THE TEMPERAMENT AND CHARACTER INVENTORY - TCI

INTRODUCTION

Temperament and Character Inventory (TCI) is a battery of tests designed to assess differences between people in seven basic dimensions of temperament and character. Temperament refers to automatic emotional responses to experience that are moderately heritable and stable throughout life; the four measured temperament dimensions are Novelty Seeking, Harm Avoidance, Reward Dependence and Persistence. In contrast, character refers to self-concepts and individual differences in goals and values, which influence voluntary choices, intentions, and the meaning of what is experienced in life. Differences in character are moderately influenced by socio-cultural learning and mature in progressive steps throughout life. The three measured character dimensions are Self Directedness, Cooperativeness and Self Transcendence. Each of these aspects of personality interacts with one another to motivate adaption to life experiences and influence susceptibility to emotional and behavioural disorders.

The unique feature of this tool is that it is suitable for measuring both normal and abnormal behaviour patterns.

THEORETICAL BASIS

The TCI is based on the biosocial theory of personality. Biosocial Theory is a theory in behavioral and social science that suggests the attribution of disorders of personality and conditions of mind to the reaction of biologically determined personality traits to environmental stimuli. In an effort to integrate information from diverse sources Cloninger (1986) sought to provide a model of personality that was both complete and anchored in specific neuropharmacological mechanisms. He wished to develop a general model to explain the differences between patients with somatisation disorder (Briquet’s syndrome) and generalized anxiety disorder. Earlier, Eysenck in his Eysenck Personality Questionnaire (EPQ), had described hysterics and others with somatic anxiety as neurotic extraverts and neurotics with cognitive anxiety as neurotic introverts. Cloninger wanted to develop a general model that applied to both normal and abnormal personality like Eysenck’s, but felt that his model was unacceptable. Eysenck’s model was based on the phenotypic (observed) structure of personality. Phenotypic variation is the product of the interaction of both genetic and environmental factors, and Eysenck assumed that the phenotypic and genotypic structures are the same. This is the same as saying that genetic and environmental factors influence behaviour in the same way. Cloninger opposed this view and asserted that genetic and environmental influences do not influence behaviour in the same way. He also felt that 2 dimensions are too few to provide a comprehensive model of personality. Hence, he developed a neurobiologically based operant learning model to guide the rational development of descriptors of temperament (Cloninger, 1987-1991).

He hypothesized that the temperament systems in the brain were functionally organized as independently varying systems for the activation, maintenance and inhibition of behaviour in response to specific classes of stimuli. Behavioural activation involved the activation of behaviour in response to novelty and signals of reward or relief of punishment or non-reward, so individual differences in inhabitability were called ‘Harm Avoidance’. Behaviour that was previously rewarded was later maintained for a while without continued reinforcement, and individual differences in such maintenance were called ‘Reward dependence’. The TPQ was developed to test these hypotheses and to evaluate their adequacy as a general model of personality.

Cloninger’s four factor model can be seen as a modern interpretation of the ancient 4 temperaments: melancholic (harm avoidance), choleric (novelty seeking), sanguine (reward dependence) and phlegmatic (persistence). However, now the 4 temperaments are understood to be genetically independent dimensions that occur in all factorial combinations rather than mutually exclusive categories. The 4 temperaments can also be seen to correspond to the 4 basic emotions of fear (harm avoidance), anger (novelty seeking), love (reward dependence) and tenacity (persistence).

The 4 character dimensions were added to the TCI. The characterologic aspects of personality involve individual differences in self-concepts about goals and values, in contrast to the temperaments that involve differences in autonomic emotional reactions and habits. Such self-concepts modify the significance or meaning of what is experienced, thereby also changing emotional reactions. Accordingly, the 3 character dimensions involve both an intellectual perspective about self/non-self boundaries and an emotional perspective. Self-directedness is based on the concept of the self as an autonomous individual; from this self-concept are derived feelings of personal integrity, honour, self-esteem, effectiveness, leadership and hope. Likewise, cooperativeness is based on the concept of the self as an integral part of humanity or society; from this self-concept are derived feelings of community, compassion, conscience and charity. Self-transcendence is based on the concept of self as an integral part of the universe and its source; from this self concept are derived feelings of mystical participation, religious faith, and unconditional equanimity and patience. According to Cloninger’s psychobiological theory, character development involves changes in the propositional memory system, whereas temperament involves differences in procedural memory.

