Gene expression networks regulated by human personality

Genome-wide association studies of human personality have been carried out, but transcription of the whole genome has not been studied in relation to personality in humans. We collected genome-wide expression profiles of adults to characterize the regulation of expression and function in genes related to human personality. We devised an innovative multi-omic approach to network analysis to identify the key control elements and interactions in multi-modular networks. We identified sets of transcribed genes that were co-expressed in specific brain regions with genes known to be associated with personality. Then we identified the minimum networks for the co-localized genes using bioinformatic resources. Subjects were 459 adults from the Young Finns Study who completed the Temperament and Character Inventory and provided peripheral blood for genomic and transcriptomic analysis. We identified an extrinsic network of 45 regulatory genes from seed genes in brain regions involved in self-regulation of emotional reactivity to extracellular stimuli (e.g., self-regulation of anxiety) and an intrinsic network of 43 regulatory genes from seed genes in brain regions involved in self-regulation of interpretations of meaning (e.g., production of concepts and language). We discovered that interactions between the two networks were coordinated by a control hub of 3 miRNAs and 3 protein-coding genes shared by both. Interactions of the control hub with proteins and ncRNAs identified more than 100 genes that overlap directly with known personality-related genes and more than another 4000 genes that interact indirectly. We conclude that the six-gene hub is the crux of an integrative network that orchestrates information-transfer throughout a multi-modular system of over 4000 genes enriched in liquid-liquid-phase-separation (LLPS)-related RNAs, diverse transcription factors, and hominid-specific miRNAs and lncRNAs. Gene expression networks associated with human personality regulate neuronal plasticity, epigenesis, and adaptive functioning by the interactions of salience and meaning in self-awareness.

Resilience personality profiles among Swedish long-term unemployed

Our aim was to investigate the prevalence of resilience personality profiles in a sample of Swedish long-term unemployed in relation to the general Swedish population. We found that only 1.50% (vs. 26% in the general population) in the long-term unemployed sample had a resilient personality profile, that is, low in harm avoidance (e.g., relaxed and optimistic), high in persistence (e.g., hard-working), and high in self-directedness (i.e., goal-oriented and resourceful).

Longitudinal Associations of Explosive and Adventurous Temperament Profiles With Character Development: The Modifying Effects of Social Support and Attachment

OBJECTIVE

The aim of this study was to examine (a) whether adventurous and explosive temperament profiles (presumed precursors of antisocial and borderline personality) are associated with character traits over a 15-year follow-up and (b) whether social support and attachment security modify the relationship between temperament profiles and character development.

METHODS

2,028 subjects of the Young Finns study completed the Temperament and Character Inventory, the Multidimensional Scale of Perceived Social Support, and the Relationship Questionnaire at 3 assessment points between 1997 and 2012.

RESULTS

Both explosive and adventurous temperament profiles seemed to predispose individuals to have less mature personalities; that is, these profiles were consistently associated with lower cooperativeness (P < .001), and explosive temperament also with lower self-directedness (P < .001), over the entire follow-up period. These relationships did not vary significantly at the individual level and were sustained after controlling for age, gender, and socioeconomic status. However, the presence of high social support and secure attachment was found to decrease the likelihood that explosive temperament would lead to an immature adulthood character (P < .001). In contrast, persons with the adventurous temperament were likely to have a more mature character under low social support and an immature one under high experienced social support (P < .05).

CONCLUSIONS

Individuals with the explosive temperament benefit from high social support and secure attachment. From the point of view of the therapy process, this knowledge might be of importance. In contrast, individuals with the adventurous temperament were able to direct their behavior better in social environments that were not likely to support their basic temperaments.

Promoting healthy lives and well-being for all: The contribution of the International College of Person-Centered Medicine (ICPCM)

This article defines the scope of Person-Centered Medicine, traces its roots in ancient conceptions, explains the reasons for the revival of this perspective in our times, and highlights the contribution of the International College of Person-Centered Medicine (ICPCM) in the promotion of the personcentered perspective in health and disease. The value of communication is underlined with reference to both diagnosis and treatment. The concept of Health is considered historically and the inclusiveness, holistic vista and positive health orientation of the WHO definition of Health (1948) is underlined. It is emphasized that Mental Health Promotion is differentiated conceptually from Disease Prevention in that promotion deals with health and prevention deals with illness, the relationship of Health Promotion with Salutogenesis (Antonovsky 1996) is noted and it is pointed out that among the targets of health promotion, preservation of peace is also included (WHO, 2004). In line with this, the ICPCM has supported and co-signed the Athens Anti-War Declaration (2016). Evaluating the impact of Health Promotion efforts is a necessary but difficult task as it requires targeted research and there are many inherent confounding factors. The social or environmental contexts of health behaviors should be taken into account as well as the subjective indicators of health. In an attempt to resolve the difficulties arising from this issue, the ICPCM has developed a prototype "Person-centered Care Index" (Kirisci et al 2016). With reference to Education it is pointed out that it is necessary for the educators to speak with the students rather than speak to them. Concerning research, the ICPCM in its 2013 Geneva Declaration has identified the main research areas in the person-centered field. The importance of assuring healthy lives and well-being for ALL is underlined and the difficulties associated with the achievement of this goal are noted. Lastly, the need to apply the principles of Person-centered Medicine to victims of natural, human-made and economic disasters (Christodoulou et al 2016) is underlined, especially in view of the frequent occurrence of these disasters in our times. In conclusion, the contribution of the ICPCM during the ten years of its existence, with reference to the sensitization of health professionals in the Person-centered approach is noted. This contribution has been carried out in line with the principles of the ICPCM and with its Geneva Declarations.

