An Australian validation study of the temperament and character inventory

Adolescent attachment styles and their relation to the temperament and character traits of personality in a general population

Attachment styles as well as personality traits in adolescents and adults have been found to be associated with their health outcomes and with their personality pathology. In this cross-sectional exploratory study, we study the relationship between attachment styles that derive from our data employing the items of Feeney et al. (1994) self-report attachment style questionnaire (ASQ), and personality traits given by the junior version of Cloninger et al. (1993) self-report temperament and character inventory (TCI), in a sample of 426 adolescents (54% females) from a general population. The secure attachment style was correlated significantly negatively with the personality trait harm avoidance (HA), but significantly positively with the personality traits novelty seeking (NS), reward dependence (RD), cooperativeness (CO) and self-transcendence (ST). The preoccupied (anxious/ambivalent) attachment style was correlated significantly positively with HA and NS, but significantly negatively with self-directedness (SD). The fearful-avoidant category was correlated significantly negatively with NS. Our five-factor solution of the attachment styles and their relation to the TCI point towards a need for a modification of the two-axis, four-category attachment model of Bartholomew (1990) and Bartholomew and Horowitz (1991), with their category dismissing-avoidant replaced by the two categories defined here as dismissing relations (correlated significantly negatively with CO) and dismissing others (correlated significantly negatively with RD and significantly positively with SD).

How Do Allied Health Professionals Construe the Role of the Remote Workforce? New Insight into Their Recruitment and Retention

Purpose

Allied health workforce recruitment and retention in remote areas is a global problem. Using case studies from the Australian allied health workforce, this paper adds new information by combining personality trait information with a detailed understanding of how the cases construe the demands of remote work, which may be useful in addressing this problem.

Methods

Four cases (two urban, two remote) are presented from a mixed methods study (n = 562), which used (1) the Temperament and Character Inventory to investigate personality traits of allied health professionals; and (2) repertory grid interviews to reveal quantitatively and qualitatively how the cases construed their Ideal work role compared with their Current and a Remote role. Cases also self-assessed their fit (‘suited’ or ‘not suited’) with remote.

Findings

Differences in the way cases construed their fit with remote work was related to prior experience. However all were satisfied with their work, perceiving their Current role as similar to their Ideal. All saw remote work as requiring generalist expertise and a reliance on relationships. Personality traits, especially Novelty Seeking and Harm Avoidance, fit with how allied health professionals perceived their role.

Conclusions

The combination of two distinct lines of investigation, illustrates what more can be revealed about allied health professional’s career choices by taking into account the fit or lack of fit between their personality tendencies, their construing of remote work and their life circumstances. Understanding the combined influence of perceptions and traits on an individual toward or away from remote work may enhance recruitment and retention internationally.

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.

Profiles of rural longitudinal integrated clerkship students: a descriptive study of six consecutive student cohorts *

BACKGROUND

Medical schools worldwide are challenged to address the rural primary care workforce shortage by creating community-engaged curricula to nurture student interest in rural practice.

AIM

To examine the personal characteristics of six consecutive rural longitudinal integrated clerkship student cohorts to understand whom the programs attract and select and thus inform the development of such programs.

METHOD

A cross-sectional cohort design was used. Six cohorts (2007-2012) completed a survey on demographics and factors that influenced their choice of rural primary care. The Temperament and Character Inventory was used to measure personality. Analysis was mainly descriptive. Where appropriate univariate analysis compared variables between groups.

RESULTS

Sample size was 205 with the majority female (61%), between 25 and 29 years (64%), single (60%) and lived longest in rural communities with populations less than 20,000 (60%). Rural lifestyle, background and desire to work in underserved areas were noted to impact rural medicine interest. Professional satisfaction, personal and professional goals and family needs had the highest impact on career decisions, and financial concerns lowest.

CONCLUSION

The stability of students' personal characteristics across cohorts and the workforce outcomes of this program suggest the recruitment process successfully nurtures students who will fit well into future rural practice.