ALTERNATE VERSIONS:

TCI is a family of tests designed for varying types of informants- self report, informant ratings and interviewers. It can be used on varying age group- 7 to 14 years and above 15 years of age. The version of the TCI appropriate content and reading level for children aged 7-14 was developed in collaboration with child psychiatrists Joan Luby and Kimberli McCallam. The child and adolescent version is now being studied in normative and clinical samples.

The test measuring the temperament dimensions only was originally called the Tri-dimensional Personality Questionnaire (TPQ). In TPQ, novelty seeking, harm avoidance, reward dependence and persistence were all measured, but persistence was originally scored as a component of reward dependence. The name of test was changed when the character scales were added and Persistence was recognized as a fourth, separately inherited temperament dimension.

TCI has broad applications and is used to account for individual differences in both normal and abnormal behaviour patterns. It is useful in practical clinical work notable in diagnosis, differential diagnosis and treatment planning of psychiatric disorders. The character scales are designed to distinguish whether the person has any personality disorder and the temperament scales allow the differential diagnosis of categorical subtypes of personality disorders as well as types of normal temperament. TCI also helps in assessment of comorbid psychopathology. Differential responses to psychoactive drugs including antidepressants and antianxiety agents, has been strongly related to the TCI temperament variables. In contrast, the character scales are designed as targets for psychotherapeutic development. The correlations between the original scale scores and the TCI temperament scales are very high. The TCI 125 is a shorter, 125 item version of the TCI which was derived to provide a convenient screener for personality disorders. However, validity indicators have been developed only for the full TCI.

The TPQ and TCI have been translated into several languages like Czech, Serbian, Swedish, German, Japanese and Norwegian. However, normative data for all are not available yet. There is also a revised version TCI-R. Whereas the original TCI had statements that the subject should indicate whether true or false the TCI-R has a five point rating for each statement.

ADMINISTRATION AND SCORING

Using TCI is easy and self-explanatory. The self-report questionnaires are paper and pencil tests where the subject answers true or false to a series of questions about their likes and dislikes, emotional reactions, interests, attitudes, goals and values. The S is asked to answer all the questions fairly rapidly. Scoring is simply done by adding one point for each item answered appropriately. The replies to items on individual scales are expected to usually be balanced for true and false responses; that is, the items are phrased so that both true and false responses can increment the scales. Such balance helps reduce response set problems. The profiles can be scored either by the hand scoring method or by the available computerised program.

CONFIGURAL ANALYSIS OF THE TCI

The classification and description of multidimensional profiles is called configural analysis. It provides a clinically important bridge between dimensional and categorical approaches to describing differences between people. The subtypes of personality disorders can be understood largely in terms of the interaction of 3 temperament dimensions – harm avoidance, novelty seeking and reward dependence. Persistence facilitates mature character development, and the character dimensions primarily determine whether an individual has a personality disorder. Thus, the style of behaviour, whether it is mature or immature, can be described primarily in terms of the interaction of the 3 temperaments.

Fig. 1 Interaction of 2 personality dimensions, novelty seeking and harm avoidance

High novelty seeking

Impulsive ExcitableExploratory quick temperedFickle extravagant

Danger seeking HypothymicAggressive easily distressedCompetitive conflicted/waveringOveractive uncertain/indecisiveImpatientTalkativeExtraverted

Cofident, carefree Cautious, apprehensiveLow harm avoidance High Harm avoidance

Uninhibited, energetic Fatiguable, inhibited

Hyperthymic serenity seekingCheerful passiveUnwavering/stubborn inactiveBoastful/overconfident patient

Reflective quietRigid introvertedLoyal stoic

Slow temperedfrugal

Low novelty seeking

In the above figure, the interaction between the two temperaments, harm avoidance and novelty seeking and the expected behaviour patterns from their various combinations are shown.

