, affecting nearly 85% of the population as well as their lives. Acne can severely affect social and psychological functioning. Patients with acne may have anxiety, depression, decreased self-esteem, interpersonal difficulties, unemployment, social withdrawal, and even suicidal intent.

AIMS

The aim of this study was to evaluate the temperament and character inventory (TCI) of patients with acne and to compare the results with those of healthy controls.

STUDY DESIGN

Case-control study.

METHODS

The study population consisted of 47 patients with acne, and 40 healthy control subjects. All participants were instructed to complete a self-administered 240-item TCI and the Hospital Anxiety and Depression Scale.

RESULTS

In this study, the scores for the temperament properties Worry and pessimism (HA1) and Dependence (RD4) and the character properties Social acceptance (C1) and Integrated conscience (C5) were found to be higher in acne patients than in healthy controls (p<0.05). Compared to the controls, depression and anxiety scores were found to be markedly higher in the patients with acne. Acne type correlated positively with the Disorderliness (NS4) subscale of Novelty seeking (NS) and anxiety. Additionally, acne type correlated negatively with the Attachment (RD3) subscale of Reward Dependence (RD), with the Transpersonal identification (ST2) and Spiritual acceptance (ST3) subscales of Self-Trancendence (ST), and with the Compassion (C4) sub-scale of Cooperativeness (C).

CONCLUSION

Studies in this area may lead to the development of specific and focused interventions for TCI in patients with acne vulgaris. We suggest that the evaluation and treatment of acne should also include psychosomatic approaches in clinical practice.

Temperament and character traits in patients with epilepsy: epileptic personality

Personality and behavioral changes in epilepsy are well documented. However, neither the quantitative characteristics nor the etiology of these changes is clear yet. Cloninger has developed a psychobiological personality model that provides a way to evaluate personality in a dimensional way. This study examined the relationship between epilepsy and Cloninger's dimensional psychobiological personality model. A total of 73 epilepsy outpatients and 79 healthy controls were examined using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis I Disorders, the Turkish version of the Temperament and Character Inventory, and an epilepsy questionnaire. Epilepsy patients had higher harm avoidance (HA) and lower persistence, self-directedness (SD), and cooperativeness scores than healthy controls did. In epileptic subjects, there was no correlation between age and duration of epilepsy. Subjects with partial seizures had higher HA scores and lower SD scores than generalized ones. Comorbid depression was represented with lower SD scores. In multiple linear regression models, only major depressive disorder predicted lower scores of SD. This study confirms specific personality changes among epileptics according to Cloninger's dimensional personality model and indicates a relationship between the characteristics of epilepsy and psychiatric comorbidity.

Personality traits of Turkish handgun license applicants

Several theories have sought to explain the motivations for handgun possession and the relationship with personality. Perception of handguns also has cultural variations. The aim of the study is to evaluate handgun license applicants' personality profiles. 109 handgun license applicants were included in the study. Temperament and Character Inventory (TCI) scores of the applicants were recorded. Scores were compared with Turkish and American normative data for the Inventory. The study group had significantly lower subscores on novelty seeking, harm avoidance, and higher subscores on reward dependence and persistence compared to Turkish norms and significantly lower subscores on novelty seeking, reward dependence, and self-directedness compared to American norms. Results indicate that Turkish handgun license applicants' personality features are more similar to American norms.

Temperament and character personality profile in relation to suicide attempts in patients with schizophrenia

INTRODUCTION

Schizophrenia is associated with a significant risk of suicide, and suicide still remains one of the main causes of death in schizophrenic patients. Beside classic risk factors for suicidality, temperament and character traits have been researched and considered as risk factors for suicidal behavior in recent years.

METHOD

Subjects were 94 patients with schizophrenia who were under treatment. All patients were in a stable phase of the illness. Patients with lifetime suicide attempt (n = 46) and without suicidal attempt (n = 48) were compared with each other in terms of temperament and character traits by using the Temperament and Character Inventory.

RESULTS

Harm avoidance and persistence scores were higher in suicidal schizophrenic patients compared with nonsuicidal schizophrenic patients. The scores of self-directedness and cooperativeness were lower in suicidal schizophrenic patients compared with nonsuicidal schizophrenic patients. These 4 variables remained significant predictors of lifetime suicidal attempts in a logistic regression model.

CONCLUSION

To the best of our knowledge, the present study is the first that specifically compares schizophrenic patients with and without suicidal behavior by the Cloninger temperament and character model. Our data indicate that schizophrenic patients will show a greater risk for suicide according to certain personality configurations. However, to establish causal relationships between personality and suicidality in schizophrenia, longitudinal studies are warranted within a multifactorial interactive framework of biologic and clinical variables.

Temperament and character in euthymic major depressive disorder patients: the effect of previous suicide attempts and psychotic mood episodes

OBJECTIVE

The purpose of this study was to examine personality traits of patients with major depressive disorder and explore the possible connections between personality and clinical and sociodemographic variables.

METHODS

The sociodemographic and clinical properties of 80 patients with major depression, who were euthymic according to Hamilton Depression Scale scores, were recorded. Their personality was evaluated by using Temperament and Character Inventory and results were compared with 80 age- and sex-matched healthy controls. We used general linear model analysis to evaluate the manner in which the variables contributed to TCI scores.