Investigating personality and conceptualising allied health as person or technique oriented

OBJECTIVE

Allied health (AH) includes many diverse professions, each with a unique contribution to healthcare, making it possible to consider these professions as person oriented (PO) or technique oriented (TO). This paper explored the personality traits of AH professionals from the perspective of both the PO or TO orientation and the individual professions.

METHODS

AH professionals (n=562) provided demographic data and completed the Temperament and Character Inventory. Examination of the literature and a consultation process resulted in nine professions classified as PO and 10 classified as TO. Multivariate analyses compared levels of personality traits and demographic variables between the PO (n=492) and TO (n=70) groups, and the professions within the groups.

RESULTS

Professionals in the PO group showed significantly higher levels of traits that emphasise person orientation attributes, such as being sociable, empathic and cooperative, compared with AH professionals in professions with an emphasis on TO.

CONCLUSIONS

Trends in personality traits among AH professionals were congruent with the PO and TO aspects of their chosen profession. This supports the usefulness of the PO and TO concepts in describing AH professions and may provide new clues for policy aiming to enhance job satisfaction, retention and career development. WHAT IS KNOWN ABOUT THE TOPIC? The literature suggests that certain medical specialities can be classified as person (PO) or technique oriented (TO) and that individuals attracted to those specialties display traits that are similar to that orientation. There is scant information on the AH professions regarding similar person or technique orientations. WHAT DOES THIS PAPER ADD? The diversity of professions within AH allows a new approach to describing each profession as either PO (socially dependent, cooperative and relationship focused), or TO (focused on skills and procedures). The trend in personality traits of individuals in certain AH professions is compatible with the orientation of that profession. Findings suggest that individuals may be attracted to professions that favour a similar personality pattern to their own. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? Gaining an improved understanding of the AH professions and individuals who are attracted to them in a climate of workforce shortage and increasing multidisciplinary service demand. The findings provide a new approach to understanding the characteristics of AH professions according to the personalities they attract. This information could guide recruitment and retention policy, and assist in career counselling by providing greater insight into personality profiles that are best suited to certain professions.

Toward a global understanding of students who participate in rural primary care longitudinal integrated clerkships: considering personality across 2 continents

PURPOSE

Medical schools worldwide have developed rural primary care immersive experiences to nurture students' interest in future rural careers and address workforce shortages. Few studies have looked at the students who participate in these programs. This study explores personality traits in US and Australian students who undertake rural-focused medical training.

METHODS

A cross-sectional cohort design used the Temperament and Character Inventory to identify levels of the 7 basic dimensions of personality. Data were collected in successive cohorts over 2007-2011. Multivariate analysis compared trait levels between groups and by demographic variables.

FINDINGS

The majority of the 302 students (US-167; Australia-135) were female, aged 20-29 years and single. A greater proportion of US students reported being partnered, living longest in a small rural/remote community and having a rural background. Significant differences between groups were detected in several traits but effect sizes were small. The personality pattern of the combined sample indicates students with a mature and stable personality high in Self-Directedness, Persistence, and Cooperativeness. Rural background and marital status enhanced this pattern.

CONCLUSIONS

Despite coming from different educational and societal backgrounds, similar personality patterns are evident in US and Australian students who pursue rural medical education. Data provide support for a pattern of traits associated with a rural background and its predictive influence on interest in rural practice. Considering the international expansion of rural longitudinal integrated clerkships, understanding student attributes may assist in identifying strategies to enhance the rural workforce that are relevant across cultures and continents.

Investigating the development of temperament and character in school-aged children using a self-report measure

BACKGROUND

Developmental studies of temperament and character dimensions are crucial for a better understanding of how genetic and environmental factors interact in shaping individual personality. However, although several studies have been conducted in adults, a few studies have addressed the evaluation of temperament and character in children. Here, we tested the suitability of self-report evaluation and the developmental trend of temperament and character dimensions among school-aged children using an Italian version of the junior Temperament and Character Inventory (jTCI).

METHODS

The jTCI was completed by 572 Italian children (292 girls and 280 boys) aged 8 to 12 years. We evaluated the internal consistency of the 7 jTCI scales at each age, the intercorrelations between the scales, and the factorial model of the questionnaires. Furthermore, we tested the differences between the development of the temperament and character dimensions in girls and boys.