Longitudinal associations of temperament and character with paranoid ideation: A population-based study

The aim of this study was to examine (a) the associations of temperament and character dimensions with paranoid ideation over a 15-year follow-up in the general population (b) the associations of explosive temperament and organized character profiles with paranoid ideation. 2137 subjects of the Young Finns Study completed the Temperament and Character Inventory and the Paranoid Ideation Scale of the Symptom Checklist-90 Revised in 1997, 2001, and 2012. Temperament dimensions of high novelty seeking, high harm avoidance, low reward dependence and explosive temperament profile were associated with the development of higher paranoid ideation. Regarding character, high self-directedness, high cooperativeness, and low self-transcendence and organized character profile were associated with lower paranoid ideation. These associations sustained after controlling for age, gender, and socioeconomic factors. However, the associations between temperament and paranoia mostly disappeared after taking character into account. Our study supported the hypothesis that personality dimensions contribute to the development of paranoid ideation. Temperament and character might combine a variety of single previously found risk factors into a more comprehensive framework for the developmental etiology of paranoia. Our findings provide evidence for psychotherapeutic interventions that support the self-regulation of temperamental vulnerabilities by internalizing mature concepts about the self and social relationships.

The Psychometrics of the European Portuguese Version of the Temperament and Character Inventory-Revised

Cloninger's psychobiological model of personality integrates contributions from behavioral genetics, neurobiology, and psychology in the description of the human personality. The temperament and character inventory (TCI) is its assessment instrument. The Brazilian Portuguese version of the TCI has shown good psychometric properties. However, Portuguese spoken in Brazil presents marked and substantial differences to that spoken in Portugal, and no study has yet described the psychometrics of the European Portuguese version. The objective of this study was thus to describe the psychometric properties of the European Portuguese adult version of the TCI (the temperament and character inventory-revised (TCI-R)). This study involved 1400 Portuguese adult participants. The factorial structure of the European Portuguese version was tested using four methods: exploratory factor analysis, orthogonal procrustes rotation analysis, confirmatory factor analysis, and exploratory structural equation modeling. The integration of data coming from these methods suggested that the Portuguese version of the TCI-R presented good structural validity (as revealed by the emergence of the temperament and character structures predicted by theory) and high levels of congruence between the American and the Portuguese versions. An improvement in the goodness of fit of the models for the Portuguese population was achieved by using exploratory structural equation modeling over confirmatory factor analysis. Although some facets registered questionable consistency, all dimensions had acceptable to good consistency (all ≥ .79). These results confirm the validity of the Portuguese TCI-R and its adequacy for use in European Portuguese samples.

Prediction of Neurocognitive Deficits by Parkinsonian Motor Impairment in Schizophrenia: A Study in Neuroleptic-Naïve Subjects, Unaffected First-Degree Relatives and Healthy Controls From an Indigenous Population

BACKGROUND

Neurocognitive deficits are among the most debilitating and pervasive symptoms of schizophrenia, and are present also in unaffected first-degree relatives. Also, multiple reports reveal parkisonian motor deficits in untreated subjects with schizophrenia and in first-degree relatives of affected subjects. Yet, the relation between motor and cognitive impairment and its value as a classifier of endophenotypes has not been studied.

AIMS

To test the efficacy of midbrain hyperechogenicity (MHE) and parkinsonian motor impairment (PKM) as predictors of neurocognitive impairment in subjects with or at risk for schizophrenia, that could be used to segregate them from first-degree relatives and healthy controls.

METHOD

Seventy-six subjects with chronic schizophrenia never exposed to antipsychotic medication, 106 unaffected first-degree relatives, and 62 healthy controls were blindly assessed for cognitive and motor function, and transcranial ultrasound.

RESULTS

Executive function, fluid intelligence, motor planning, and hand coordination showed group differences. PKM and MHE were significantly higher in untreated schizophrenia and unaffected relatives. Unaffected relatives showed milder impairment, but were different from controls.

CONCLUSIONS

PKM and MHE predict cognitive impairment in neuroleptic-naive patients with schizophrenia and their unaffected first-degree relatives and may be used to segregate them from first-degree relatives and healthy controls.

Association between neurological soft signs, temperament and character in patients with schizophrenia and non-psychotic relatives

The heritability of schizophrenia and most personality traits has been well established, but the role of personality in susceptibility to schizophrenia remains uncertain. The aim of this study was to test for an association between personality traits and Neurological Soft Signs (NSS), a well-known biological marker of schizophrenia, in non-psychotic relatives of patients with schizophrenia. For this purpose, we evaluated the NSS scale and personality measured by the Temperament and Character inventory (TCI-R) in three groups of subjects: 29 patients with schizophrenia, 24 unaffected relatives and 37 controls. The results showed that patients with schizophrenia were more asocial (higher harm avoidance and lower reward dependence), more perseverative (higher persistence), and more schizotypal (lower self-directedness and cooperativeness, higher self-transcendence). The unaffected relatives showed higher harm avoidance, lower self-directedness and cooperativeness than the healthy controls. Higher NSS scores and sub-scores were found in patients and non-psychotic relatives compared with the controls. Among all the patients, total NSS scores were positively correlated with harm avoidance but negatively correlated with novelty seeking and persistence. Total NSS were also correlated with low scores on self-directedness and cooperativeness, which are indicators of personality disorder. Our results show that susceptibility to NSS and to schizophrenia are both related to individual differences in the temperament and character features in non-psychotic relatives of patients with schizophrenia. High harm avoidance, low persistence, low self-directedness and low cooperativeness contribute to both the risk of NSS and schizophrenia. These findings highlight the value of using both assessments to study high risk populations.