Fig. 2Interaction of 2 personality dimensions, reward dependence and harm avoidance

High reward dependence

ambitious sympathetic/warmindustrious quick sentimentalpersistent moody

heroic passive avoidancepersuasive/pushy submissive/deferentialperseverant indirectly manipulativegullible dependently demanding

Cofident, carefree Cautious, apprehensiveLow harm avoidance High Harm avoidance

Uninhibited, energetic Fatiguable, inhibited

Oppositional/defiant cunning/deviousDirectly confronting ineffectual/reservedDetached indifference underachievingimperturbable alienated/cynical

unambitious tough minded self-willed detached practical emotionally cool

reward dependence

In the above figure, the interaction between the two temperaments, harm avoidance and reward dependence and the expected behaviour patterns from their various combinations are shown.

Fig. 3Interaction of 2 personality dimensions, high novelty seeking and reward dependence

High novelty seeking

impulsive excitableexploratory quick temperedfickle extravagant

libertarian attention-seekingskilfully charming self-indulgentcoolly poised passionateunconventional insecurely vain/narcissistic

detached AmbitiousLow reward dependence High reward dependence

Tough minded sentimental

Privacy seekingSelf-effacing authoritariandispassionate scrupulousmodest unaffected/candidunimaginative warm/direct

traditional

reflective stoic rigid slow tempered loyal loyal

Low novelty seeking

In the above figure, the interaction between the two temperaments, reward dependence and novelty seeking and the expected behaviour patterns from their various combinations are shown.

In general, extreme combinations (high or low) of pairs of the 3 temperament dimensions of NS, HA and RD produce certain second order traits summarized in the following table –

TABLE NO. 1

Clusters of personality traits associated with various combinations of basic stimulus-response characteristics Basic stimulus-response characteristicsPersonality cluster Novelty seeking Harm avoidance Reward dependenceImpulsive vs. high low ----Rigid low high ----Hyperthymic vs. low low ---- Hypothymic high high ---- Scrupulous vs. low ---- highOpportunistic high ---- lowNarcissictic vs. high --- highSelf-effacing low ---- lowPassive-avoidant vs. ---- high highOppositional ---- low lowGullible vs. ---- low highAlienated ---- high low

Furthermore, extreme combinations of all these 3 dimensions produce 8 possible configurations are summarized in the table below. These configurations are called profile types and correspond to the 8 traditional categories of personality disorder as shown in the table.

TABLE NO.2

TRADITIONAL PERSONALITY CATEGORIESPersonality disorder Novelty seeking Harm avoidance Reward dependenceAntisocial High Low LowHistrionic High Low LowPassive-aggressive High High HighExplosive High High LowObsessional Low Low HighSchizoid Low Low LowCyclothymic Low Low HighPassive-dependent Low High High

Combining the descriptions in the previous 2 tables, descriptions of the 8 third order profile types in terms of their second order characteristics are shown below –

TABLE NO.3

Personality clusters associated with traditional categoriesSecond order personality clusters

Personality disorder

impulsive vs.Rigid

hyperthymic vs.hypothymic

scrupulous vs.opportunistic

narcissistic vs.self-effacing

passive-avoidantoppositional

gullible vs.alienated

Antisocial impulsive Opportunistic OppositionalHistrionic impulsive narcissistic GulliblePassive-aggressive hypothymic Narcissistic Passive-

avoidantExplosive hypothymic Opportunistic alienatedObsessional Rigid Self-effacing alienatedSchizoid hyperthymic Self-effacing OppositionalCyclothymic hyperthymic scrupulous GulliblePassive-dependent Rigid

scrupulous Passive-avoidant

This clustering or categorization is not simply an arbitrary process; rather it recognizes the typical interaction patterns arising from particular multidimensional configurations over the course of development and the degree of stability of the multidimensional profiles observed empirically.