RESULTS

Remitted depressive patients scored significantly lower on on self-directedness and higher on harm avoidance than HC. Previous suicide attempts had a main effect only on harm avoidance while previous psychotic mood episodes were significantly associated with novelty seeking, self-directedness and cooperativeness. With respect to numeric clinical variables, only duration of illness was significantly and negatively correlated with NS and RD scores.

CONCLUSION

Patients with euthymic major depressive disorder may have significantly different personality traits than the normal population, and patients with different clinical and sociodemographic characteristics may show different personality patterns. In addition, assessment of major depressed patients by means of the Temperament and Character Inventory may be helpful to get a deeper insight into those personality traits underlying suicidality and the emergence of psychotic mood episode.

Relationship of trait impulsivity with clinical presentation in euthymic bipolar disorder patients

The purpose of this study was to examine trait impulsivity in patients with bipolar disorder and explore the possible connections between impulsivity and clinical presentation of the illness. Diagnoses were based on the Structured Clinical Interview for DSM-IV. The sociodemographic and clinical properties of 71 patients with bipolar disorder, who were euthymic according to Young Mania Rating Scale and Hamilton Depression Scale scores, were recorded. Their trait impulsivity was evaluated by using the Barratt Impulsiveness Scale (BIS) and impulsivity subscale of the Temperament and Character Inventory, and the results were compared with 50 age- and sex-matched healthy controls and among patients with different clinical properties. All BIS-11 subscale scores were higher in bipolar than in comparison subjects. There were no effects of education and age. Elevated BIS-11 scores were associated with predominant depressive polarity, longer duration of illness and a history of psychotic mood episodes and suicide attempts. These relationships persisted when age, gender, and education were taken into account. These results show that after accounting for common confounding factors, trait-like impulsivity was substantially higher in subjects with bipolar disorder than in nonbipolar comparison subjects and may vary according to different clinical presentations.

Validity and reliability of the Japanese version of the Temperament and Character Inventory: a study of university and college students

OBJECTIVE

The Temperament and Character Inventory (TCI) is a widely used self-report measure of adult personality.

METHOD

We studied 586 Japanese university and college students with the 125-item version of the Japanese TCI.

RESULTS

The factor structure of the TCI scales was similar to that reported in other languages. Depression was positively correlated with Novelty Seeking and Harm Avoidance but inversely correlated with Persistence, Self-Directedness, and Cooperativeness. Good Self-Image in the framework of adult attachment was correlated positively with Self-Directedness but inversely with Harm Avoidance and Reward Dependence. Good Other-Image in the framework of adult attachment was positively correlated with Reward Dependence and Cooperativeness. The scores of the TCI scales were stable over a time span of 1.5 to 2 months.

CONCLUSION

The Japanese version of the TCI may be a valid and reliable measure of temperament and character, at least among the adolescent and young adult population.

An Increase of the Character Function of Self-Directedness Is Centrally Involved in Symptom Reduction during Remission from Major Depression

Background. Studies with the Temperament and Character Inventory (TCI) in depressive disorders have shown changes (Δ) of the character of Self-Directedness (SD) and the temperament of Harm Avoidance (HA). The central question of this study is which of these two changes is most proximally related to the production of depressive symptoms. Methods. The start and endpoint data from a two-year followup of 58 depressed patients were reanalyzed. We used the ΔHA and ΔSD scores as well as the Δ scores on three dimensions of psychopathology, called Emotional Dysregulation (ED), Retardation (RET), and Anxiety (ANX). The presence of the main relation between personality and psychopathology was tested in all patients and in four subcategories. The data were analyzed by MANCOVA and Structural Equation Modelling (SEM). Results. ΔHA and ΔSD correlated negatively, and only ΔSD was related (negatively) to ΔED. This pattern was found in all subcategories. SEM showed ΔHA and ΔSD had an ambiguous causal interrelationship, while ΔSD, ΔRET, and ΔANX had unidirectional effects on ΔED. Conclusion. The results correspond with a central pathogenetic role for a state-related deficit at the character level in depression. This may have important consequences for investigations of endophenotypes and clinical treatment.

Temperament and character in psychotic depression compared with other subcategories of depression and normal controls

Background. Support has been found for high harm avoidance as general vulnerability trait for depression and decreased self-directedness (SD) as central state-related personality change. Additional personality characteristics could be present in psychotic depression (PD). Increased noradrenergic activation in PD predicts the involvement of reward dependence (RD). Methods. The data during the acute episode and after full remission from the same subjects, that we used before, were reanalyzed. The dependence of the 7 dimensions of the Temperament and Character Inventory version 9 on PD, three other subcategories of depression, and a group of normal controls was tested by MANCOVA. Results. Low RD at both time points, and low Cooperativeness during the acute episode, were found as additional characteristics of PD. Conclusion. The combination of two premorbid temperaments, high HA and low RD, and the development of a state-related reduction of two character functions, SD and CO, may be the precondition for the development of combined depressive and psychotic psychopathology.