MMPI-2 clusters of alcohol-dependent patients and the relation to Cloninger’s temperament-character inventory
J.I.M. EggerMarian GringhuisMarinus A. BretelerH.R.A. De MeyEllen WingbermühleJan DerksenSander R. Hilberink
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Abstract:
Psychometric research in the field of alcohol dependence has concentrated on identifying certain (personality) characteristics (i.e. typologies). This paper is aimed to identify such typologies and studies the relation of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Cloninger's temperament-character inventory (TCI).To find MMPI-2 scales associated with maximization of group differences between 222 DSM-IV alcohol dependent inpatients and a control group of 222 normal subjects, discriminant analysis was used. In addition, a cluster analysis was performed with these scales, and the MMPI-2 mean scale values of the resulting patient clusters were examined for their TCI-correlates.The discriminant analyses showed several MMPI-2 scales that could clearly distinguish between alcohol-dependent patients and the normal controls. Cluster analysis resulted in semantically different MMPI-2 profiles implying qualitatively different groups of patients. When related to TCI scales, these differences revealed harm avoidance, self-directedness, and persistence, amongst others, as important elements in the description of the clusters.Evidence for the validity of MMPI-2 constructs as well as those of the TCI in the assessment of alcohol-dependent patients was provided.Keywords:
Reward dependence
Personality test
Persistence (discontinuity)
Cooperativeness
Reward dependence
Depression
Persistence (discontinuity)
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Objective: Cloninger has developed a dimensional psychobiological model of
personality that accounts for both normal and abnormal variation of two
major components of personality: temperament and character. The Temperament
and Character Inventory (TCI) is a 240-item self-administered questionnaire
constructed to assess four temperament (Novelty Seeking, Harm Avoidance,
Reward Dependence, and Persistence) and three character dimensions
(Self-Directedness, Cooperativeness, and Self-Transcendence). In this study,
we aimed to examine the psychometric properties of the Turkish version of
the TCI in a healthy Turkish population and obtain normative data for the
Turkish TCI.
Methods: The study was conducted in both Karadeniz Technical University
School of Medicine and Ataturk University School of Medicine using a sample
of 683 healthy volunteers. Participants were administered a short version of
Marlowe-Crowne Social Desirability Scale and the Turkish TCI that was
translated by Kose and Sayar and officially approved by Cloninger to be used
in this validation study.
Results: Turkish sample had significantly lower mean scores on Novelty
Seeking, Reward Dependence and higher mean scores on Harm Avoidance than the
American sample. On character dimensions, the Turkish sample had
significantly lower scores on Self-Directedness, Cooperativeness, and
Self-Transcendence. Self-Directedness and Harm Avoidance, Cooperativeness
and Reward Dependence, and Cooperativeness and Self-Directedness were
intercorrelated. The Cronbach?s coefficients were between .60 and .85 on
temperament dimensions, and were between .82 and .83 on character
dimensions. The lowest Cronbach?s coefficients were found in Reward
Dependence (.60) and Persistence (.62). A principal axis factor analysis
with a four-factor solution by Oblimin rotation reproduced highest loadings
on Novelty Seeking and Harm Avoidance and relatively weaker loadings on
Reward Dependence and Persistence. A three-factor solution for character
subscales reproduced highest loadings on Cooperativeness and
Self-Transcendence.
Conclusions: The reliability and validity of the Turkish version of the TCI
were supported by its reliable psychometric properties and construct
validity. The Turkish version of the TCI successfully confirmed Cloninger's
seven-factor model of personality. This pioneering work suggests that the
Turkish TCI can be applied in clinical populations as well as in
neurobiological and neuroimaging investigations.