For interpretation & categorization purposes, the breakdown of individuals is extended into 3 groups of equal size in terms of their percentile scores on each dimension: low (lowest 1/3rd, 0-34%), average (middle 1/3rd, 34-66%), high (highest 1/3rd,67-100%). The categorical labels primarily help to remind the clinician about expected interaction patterns, not to replace the full quantitative information about each dimension.

Adequate data is currently available to classify individuals into temperament types based on novelty seeking, harm avoidance and reward dependence, in accord with the above table. Specifically, an individual who is extreme (high or low) on the three temperaments in the designated direction should be classified as a case of that temperament. For e.g. an individual who is high in novelty seeking, low in harm avoidance and low in reward dependence is a severe case of the antisocial temperament type. Likewise, individuals who are average (34-66%) on all 3 temperaments are classified as average or ‘flexible’ in type. All others are classified as ‘mild’ cases on the basis of their pattern of deviation above or below the median on all the 3 temperaments. The utility and biological significance of median splits has been empirically supported in the prediction of antidepressant drug responses in depressives.

DESCRIPTION OF TEMPERAMENT & CHARACTER TYPES

Table No.4 describes the different temperament and character types –

SCALES HIGH SCORERS LOW SCORERS

TEMPERAMENT HARM AVOIDANCE

Worrying & pessimistic; fearful & doubtful; shy; fatigable.

Relaxed & optimistic; bold & confident; outgoing; vigorous.

Anticipatory worry and pessimism VS Uninhibited optimism (HA1).

Pessimistic worriers, anticipate harm and failure. Difficulty in getting over humiliating and embarrassing situations

Positive thinking, optimists. Get over quickly when humiliated and embarrassed.

Fear of uncertainty (HV2)

Cannot tolerate uncertainty, difficulty in adapting to changes in routine. quite and inactive

Confident, calm and secure. Prefer to take risks. Adapt to changes.

Shyness with strangers (HA3)

Unassertive and shy. Lack confidence

bold, forward and outgoing

Fatigability VS vigor

asthenic, less energy recover slowly from minor illnesses and stress

Highly energetic and dynamic recover quickly from minor illnesses and stress.

NOVELTY SEEKING

Exploratory & curious; impulsive; extravagant & enthusiastic; disorderly.

Indifferent; reflective; frugal & detached; orderly & regimented.

Exploratory excitable VS Stoic rigidity

Enjoy exploring, sensation seeking. Seek thrills , excitement and adventures intolerant to routine & introduce change

no need for novel stimulation resistance or slow to engage in change conventional, rarely bored from routine

Impulsiveness VS reflection (NS2)

Excitable, dramatic, impressionistic, make decisions quickly poor impulse control. Attention span is <

Reflective, analytical and require detailed information when making decisions. Rarely break rules. Not easily distracted.

Extravagance VS reserve (NS3)

Extravagant with their money, energy. And feelings. Gallant, flamboyant and unrestrained.

Reserved, controlled or restrained. Don’t waste their money, energy and

Prefer to spend money than to save it.

feelings. Frugal and stingy

Disorderliness VS regimentation (NS4)

Quick tempered and disorderly. Express anger outwardly. Don’t like fixed rules and regulations and routines.

Organized, orderly, methodical and systematic. Prefer strict rules. Slow to lose their temper.

REWARD DEPENDENCE

Sentimental & warm; dedicated & attached; dependent.

Practical & cold; withdrawn & detached; independent.

Sentimentality (RD1)

Sentimental, sympathetic, understanding individuals. Show their emotions easily. Experience vicarious emotions easily.

Tough minded, practical, coolly detached rarely moved by sentimental appeals.