Who attracts whom to rural general practice? Variation in temperament and character profiles of GP registrars across different vocational training pathways

INTRODUCTION

The ongoing rural doctor workforce shortage continues to stimulate interest in new strategies to alleviate the situation. Alongside increasingly promising approaches is the notion that attracting and nurturing the 'right' individuals may be paramount to achieving long-term success in recruitment and retention. This study compares the patterns of demographic and temperament and character trait profiles of general practice registrars in training across three Australian vocational training pathways: the Australian College of Rural and Remote Medicine independent rural pathway, and the rural and general pathways of Australian general practice training. The aim is to describe the predominant personalities of existing trainees. At its foundation, this study strives to obtain more information about those individuals choosing rural practice, which may inform ways to enhance future recruitment and training into rural medicine. This rationale has been explored with medical students using intention as the dependent variable, but registrars are that much closer to their final career choice, and therefore may provide more practical and reliable indicators of the notion of who attracts whom into rural practice.

METHODS

A cross-sectional design sampled four registrar training groups: one from the Australian College of Rural and Remote Medicine, one Australian general practice training rural only, and two Australian general practice training rural and general pathway regional training providers. Registrars (451) completed a questionnaire that gathered basic demographics and a personality trait profile using the Temperament and Character Inventory plus a measure of resilience. Statistical analysis explored the relationships between variables (multivariate analyses of variance) and compared levels of traits between registrar groups (analyses of variance).

RESULTS

Registrars training via the Australian College of Rural and Remote Medicine pathway were more likely to be male, older, have a definite interest in or already practising in a rural area and were significantly (with moderate effect sizes) lower in levels of harm avoidance and higher in persistence, self-directedness and resilience compared to the other training pathways.

CONCLUSIONS

The implications of the data to the recruitment and training of general practice registrars goes further than identifying groups of individuals with similar temperament and character trait patterns. This sample is portrayed as relatively homogenous in light of their overall trait levels as compared to population norms. However, it is the combination of the levels of individual traits that suggests a profile that differs between registrars on a rural or general training path. Importantly the combination of trait levels that tend to differentiate registrars (low harm avoidance, high self-directedness and persistence) correlates strongly with high levels of resilience. Doctors and medical students benefit from a high level of resilience to cope with and manage the challenges of the profession and arguably more so in rural practice. Along with certain demographic characteristics, the combination and levels of temperament (stable) and character (developmental) traits support the notion of a mixture of personal traits that may be indicative of individuals best suited to rural and remote medicine. Further investigation is needed to determine whether individuals with a certain pattern of personal traits are attracted to rural practice training or whether the training itself, in part by exposure to rural life and rural medical practice, selects for those who are most suited to and will eventually choose to practice in a rural location.

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.

Role of allelic variants of FK506-binding protein 51 (FKBP5) gene in the development of anxiety disorders

BACKGROUND

Anxiety disorders exhibit remarkably high rates of comorbidity with major depressive disorder (MDD). Mood and anxiety disorders are considered stress-related diseases. Genetic variations in the co-chaperone FK506-binding protein 51, FKBP5, which modulates the function of glucocorticoid receptors, have been associated with an increased risk for the development of posttraumatic stress disorder, but data regarding its role in MDD are controversial. The aims of this study were to clarify the role of the FKBP5 gene in depression and anxiety disorders through a case-control study and an association study with personality traits using the Temperament and Character Inventory (TCI) in healthy subjects.

METHODS

Six hundred fifty-seven MDD patients, with or without an anxiety disorder in comorbidity, and 462 healthy volunteers were enrolled in the study. Two hundred fifty-six controls agreed to fill out the TCI.

RESULTS

The results showed that the T allele of rs1360780 was more frequent among the patients affected by MDD with a comorbidity of anxiety disorders, compared to those without (P < .001). Among the controls, we found that the T allele more often exhibited personality traits associated with an increased vulnerability to anxiety.

CONCLUSIONS

These results support the hypothesis that allelic variants of FKBP5 are a risk factor for anxiety disorders. The identification of genetic variants involved in anxiety may have implications for the optimization of therapeutic interventions.

Parental care-giving and home environment predicting offspring's temperament and character traits after 18 years

Although many personality theories emphasize the role of parental behaviors in shaping personality development, empirical data from longitudinal studies remain scarce. It is also not known, if parental behaviors affect character development more strongly than temperament or vice versa. In a prospective study, 1083 volunteer participants of the Young Finns study completed the Temperament and Character Inventory (TCI). Parents of the participants had answered questions about parenting attitudes, socioeconomic status, health behaviors, and role satisfaction 18 years before. We studied the univariate and the cumulative effects of parental care-giving and family environment on offspring's personality traits. Parental care-giving and home-environment were more strongly associated with offspring character traits reflecting personality maturity (Self-directedness and Cooperativeness) than with offspring temperament traits (Novelty seeking, Harm avoidance, Reward dependence and Persistence) reflecting emotional and behavioral tendencies. The differences were most evident in the cumulative effects model. Maternal variables were stronger predictors than paternal variables. The present findings suggest that not all personality traits are similarly predicted by parental care-giving and home-environment. In particular, character development is more strongly related to such measures than temperament. Parental care-giving and home-environment are more strongly related to psychological maturity (character) than emotional and behavioral tendencies (temperament).