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The purpose of this study was to identify personality traits associated with suicide attempt in a clinical sample. Temperament and character inventory (TCI) profiles of 759 patients who met the inclusion criteria among 1000 randomly selected hospital records collected. Of these 759 patients, 103 had a history of at least 1 actual suicide attempt (suicidal group) whereas 656 had no such history (nonsuicidal group). The suicidal group showed higher scores of novelty seeking (mean ± SD: 36.1 ± 1.2 vs 33.3 ± 0.5; P = .026) and harm avoidance (57.1 ± 1.5 vs 53.0 ± 0.6; P = .01) but lower scores of self-directedness (27.5 ± 1.5 vs 34.4 ± 0.6; P < .001) than the nonsuicidal group. Higher novelty seeking (OR [95% CI]: 1.031 [1.008–1.054]; P = .007) and lower self-directedness: 0.955 [0.927–0.983]; P = .002 were also associated with suicide attempts in the analysis of 7 personality scales. These findings suggest that patients who attempt suicide differ from nonattempters in terms of personality traits, especially in novelty seeking (NS), harm avoidance (HA), and self-directedness (SD). It is noteworthy that this study contains data from actual visits to the emergency room to evaluate suicide attempts. Abbreviations: CO = cooperativeness, Ha = harm avoidance, NS = novelty seeking, PS = persistence, RD = reward dependence, SD = self-directedness, ST = self-transcendence, TCI = temperament and character inventory.
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We applied the temperament and character inventory (TCI) personality questionnaire in 41 inpatients dependent on metamphetamine, and 35 controls. Novelty seeking, harm avoidance and self-transcendence were significantly higher, and persistence, self-directedness and cooperativeness were significantly lower in the patients than in the healthy volunteers. The detected differences may be important for prevention and treatment.
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It has been reported that the human temperament dimensions of novelty seeking and harm avoidance are associated with polymorphisms in the D(4) dopamine receptor gene (D4DR) and the serotonin-transporter-linked promoter region (5-HTTLPR), respectively. Although these findings are consistent with Cloninger's hypothesized psychobiological model of temperament and character, many studies failed to replicate these findings. In the present study the authors tested whether the psychobiological model taps the genetic architecture of personality by exploring associations between these candidate genes and the dimensions of the Temperament and Character Inventory and by examining its phenotypic structure.Of the 946 male and female participants in the Baltimore Longitudinal Study of Aging to whom the Temperament and Character Inventory was administered, 587 were genotyped for a polymorphism with a 48-base-pair repeat in the D4DR gene and 425 were genotyped for a 44-base-pair insertion or deletion in the 5-HTTLPR polymorphism.There was no significant association between D4DR polymorphisms and novelty seeking. The authors also failed to find an association between 5-HTTLPR polymorphisms and harm avoidance. The factor structure of the Temperament and Character Inventory did not reveal the hypothesized phenotypic structure.This investigation produced no support for the temperament-character model at either the biological or psychological level.
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The relationship between major depressive disorder (MDD) and, especially harm avoidance, self-directedness, and cooperativeness has been determined based on Cloninger's psychobiological personality model; there are not enough studies in the literature on the role of the subdimensions. Therefore, the aim of this study was to compare the patients with MDD and healthy controls in terms of temperament and character traits and especially subdimensions and thus to determine the role and predictive value of temperament and character subdimensions in major depression patients.The sample of this cross-sectional study consisted of 105 participants, 65 of whom were MDD patients, and 40 healthy controls, who voluntarily agreed to participate in the study. Sociodemographic data form, temperament and character inventory, and Hamilton depression rating scale were administered to the participants.Compared with healthy controls, patients with MDD had lower self-directedness (p<0.001), cooperativeness (p=0.017), persistence (p<0.001), self-transcendence (p=0.001), and higher harm avoidance (p<0.001) scores. While there was no significant difference in novelty seeking (p=0.774); it was determined that MDD patients got higher scores in "Impulsiveness" (p=0.013) and lower scores in "Exploratory excitability" (p=0.001) subscales. Reward dependence has been identified as the only personality trait that there was no significant difference between major depression patients and healthy controls (p=0.511). As a result of the logistic regression analysis performed to determine the predictors of temperament and character subdimensions in major depression patients, only three temperament and character traits "Fatigability, Purposefulness, and Spiritual Acceptance" were determined as significant predictors (p<0.001). Fatigability was determined to be a serious risk factor, increasing the probability of MDD 3.6 times (p<0.001); purposefulness and spiritual acceptance were found to be protective personality traits that together reduced the probability of MDD by 0.8 times (p<0.001).This study shows that the risk of developing MDD is increased in individuals with low self-directedness, cooperativeness, persistence, and self-transcendence profiles, and whereas with prominent Harm avoidance personality traits. Therapeutic interventions, especially considering the temperament and character traits of "Fatigability, Purposefulness, and Spiritual Acceptance" determined in our study, may contribute positively to MDD treatment.
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