Attachment VS detachment (RD3)

Prefer intimacy over privacy. Discuss their experiences and feelings openly. They form warm and lasting social relationships sensitive to rejection and slights.

Disinterest in social relationships. Prefer privacy. Self contained. Alienated, detached, and distant

Dependence VS independence (RD4)

Dependent on emotional support. Reluctant to make decisions. Seek support please others. Easily hurt by criticism.

Neither depends on nor actively seeks emotional support from others. Independent, self sufficient. Unresponsive to social pressure

PERSISTANCE

Industrious & diligent; hard working; ambitious & overachiever; perseverant & perfectionist

inactive & indolent; gives up easily; modest & underachiever; quitting & pragmatist

CHARACTER SELF- DIRECTEDNESS

Mature & strong; responsible & reliable; purposeful; resourceful & effective; self accepted; habits congruent with long term goals.

Immature & fragile; blaming & unreliable; purposeless; inert & ineffective; self striving; habits incongruent with long term goals.

Responsibility VS Blaming(SD1)

Recognize their attitudes, behaviors & problems reflect their own choices. Accept responsibility for their attitudes

Blame other people and external circumstances. Not to accept responsibility for their

and behavior. Reliable and trustworthy.

actions. Unreliable and irresponsible.

Purposefulness VS lack of goal direction (SD2)

Goal oriented or purposeful. Sense of meaning and direction in their lives. Activities guided by long term goals.

Struggle to find direction, purpose, and meaning in their lives. Uncertain about long term goals. Unable to delay gratification.

Resourcefulness VS inertia (SD3).

Resourceful and effective. Productive, proactive, competent and innovative individuals. Rarely lack ideas.

Helpless, hopeless and ineffective. Incompetent when faced with obstacles.

Self acceptance VS self striving (SD4)

Self confident. Accept their strengths and limitations. Very comfortable with their actual mental and physical features.

Self striving. Low self esteem, neither accept not enjoy their actual mental and physical features.

Congruent second nature VS Bad habits (SD5)

Goal congruent, good habits. Act in accord with their long term goals. Self discipline. Feel Safe and self trusting in many tempting situations.

Self defeating and weak willed.

COOPERATIVENESS

Socially tolerant, empathetic, helpful, compassionate & constructive, ethical & principled.

Socially intolerant, critical, unhelpful, revengeful & destructive; opportunistic.

Social acceptance VS Social intolerance (C1)

Tolerant and friendly. Accept other people.

Intolerant and unfriendly, impatient with critical of other people.

Empathy VS Social disinterest (C2)

Imagine in other people's shoes; highly attuned to and considerate of other people's feelings.

Insensitive; don't seem very concerned about other's feelings; unwilling to respect the goals and values of others.

Helpfulness Vs Unhelpfulness (C3)

helpful; supportive; encouraging or reassuring; work as part of a team

Self centered; egotistic or selfish. Prefer to work alone

Compassion VS revengefulness (C4)

Compassionate, forgiving, charitable and benevolent; they don't enjoy revenge.

Revengeful; either overt or disguised. Hurting others physically, emotionally and

financially.

Integrated conscience VS Self serving advantage (C5)

Honest, genuinely scrupulous and sincere persons; incorporated stable ethical principles.

Opportunistic; unfairly, biased, self serving, manipulative or deceitful.

SELF TRANSCENDENCE

Wise & patient; creative & self forgetful; united with universe;

impatient; unimaginative & self conscious; pride & lack of humility

Creative self forgetfulness VS self consciousness (STI)

transcend their self boundaries; absent minded; seem in another world i.e., are absorbed; creative and original;

tendency to be aware of their surroundings; rarely deeply moved by art or beauty; unimaginative;

Transpersonal identification (ST2)

Extraordinary strong connection to nature. Trying to prevent war, poverty or injustice; they are fuzzy-thinking idealists.

View nature as an external object to be manipulated instrumentally, rather than something of which they are an integral part.