PGMRA: a web server for (phenotype x genotype) many-to-many relation analysis in GWAS

It has been proposed that single nucleotide polymorphisms (SNPs) discovered by genome-wide association studies (GWAS) account for only a small fraction of the genetic variation of complex traits in human population. The remaining unexplained variance or missing heritability is thought to be due to marginal effects of many loci with small effects and has eluded attempts to identify its sources. Combination of different studies appears to resolve in part this problem. However, neither individual GWAS nor meta-analytic combinations thereof are helpful for disclosing which genetic variants contribute to explain a particular phenotype. Here, we propose that most of the missing heritability is latent in the GWAS data, which conceals intermediate phenotypes. To uncover such latent information, we propose the PGMRA server that introduces phenomics--the full set of phenotype features of an individual--to identify SNP-set structures in a broader sense, i.e. causally cohesive genotype-phenotype relations. These relations are agnostically identified (without considering disease status of the subjects) and organized in an interpretable fashion. Then, by incorporating a posteriori the subject status within each relation, we can establish the risk surface of a disease in an unbiased mode. This approach complements-instead of replaces-current analysis methods. The server is publically available at http://phop.ugr.es/fenogeno.

Temperament, character and serotonin activity in the human brain: a positron emission tomography study based on a general population cohort

BACKGROUND

The psychobiological model of personality by Cloninger and colleagues originally hypothesized that interindividual variability in the temperament dimension 'harm avoidance' (HA) is explained by differences in the activity of the brain serotonin system. We assessed brain serotonin transporter (5-HTT) density in vivo with positron emission tomography (PET) in healthy individuals with high or low HA scores using an 'oversampling' study design. Method Subjects consistently in either upper or lower quartiles for the HA trait were selected from a population-based cohort in Finland (n = 2075) with pre-existing Temperament and Character Inventory (TCI) scores. A total of 22 subjects free of psychiatric and somatic disorders were included in the matched high- and low-HA groups. The main outcome measure was regional 5-HTT binding potential (BPND) in high- and low-HA groups estimated with PET and [11C]N,N-dimethyl-2-(2-amino-4-methylphenylthio)benzylamine ([11C]MADAM). In secondary analyses, 5-HTT BPND was correlated with other TCI dimensions.

RESULTS

5-HTT BPND did not differ between high- and low-HA groups in the midbrain or any other brain region. This result remained the same even after adjusting for other relevant TCI dimensions. Higher 5-HTT BPND in the raphe nucleus predicted higher scores in 'self-directedness'.

CONCLUSIONS

This study does not support an association between the temperament dimension HA and serotonin transporter density in healthy subjects. However, we found a link between high serotonin transporter density and high 'self-directedness' (ability to adapt and control one's behaviour to fit situations in accord with chosen goals and values). We suggest that biological factors are more important in explaining variability in character than previously thought.

Active Reward Processing during Human Sleep: Insights from Sleep-Related Eating Disorder

In this paper, we present two carefully documented cases of patients with sleep-related eating disorder (SRED), a parasomnia which is characterized by involuntary compulsive eating during the night and whose pathophysiology is not known. Using video-polysomnography, a dream diary and psychometric examination, we found that both patients present elevated novelty seeking and increased reward sensitivity. In light of new evidence on the mesolimbic dopaminergic implication in compulsive eating disorders, our findings suggest a role of an active reward system during sleep in the manifestation of SRED.

PCLO gene: its role in vulnerability to major depressive disorder

BACKGROUND

A recent genome-wide association study on Major Depressive Disorder (MDD) identified a specific association with a non-synonymous polymorphism (rs2522833) of a gene encoding the presynaptic protein piccolo (PCLO). A high percentage of patients who develop MDD have particular temperamental traits, such as passivity, pessimism, indecisiveness, and low self-esteem, which are related to the subsequent development of depression. The aims of this study were to perform a replicate case-control study and to conduct the first association study between the rs2522833 polymorphism and depression-related personality traits using the Temperament and Character Inventory (TCI) in a healthy subject sample.

METHODS

A total of 522 MDD patients and 375 healthy volunteers were enrolled in the study. Two hundred and forty-six controls agreed to fill out the TCI.

RESULTS

The results showed that rs2522833 CC homozygotes were more frequent among the depressed patients than in the controls (p<0.01). The C allele distribution showed a trend in the same direction (p=0.08). Among controls, we found that the C allele carriers were associated with personality traits increasing vulnerability to depression, including higher Harm Avoidance (HA) and lower in Novelty Seeking (NS). In particular, C allele carriers were more fearful (HA2) and fatigable (HA4), and less impulsive/more deliberate (NS2) and less extravagant/more frugal (NS3).

LIMITATIONS

The absence of possible epistatic interaction effect.

CONCLUSIONS

These results provide further support for the involvement of the PCLO gene in MDD and show that this effect may be mediated by influencing personality traits that increase the risk of major depression.