RESULTS

Although the data from 8-year children showed unacceptably low internal consistency, better reliability was observed for older children. Intercorrelations and factor analysis partially confirmed the hypothesized structure of the jTCI items, with problems observed for some items of the Novelty Seeking, Harm Avoidance, Reward Dependence (RD), and Self-Directedness scales. Furthermore, in keeping with previous studies, girls presented lower scores in Novelty Seeking and higher RD, Self-Directedness, and Cooperativeness scales than did boys, with the between-sex difference in RD becoming larger at older ages.

CONCLUSIONS

Although the use of the self-administered jTCI in clinical settings should be cautious, it may serve as a useful complementary instrument to describe the development of personality in childhood.

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.

The Swedish Version of the Parent-Rated Junior Temperament and Character Inventory (J–TCI)

To evaluate the psychometric characteristics of the Swedish version of the Junior Temperament and Character Inventory (J–TCI), it was sent to parents of 9- and 12-yr.-old twins in Sweden. The final number of responders was 196 parents who rated 92 female and 104 male twin pairs. The inventory of one twin, randomly chosen from each pair, was included in the analyses. Reward Dependence, Persistence, and Cooperativeness were scored higher in girls; Novelty Seeking was higher in the 9-yr.-olds and Persistence in the 12-yr.-olds. Pearson's correlations showed that some dimensions were not statistically independent from each other, even if the covariance was moderate. Internal consistency (Cronbach's alpha) was satisfactory for Harm Avoidance, Novelty Seeking, Self-Directedness, and Cooperativeness (.68–.81), while it was lower in those dimensions that had fewer items. The Swedish parent version of the J–TCI shared about the same psychometric characteristics as found in international samples.

Temperament and character in patients with bipolar II disorder and recurrent brief depression

OBJECTIVES

We compared the temperament and character profiles of 21 patients with bipolar II disorder, 40 patients with recurrent brief depression (RBD; at least monthly depressive episodes meeting the diagnostic criteria for major depressive episode except for duration that is less than 2 weeks, typically 2-3 days, without fixed relation to menstrual cycle) of which 21 had no history of hypomania and 19 had experienced hypomanic episodes, and 21 age- and sex-matched controls.

METHODS

Assessments included the Montgomery-Åsberg Depression Rating Scale, Hypomania Checklist, and Temperament and Character Inventory-125. Patients with cluster A and B personality disorders were excluded.

RESULTS

Bipolar II and RBD patients had higher harm avoidance (HA) and lower self-directedness (SD) compared with controls. Excluding panic disorder comorbidity effaced this difference in HA and SD (bipolar II only) and harm avoidance. No other differences were found.

CONCLUSIONS

In this first study comparing personality profiles of patients with bipolar II vs RBD, when controlling for confounders, neither bipolar II nor RBD patients differed significantly from healthy controls. The lower SD scores among RBD patients may reflect sampling bias (a higher rate of Axis 2 cluster C disorders).

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

Cloninger's dimensional psychobiological model of personality accounts for both normal and abnormal variation in 2 major personality components: temperament and character. Here, we examined the psychometric properties of the Turkish version of the Temperament and Character Inventory (TCI) in a healthy Turkish population, obtaining normative data for the Turkish TCI. The study was conducted in healthy volunteers at both Karadeniz Technical University School of Medicine and Atatürk University School of Medicine (n = 683). The Turkish sample had significantly lower mean scores on Novelty Seeking and Reward Dependence and higher mean scores on Harm Avoidance than the American sample. 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 coeficients were between 0.60 and 0.85 on temperament dimensions, and between 0.82 and 0.83 on character dimensions. The lowest Cronbach coefficients were found in Reward Dependence (0.60) and Persistence (0.62). A principal axis factor analysis with a 4-factor solution revealed the highest loadings on Novelty Seeking and Harm Avoidance and relatively weaker loadings on Reward Dependence and Persistence. A 3-factor solution for character subscales indicated the highest loadings on Cooperativeness and Self-Transcendence. The factorial structure was consistent with Cloninger's 7-factor model of personality, and test-retest indicated a good stability of scores over time. The reliability and factorial validity of the Turkish version of the TCI are therefore supported.