Spiritual acceptance VS rational materialism (ST3)

Believe in miracles, magical thinking, extrasensory perception, and other spiritual phenomena.

Accept only materialism and objective empiricism. Unwilling to accept unscientifically explained things.

VALIDITY INDICATORS: DESCRIPTION OF VALIDITY SCALES.

In TCI, there are several scales which can be used to judge the validity of the set of responses. Normative data has been obtained on these validity indicators in order to allow objective statements about the probability that a particular response pattern has occurred by chance. Extreme scores on any of the validity scales should raise caution in the process of interpretation of the self report description of the respondent (that is, has T score of 70 or more or 30 or less which correspond to the extreme 5 th

percentile). TCI validity scales provide a profile of the performance style of the test taker. There are predictable relationships between the performances styles of test taking that correspond to the reported personality of the respondent. For example, individuals who are described as submissive on the TCI content dimensions are predictably more likely to be acquiescent (i.e. to answer true when in doubt ) in test taking where are those who are oppositional are more likely to answer false when in doubt. If incongruence is between the profile of the validity scales and the self description of personality on the content scales suggests invalidity. The validity indicators of TCI are Rarity scale, the Runs scale, the number true, the scale of like items, the scale of unlike items. And a single item inquiring directly about honesty.

1. Rarity scale: - it includes the least frequently endorsed item response from each of the 25 subscales. Endorsement of many such infrequent items across the entire range of personality

dimensions is expected to indicate a deliberate effort to depict oneself in a highly unlikely way or careless disregard for the content of item being endorsed.

2. Runs: - The runs scale counts the number of sequences of consecutive true or false answers. The high no. of runs out of possible 240 may indicate deliberate alternation responses without regard to content. Very low no. of runs may indicate a uniform response pattern. Again responding without regard to content. Average no. of runs = 120

3. Number of true endorsements (Numtrue):- The no. of items endorsed true is useful to indicate an overall tendency to answer yes more or less frequently than usual.

4. Scales of like items and scales of unlike items:- These two scales provide a measure of the extent to which the respondent is consistent in his responses. The scale of like items consists of 29 pairs of questions which are usually answered in the same way (that is, both true of both false). Thus low score indicates inconsistency in answering. A very high score might indicate that the respondent is consciously trying to portray himself in a certain manner and is being overly careful to answer all questions in the same direction In order to manipulate the test outcome. The scale of unlike items has 21 pairs of items usually answered in opposition, one true and one false. It is best to consider the scores on both of these scales. Clearly, it is easier to decide that a test is invalid due to random or very inconsistent responses than to overly consistent answering.

5. In addition to above 5 scales, respondent is given the opportunity to acknowledge or deny honesty in responding to the items. Item 230 in the TCI is “I have lied a lot on this test”. If the answer is yes, the test is considered to be invalid.

USE IN CLINICAL ASSESSMENT AND TREATMENT PLANNING

Interpretation of the TCI scores for both clinical subjects and normal individuals is based on the scores obtained in a community sample of 300 normal adult individuals (Cloninger et al, 1993). Each score sheet for the TCI higher and lower order temperament and character traits provides raw scores, T scores and percentile scores. These scores are provided for each of the higher order temperament and character dimensions, as well as for each of the lower order temperament and character traits.

For interpretation, individuals can be divided into 6 equal groups using the following cut off points for the percentile scores:

Percentile scores:

0-16.7% - VERY LOW

17-33% - LOW

34-66.7% - AVERAGE

67-83.3% - HIGH

84-100% - VERY HIGH

The distinction between low and very low, or high and very high has been found to be reliable and useful for precision in clinical description. Individuals who are very low or very high are much more consistent and intense in their emotional responses and characterological attitudes than those with moderate deviations. For instance, people who are very low in self-directedness nearly always (>90%) have a personality disorder, whereas about 40-50% of those who are only low have a personality disorder.