Associations between dimensional personality measures and preclinical atherosclerosis: the cardiovascular risk in Young Finns study

OBJECTIVE

To assess how multidimensional personality-trait theories, such as the Psychobiological Model of Temperament and Character, and the Five-factor Model of Personality, are associated with subclinical atherosclerosis as indicated by carotid intima-media thickness (IMT). The analysis was designed to tolerate non-linear development in which the same personality profiles can have multiple final outcomes and different antecedent profiles can have the same final outcome.

METHODS

605 men and 844 women (average age 31.6year, s.d.=5.0, range=24-39) provided data on IMT and traits of the psychobiological model, 725 men and 1011 women were assessed for IMT and the five-factor model (age 37.7year, s.d.=5.0, range=30-45). Robust multidimensional Hotelling's T(2) statistic was used to detect personality differences between participants with high IMT and others. Model-based clustering method further explored the effect.

RESULTS

Those with a high level of subclinical atherosclerosis within the sample (highest IMT-decile) had a combined higher persistence (i.e., were perseverative or perfectionistic), more disorganized (schizotypal) character, and more antisocial temperamental configuration than others (P=0.019). No effect was found for the five-factor model (P=0.978). Traditional methods that did not account for multidimensionality and nonlinearity did not detect an association.

CONCLUSION

Psychological well-being may have positive effects on health that reduce atherosclerosis in the population as a whole. Increased subclinical atherosclerosis was associated with a profile that combines known risk factors, such as cynical distrust and hostile tendencies. More frequent use of statistical procedures that can cope with non-linear interactions in complex psychobiological systems may facilitate scientific advances in health promotion.

Personality differences according to age and sex in a Mexican sample using the Temperament and Character Inventory-Revised

OBJECTIVES

The objectives of the study were to compare personality features according to age and sex cohorts in a community sample of Mexico City using the Temperament and Character Inventory-Revised (TCI-R) and to examine the TCI-R psychometric properties according to age and sex parameters.

METHOD

A total of 2076 adults filled out the Spanish version of TCI-R.

RESULTS

Younger subjects exhibited higher novelty seeking. Self-directedness and cooperativeness scores increased with age. Harm avoidance and self-transcendence were lower in younger adults when compared with older subjects. Women scored higher than men in harm avoidance and reward dependence. Men between 26 and 45 years old reported higher novelty seeking. Women older than 25 years scored higher in self-transcendence, and those older than 45 years exhibited higher cooperativeness scores. The identified TCI-R structure corresponded to the original one. Internal consistency of the higher-order dimensions was good in all age cohorts, in men and women, and in the total sample (αs >.80).

CONCLUSION

Our results give further support to personality specific dominant features in men and women. Differences in age cohorts may be explained by maturity and personal experiences acquired during life. The TCI-R psychometric properties and score distributions by age and sex cohorts may be useful for future studies with clinical samples and for cross-cultural comparison purposes.

Temperament and character inventory dimensions and anhedonia in detoxified substance-dependent subjects

In this study we aimed to investigate the relationship between anhedonia, craving and temperament and character dimensions in a sample of 50 patients with alcohol and opiate dependence recruited after a period of detoxification. The following scales were applied: Snaith-Hamilton Pleasure Scale (SHAPS), Bech-Rafaelsen Melancholia Scale (BRMS), Scale for the Assessment of Negative Symptoms (SANS), Visual Analogue Scales (VAS) for craving, and Temperament and Character Inventory (TCI). The temperament dimension of Novelty Seeking was positively correlated to craving and anhedonia (p < .01), with a higher score of Novelty Seeking in the subsample of anhedonic subjects with respect to both non-anhedonic and control subjects. In our study, the possibility that difficulty in experiencing pleasure in psychiatric disorders can lead to the use of psychoactive substances in an attempt to decrease anhedonia, is extended to subjects without psychiatric disorders who may try substances to counterbalance a tonic state of anhedonia.

Personality characteristics in obesity and relationship with successful weight loss

OBJECTIVE

Personality influences lifestyle behaviors. Therefore, certain personality traits could contribute to obesity and the response to behaviorally based weight loss therapy.

PURPOSE

The aims of this study were to test the hypothesis that personality characteristics differ between lean and obese persons in the community, obese persons in the community and obese persons seeking weight loss therapy by enrolling in a comprehensive weight loss program, and in obese persons who were successful and unsuccessful in achieving behavioral therapy-induced weight loss.

METHODS

The Temperament and Character Inventory was administered to 264 lean (body mass index (BMI) <25 kg/m(2)) and 56 obese (BMI> or =35 kg/m(2)) subjects from the St Louis community and 183 obese patients (BMI=44+/-10 kg/m(2)) enrolled in the Washington University Weight Management Program (WUWMP), which involved weekly group behavioral therapy and diet education sessions for 22 weeks.

RESULTS

Compared with lean subjects, obese subjects in the community scored higher in novelty seeking (19.7+/-5.9 vs 16.2+/-6.0, P<0.05), lower in Persistence (4.1+/-1.8 vs 4.8+/-1.7, P<0.05) and lower in self-directedness (32.1+/-7.6 vs 34.3+/-6.6, P<0.05.) Patients enrolled in the WUWMP scored higher than obese persons in the general population in both Reward Dependence (17.1+/-4.2 vs 15.7+/-4.3, P<0.05) and cooperativeness (36.9+/-5.4 vs 34.5+/-6.2, P<0.05). Patients who were successful in losing weight (>10% weight loss) after 22 weeks of behavioral therapy scored lower in novelty seeking than those who were unsuccessful in losing weight (<5% weight loss) (17.6+/-5.9 vs 20.2+/-5.9, P<0.05).