Cloninger's temperament traits and preclinical atherosclerosis: the Cardiovascular Risk in Young Finns Study

OBJECTIVE

Cloninger's psychobiological model of temperament has recently raised interest as a risk factor for CHD. However, there are no studies that have examined the associations of Cloninger's temperament traits with atherosclerosis.

METHODS

The subjects were 398 men and 657 women (mean age 31.7 years) participating in the Cardiovascular Risk in Young Finns Study. Linear regression analyses were used to examine the cross-sectional associations between temperament traits and preclinical atherosclerosis. Preclinical atherosclerosis was measured with carotid intima-media thickness ultrasound.

RESULTS

Higher novelty seeking (NS) and reward dependence (RD) and lower harm avoidance (HA) were associated with preclinical atherosclerosis. In NS and RD, associations remained significant after adjustments for various risk factors. The effect sizes of these associations were comparable to those of traditional risk factors of coronary heart disease, which is a major finding. No association for persistence (P) was found.

CONCLUSIONS

The present findings imply that examining a wider range of temperament and personality factors may offer new information that can help in explaining the between-individual variation in atherosclerosis and CHD morbidity.

Temperament, substance use and psychopathology in a prisoner population: implications for treatment

OBJECTIVE

The association between temperament and drug use or temperament and psychopathology has previously been restricted to community clinical or non-clinical samples. The aim of the present study was therefore to examine these associations in a large cohort of Australian offenders using Cloninger's Temperament and Character Inventory (TCI).

METHODS

A total of 1322 prisoners from New South Wales (NSW) who completed all dimensions of the TCI and were screened for mental illness using the Australian National Survey of Mental Health and Wellbeing were included in the study.

RESULTS

A total of 15% of the sample fulfilled the criteria for a diagnosis for depression, 36% for anxiety disorders and 54% for a substance abuse disorder. Using logistic regression analysis, the TCI dimensions of harm-avoidance and low self-direction predicted depression. Being female, a poly-substance user and having high harm-avoidance, persistence, self-direction and self-transcendence predicted anxiety disorders. Significant stepped trends across age, gender, and type of drug use were found for all TCI dimensions.

CONCLUSIONS

The TCI is useful in identifying prisoners with a history of psychopathology and substance misuse. This tool also provides clinically relevant information about at-risk individuals and has the potential to guide the development of intervention programmes for inmates.

Personality dimensions measured using the Temperament and Character Inventory (TCI) and NEO-FFI on a Polish sample

The results of two self-administered, paper-and-pencil tests based on biosocial theory of personality have been compared simultaneously: the Temperament and Character Inventory (TCI) and NEO Five Factor Inventory (NEO-FFI). The stability of the personality dimensions was assessed across age, sex and education level samples in a group of 406 Polish adults with major mental diseases excluded by use of PRIME-MD questionnaire. Significant effects of age, sex, and education have been found while comparing personality dimensions in both temperamental (novelty seeking, NS; harm avoidance, HA; reward dependence, RD; persistence, P) and character scales (cooperativeness, C; self-transcendence, ST) in TCI. Among subscales of temperament only NS1, RD4 were stable according to concerning factors. All converted to their age and sex norms NEO-FFI dimensions were stable according to sex. Extraversion scale was changeable depending on age (p = 0.04). Neuroticism dimension was a little higher in lower educated group (p = 0.035).To sum up, it was concluded that sex- and age-specific norms for the dimensions of the Polish version of TCI are necessary considering the established significant differences. Particular personality genetic studies should account for age, sex and also educational differences in their methods of associative studies.

CONCLUSIONS

In the exploration of personality dimensions on healthy volunteers the Polish version of NEO-FFI corresponds better than TCI to theory of stability and genetic determinants of human personality. As the study included persons with excluded major mental diseases, the sample is appropriate to provide a control group in the research of psychiatric patients using both TCI and NEO-FFI.