For the assessment of the TCI, it is useful to have a rough orientation of the current level of the subject’s mood and anxiety states. It provides a rough estimate of the possible effect of current mood and anxiety on temperament and character traits. In interpreting profiles, clinicians should consider the variation in scores to be expected between occasions. In the general population, there is little or no tendency for change in personality as measure on a re-test. In contrast, psychiatric patients, most of whom were mildly depressed when tested initially, were found to have harm avoidance scores that average 2 points higher when followed up 6 months later. In addition, they have scores on self-directedness and cooperativeness that are about 2 points lower on average at follow up. This average pattern is influenced in opposite ways by the onset of new episodes of depression and by the improvement from treatment. Thus, the overall evaluation, description and classification of temperament and character scores should be highly individualized. Optimally, the raters should be well informed about the respondent’s history, long term behaviour and present medical disorders.

Format example of formulation for Global description of personality on the TCI

The most distinctive features in this profile are very low HA and very high NS in the context of chronic depression. The observed combination of low HA and high NS suggests that a spectrum of second order traits dominates this patient’s behaviour. The observed high reward dependence score suggests that this patient tends to be sentimental and warm, dedicated and attached. However, the observed scores on the Persistence scale were very low, suggesting he tends to give up easily when faced with frustration or fatigue. The observed combination of temperament traits (low HA, high NA, high RD) corresponds to the histrionic type of temperament, which is associated with low risk for immaturity and personality disorders. The observed scores on the self-directedness character dimension were low, suggesting that this patient probably has a personality disorder. However, the low average Cooperativeness scores suggest that he has developed some ability to accept and respect other people, to be empathetic, and compassionate.

Format example of Clinical/diagnostic interpretation of the TCI profile

The observed low scores (27 points, or 30th percentile) on the self-directedness scale suggest that this patient has some probability of having a PD. The combined score on Self-directedness and cooperativeness is 59, which places this patient just above the lower third of the general population on this measure of maturity (58 is the 33rd percentile). The observed temperament profile, notable very high Novelty Seeking, suggests that this patient manifests a cluster B personality disorder, i.e., Several indicators suggest that histrionic personality disorder is the most likely diagnosis in this case. The observed temperament type in this case is typical histrionic (ie. Low HA, high NS and high RD). Next, high RD (primarily high sentimentality and attachment) are rarely observed in narcissistic, antisocial, or borderline personality disorder. Next, most of the observed scores on the cooperativeness subscales (e.g. social acceptance , empathy, compassion, integrated conscience) were average, suggesting a reasonably well developed social sensibility. These features are more frequently observed with histrionic than with antisocial or borderline individuals. In addition, the observed low persistence scores also match traditional clinical concepts of histrionic personality.

APPLICABILITY OF THE TCI

1. All available studies confirm that individuals with all types of anxiety disorders are high in harm avoidance. The converse is not necessarily true: that is individuals who are high in harm avoidance do not necessarily have an anxiety disorder.

2. Harm avoidance is predicted to increase susceptibility to depression in addition to anxiety. Being high in both harm avoidance and novelty seeking produces internal approach avoidance conflicts that make it difficult to be happy and hopeful. Dysthemic individuals are expected to be low in self directedness which is characterized by the feeling of emptiness. Individuals high in reward dependence are predicted to be sensitive to social loss, which produces reactive dysphoria with hypercortisolemia. Studies have shown that individuals with personality disorder or low self directedness are expected to have frequent comorbid dysthymia and depression.

3. The presence of any personality disorder was strongly determined by low scores in self directedness and cooperativeness. In addition, low reward dependence, high novelty seeking or high harm avoidance predicted personality disorder (if present) from cluster A,B and C resp. thus it may help us in differential diagnosis of the clusters.

4. TCI has been used for investigating the neurobiological foundation of personality together with other research modalities like molecular neuroimaging, structural neuroimging and genetics. Cloninger suggested that the 3 original temperaments from TPQ, NS, HA and RD were correlated with low basal dopaminergic activity, high serotonergic activity and low basal noradrenergic activity, respectively.

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