DISCUSSION

These results suggest that personality traits differ between lean and obese persons, and between obese persons who enroll and who do not enroll in a comprehensive weight management program. Moreover, high scores in novelty seeking are associated with decreased success in achieving behavioral therapy-induced weight loss.

The Temperament and Character Inventory-Revised (TCI-R): psychometric characteristics of the French version

OBJECTIVE

To explore the psychometric characteristics of a modified version of the Cloninger's personality questionnaire, the Temperament and Character Inventory-Revised (TCI-R).

METHOD

A 482-subject sample, including clinical and non-clinical subjects, completed the TCI-R. We performed principal component analyses and explored the factorial structure of the questionnaire, and the internal consistency of each dimension.

RESULTS

The factorial structure of the TCI-R was well defined as expected and similar to those shown with the TCI. Robust factors were obtained for Reward Dependence and Persistence in the TCI-R, even more clearly than in the original TCI. All dimensions obtained higher alpha Cronbach coefficients with the TCI-R than with the TCI. We obtained highly satisfying reliability coefficients in test-retest and TCI/TCI-R comparisons.

CONCLUSION

The TCI-R seems to have similar psychometric and feasibility characteristics as those of the initial version, but with significant improvements in terms of factorial structure and internal consistency of most dimensions.

[Temperament and Character Inventory Revised (TCI-R). Standardization and normative data in a general population sample]

INTRODUCTION

The revised version of the Temperament and Character Inventory (TCI-R), a tool designed by C. R. Cloninger for the evaluation of the seven dimensions defined in his psychobiological model of personality, was translated and adapted to Spanish. The aim of the study was to obtain normative data and scales with T-scores in a incidental sample of the general Spanish population.

METHODS

After adaptation to Spanish, the tool was administered to 400 subjects from several areas of Spain. The sample is stratified according to age and gender according to the year 2001 Spanish population census. We have studied the differences between men and women and the association between age and dimensions. We have checked the normal distribution of the traits, and proceeded with the standardization and normalization of the scores.

RESULTS

We present the mean and standard deviation according to sex for each of the main dimensions and subscales. The scores of the main dimensions obtained for general population according to gender show a normal distribution that has allowed us to standardize them into T-scores. The reliability of the dimensions is high. There are differences in the means depending on gender: women scored higher in Harm Avoidance, Reward Dependence and Cooperativeness. Men scored higher in Persistence. There were no high correlations between age and the dimensions.

CONCLUSIONS

The Spanish version of the new TCI-R is an adequate tool for the study of personality dimensions of normal population.

Temperament, character, and personality disorders: etiologic, diagnostic, treatment issues

OBJECTIVE

In this paper, we explore the underlying dimensional structure of personality disorder, propose a novel approach to its diagnosis, and outline our concepts of its etiology and treatment based on the seven factor psychobiological model of temperament and character.

METHOD

Temperament and character traits were evaluated in a consecutive series of 109 psychiatric out-patients, with or without personality disorder and varying mood and anxiety states.

RESULTS

Low scores on character dimensions consistently correlated with high symptom counts for personality disorder. Each subtype of personality disorder created a unique combination of correlations with the four temperament traits.

CONCLUSION

Temperament and Character Inventory (TCI) temperament and character traits efficiently diagnose personality disorder and differentiate its individual subtypes. Character traits are used to diagnose the presence and the severity of personality disorder, whereas temperament traits are used for differential diagnosis. The distinction between temperament and character provides an attractive theoretical basis for etiological postulates and treatment of personality disorder.

Evidence for the multigenic inheritance of schizophrenia

Schizophrenia is assumed to have complex inheritance because of its high prevalence and sporadic familial transmission. Findings of linkage on different chromosomes in various studies corroborate this assumption. It is not known whether these findings represent heterogeneous inheritance, in which various ethnic groups inherit illness through different major gene effects, or multigenic inheritance, in which affected individuals inherit several common genetic abnormalities. This study therefore examined inheritance of schizophrenia at different genetic loci in a nationally collected European American and African American sample. Seventy-seven families were previously genotyped at 458 markers for the NIMH Schizophrenia Genetics Initiative. Initial genetic analysis tested a dominant model, with schizophrenia and schizoaffective disorder, depressed type, as the affected phenotype. The families showed one genome-wide significant linkage (Z = 3.97) at chromosome 15q14, which maps within 1 cM of a previous linkage at the alpha 7-nicotinic receptor gene. Chromosome 10p13 showed suggestive linkage (Z = 2.40). Six others (6q21, 9q32, 13q32, 15q24, 17p12, 20q13) were positive, with few differences between the two ethnic groups. The probability of each family transmitting schizophrenia through two genes is greater than expected from the combination of the independent segregation of each gene. Two trait-locus linkage analysis supports a model in which genetic alleles associated with schizophrenia are relatively common in the general population and affected individuals inherit risk for illness through at least two different loci.