SIGNIFICANT OUTCOMES

TCI scores for persons with excluded mental disease are highly changeable depending on age, sex and education. Adjusted to sex and age scores NEO-FFI corresponded better than TCI to stability and genetic determinants of human personality.

The Swedish Version of the Temperament and Character Inventory (TCI)

Abstract. In order to establish new norms of the Swedish version of the Temperament and Character Inventory (TCI), data from 2,209 Swedish individuals (age between 13 and 80) was analyzed. The second aim was to evaluate the impact of age and gender on the questionnaire scores. The third aim was to investigate whether the TCI can be meaningfully applied to adolescents in personality assessment as a basis for further research and clinical studies. Age and gender showed independent effects on personality dimensions, which implies that age and gender specific norms have to be established for the TCI. Furthermore, the results in terms of inconsistencies in the correlational and factorial structure, as well as low internal consistency scores in the younger age groups, suggest that the adult version of the TCI should not be applied below the age of 17; for these age groups we recommend the use of the junior TCI (JTCI). The inventory is under further development and several items are in need of revision in order to create less complicated formulations, enabling an improvement in the psychometrics.

Harm avoidance, self-harm, psychic pain, and the borderline personality: life in a "haunted house"

This article investigates the pattern of temperament for patients with borderline personality disorder and the impact of psychotherapeutic treatment on temperamental variables. A cohort of patients treated in the Westmead Borderline Personality Disorder Psychotherapy research project completed the Tridimensional Personality Questionnaire. All patients had a diagnosis of borderline personality disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition, criteria. This group scored highly on novelty-seeking and harm avoidance scales and moderately on reward dependence. There was a significant reduction in harm avoidance after 12 months of psychotherapy with a further reduction after 2 years in therapy. Although at variance with Cloninger's original prediction of low harm avoidance in histrionic and borderline patients, results are consistent with other studies in this patient group. The paradox of "self-harmers" scoring highly on harm avoidance may be explained by recognition of the intensity of "psychic pain" in this group. Self-harming behaviors may frequently be motivated by avoidance of a "greater harm" in terms of the inner psychic reality for these patients. Reduction in harm avoidance with psychotherapy could suggest an impact of treatment on temperament or may indicate that the harm avoidance construct is influenced by state variables such as mood.

A large population cohort provides normative data for investigation of temperament

OBJECTIVE

We evaluated the psychometric properties of widely used scales for assessing temperament in a large birth cohort. We simultaneously compared the properties of the temperament dimensions of the Tridimensional Personality Questionnaire (TPQ) and of the Temperament and Character Inventory (TCI).

METHOD

As part of the 31-year follow-up survey of the prospective Northern Finland 1966 Birth Cohort, the TPQ and TCI temperament questions were filled in by 4349 subjects (1974 males, 2375 males). Factor analysis and Cronbach's alpha were used to explore the psychometric properties of the scales.

RESULTS

Of the three higher-order dimensions the reward dependence (RD) was the only one performing poorly in our study sample. Cronbach's alpha was higher in the TCI than in the TPQ.

CONCLUSION

The results indicate good performance of the TCI and TPQ. Factor analysis support adoption of four temperament dimensions and suggest that developmental work is still needed in the RD dimension.

Properties of the temperament and character inventory in a Chinese sample

OBJECTIVE

To determine the influence of language and culture on the temperament and character (TCI) measure in a Chinese sample.

METHOD

We translated the TCI into Mandarin and had a non-psychiatric sample of Malaysian Chinese subjects complete the TCI at baseline and at a 1-month retest, with subsets completing English or Mandarin versions alternatively or on both occasions. Analyses examine the TCI factor structure and any impact of language and culture on TCI scoring.

RESULTS

We identified age, gender, occupation and language effects on TCI scale scores. Test-retest reliability was high and not compromised by language. Scale internal consistency was also high. Factor analyses of separate sets of TCI scales corresponded strongly to the structure identified in the TCI development studies.

CONCLUSION

The results indicate that TCI is likely to have applicability to Chinese subjects, and argue against properties being constrained by the English language or by western culture.