Serotonergic pathway genes and subtypes of alcoholism: association studies

Disturbances of the serotonergic pathway have been implicated in many psychiatric disorders, including alcoholism, aggression, schizophrenia and depression. The personality dimension of harm avoidance is correlated positively with the activity of mesolimbic serotonergic neurons. The goal of this study was to determine the role of the genes in this pathway in the development of type II alcoholism. A sample of alcoholics and normal controls were screened with the variations in tryptophan hydroxylase (TPH), serotonin receptors (5-HT2A and 5-HT2C), serotonin transporter (5-HTT), and monoamine oxidase A (MAO-A) genes. The results of association studies for type II alcoholics were the most significant with 5-HTT (P = 0.011) and MAO-A (P = 0.029) genes. However, after correction for multiple comparisons, none of the results reached the significance level. These data indicate that the genes in the serotonergic pathway may be involved in the development of type II alcoholism but the gene effects are very small.

Description of the Genetic Analysis Workshop 11 Collaborative Study on the Genetics of Alcoholism

Problem 1 of Genetic Analysis Workshop 11 consists of data from a family study of the genetics of alcoholism and related traits contributed by the six centers making up the National Institute for Alcohol Abuse and Alcoholism sponsored by the Collaborative Study on the Genetics of Alcoholism (COGA). The family data included 1,214 members of 105 pedigrees ascertained for having three or more individuals affected with alcoholism. Data available to workshop participants included clinical phenotypes, personality measures, smoking behavior, event-related potentials, platelet monamine oxidase B activity, and a genome scan of 296 markers.

Visual P300 and the self-directedness scale of the Temperament and Character Inventory

Reduced amplitude of the P300 event-related brain potential has been associated with several psychopathological conditions and is thought to represent brain dysfunction in such conditions. Predisposition to personality disorders and psychopathology in general is also associated with low scores on the self-directedness (SD) scale of the Temperament and Character Inventory. The present preliminary study investigated the relationship between amplitudes of P300 elicited by rare target stimuli in a visual oddball task and SD scores in 58 healthy participants. P300 was found to be significantly reduced in subjects with low SD, as supported by correlational analysis and by comparison of groups formed on the basis of SD scores. This finding may be relevant to prior findings indicating reduced P300 amplitudes in a variety of psychopathological conditions and suggests that a common vulnerability factor, reflected in the low SD personality scores, may contribute to the P300 reduction in psychiatric populations.

Traumatic brain injury and schizophrenia in members of schizophrenia and bipolar disorder pedigrees

OBJECTIVE

Schizophrenia following a traumatic brain injury could be a phenocopy of genetic schizophrenia or the consequence of a gene-environment interaction. Alternatively, traumatic brain injury and schizophrenia could be spuriously associated if those who are predisposed to develop schizophrenia have greater amounts of trauma for other reasons. The authors investigated the relationship between traumatic brain injury and psychiatric diagnoses in a large group of subjects from families with at least two biologically related first-degree relatives with schizophrenia, schizoaffective disorder, or bipolar disorder.

METHOD

The Diagnostic Interview for Genetic Studies was used to determine history of traumatic brain injury and diagnosis for 1,275 members of multiplex bipolar disorder pedigrees and 565 members of multiplex schizophrenia pedigrees.

RESULTS

Rates of traumatic brain injury were significantly higher for those with a diagnosis of schizophrenia, bipolar disorder, and depression than for those with no mental illness. However, multivariate analysis of within-pedigree data showed that mental illness was related to traumatic brain injury only in the schizophrenia pedigrees. Independent of diagnoses, family members of those with schizophrenia were more likely to have had traumatic brain injury than were members of the bipolar disorder pedigrees. The members of the schizophrenia pedigrees also failed to show the gender difference for traumatic brain injury (more common in men than in women) that was expected and was present in the bipolar disorder pedigrees. Subjects with a schizophrenia diagnosis who were members of the bipolar disorder pedigrees (and thus had less genetic vulnerability to schizophrenia) were less likely to have had traumatic brain injury (4.5%) than were subjects with schizophrenia who were members of the schizophrenia pedigrees (and who had greater genetic vulnerability to schizophrenia) (19.6%).

CONCLUSIONS

Members of the schizophrenia pedigrees, even those without a schizophrenia diagnosis, had greater exposure to traumatic brain injury compared to members of the bipolar disorder pedigrees. Within the schizophrenia pedigrees, traumatic brain injury was associated with a greater risk of schizophrenia, consistent with synergistic effects between genetic vulnerability for schizophrenia and traumatic brain injury. Posttraumatic-brain-injury schizophrenia in multiplex schizophrenia pedigrees does not appear to be a phenocopy of the genetic disorder.

Genetic and state variables of neurocognitive dysfunction in schizophrenia: a twin study

To characterize the familiality of cognitive dysfunction in schizophrenia, we studied performance on three tasks (visuospatial attention; visuolinguistic conflict, arrow-word; and Wisconsin Card Sorting Test [WCST]) by monozygotic (MZ) and dizygotic (DZ) twin pairs discordant for schizophrenia. The subject sample consisted of six MZ twin pairs, nine DZ twin pairs, and one MZ and one DZ nonschizophrenia cotwin of a patient with schizophrenia. There were two sources of cognitive dysfunction: a nonheritable, state component and a heritable, trait component. Deficits surfaced during the WCST in nonschizophrenia MZ cotwins; this impairment resolved following training in nonschizophrenia MZ cotwins, but not in the probands with schizophrenia, who performed abnormally in all tasks. The results suggest that nonheritable protective factors modulate the specific, plastic, and sometimes subtle neurocognitive deficits related to the schizophrenia genotype.

Age of onset as a discriminator between alcoholic subtypes in a treatment-seeking outpatient population

Subtyping alcoholics may provide a more accurate guide as to the course and character of the disease. Classifications of different ages of onset of problem drinking have so far resulted in categorical inconsistencies. In the past, hospital-based alcoholics have over-represented those most severely ill, and comprehensive evaluations of psychopathology for discriminating between alcoholic subtypes have been infrequent. In a heterogeneous treatment-seeking, outpatient, alcoholic population, we tested the hypothesis that age of onset represents a continuum of disease, and that greater severity of psychopathology is associated with lower ages of onset. Using a standard questionnaire, 253 male and female treatment-seeking alcoholics were stratified according to specific ages of onset: a) < 20 years; b) 20-25 years, and c) > 25 years. These age of onset groups were compared on alcohol severity and craving, family history, childhood behavior, personality, hostility, overt aggression, mood, and social functioning. Symptom severity and age of onset were negatively correlated, and the 20-25-year onset group usually had intermediate scores. The < 20 year onset group was characterized by greater severity of alcohol-related problems, family history, childhood behavioral problems, craving, hostility, antisocial traits, mood disturbance, and poor social functioning. Alcoholics with an earlier age of onset have relatively greater psychopathology than those of later onset. While the preponderance of psychopathology among those in the < 20-year onset group could be conceptualized as a clinical "subtype," such a characterization would not define an entirely homogeneous category. Yet, this clinical characterization would be clinically important if specific age of onset levels were found to be differentially sensitive to pharmacological and/or psychological treatments.

A practical way to diagnosis personality disorder: a proposal

General criteria for the diagnosis of personality disorder are provided based on rating a few items describing four core features of personality disorder: (a) low Self-directedness, (b) low Cooperativeness, (c) low Affective Stability, and (d) low Self-transcendence. These core features correspond closely with the basic concept of personality disorder in DSM-IV and are based on specific items easy for clinicians to rate in a short time. Criteria are also provided for rating severity of personality disorganization and for subtyping based on a profile of three additional dimensions corresponding to core features of DSM-IV clusters A, B, and C. This approach should facilitate efficient screening in clinical practice, encourage an understanding of the development of comorbidity as a self-organizing process, and provide a theory-driven basis for therapeutic planning with drugs and psychotherapy.

Linkage disequilibrium for schizophrenia at the chromosome 15q13-14 locus of the alpha7-nicotinic acetylcholine receptor subunit gene (CHRNA7)

The transmission/disequilibrium test was used for fine mapping of the linkage of schizophrenia to the chromosome 15q13-14 region, the site of a candidate gene, the alpha7 nicotinic acetylcholine receptor subunit gene (CHRNA7), in parent-child triads from the NIMH Schizophrenia Genetics Initiative families. This candidate gene was identified from neurobiological studies of deficits in schizophrenics of the inhibitory gating of the P50 auditory evoked potential. The neurobiological deficit was also used as a phenotype for subsequent linkage analysis. In the present study, significant genotype-wise disequilibrium (P < 0.007) was found at D15S165, a polymorphic simple sequence marker physically located within 1 megabase of both CHRNA7 and a partially duplicated, expressed sequence that includes exons 5-10 of CHRNA7. Replication of this result was found in an additional set of families. The results support this region as a chromosomal location involved in the genetic transmission of schizophrenia.

Relationships between Tridimensional Personality Questionnaire Dimensions and DSM-III-R personality traits in Italian adolescents

The predictions of Cloninger's neurobiologic learning model on the relationships between novelty seeking (NS), harm avoidance (HA), reward dependence (RD), and persistence (P) and the traditional DSM-III-R personality disorders (PDs) were tested on a sample of 2,889 (1,475 males and 1,414 females) Italian high school students aged 16 to 18 years, using the Structured Clinical Interview for DSM-III-R Personality Disorders-self-report (SCID-II) and the Tridimensional Personality Questionnaire (TPQ). All relationships were in the predicted direction for antisocial, narcissistic, avoidant, and obsessive-compulsive PD alone, and at least two were in the predicted direction for schizoid, histrionic, borderline-explosive, dependent, and passive-aggressive PD. Eight of nine relationships were in the predicted direction for NS, but only seven of nine for HA and RD. This study provides substantial support for Cloninger's neurobiologic learning model as a useful tool to describe and classify personality variants and, because of the supposed neurochemical implications, to link personality traits to the underlying neurochemical and neuroanatomic substrate.

Diagnosis of posttraumatic stress disorder with the MMPI: PK scale scores in somatization disorder

Clinic patients with diagnoses of either major depression or somatization disorder were given the MMPI. Women with somatization disorder had high scores on Keane's MMPI scale (PK) for posttraumatic stress disorder. Following the procedure for the MMPI-2 (46 of the 49 PK items and MMPI-2 norms), 59% of the women with somatization disorder and 21% of the women with major depression would have T scores > or = 65 on the MMPI-2 scale although none of them were known to have developed psychiatric disorder after exposure to a life threatening event. The PK scale has little use in the differential diagnosis of women patients with somatization disorder.

Ondansetron for reduction of drinking among biologically predisposed alcoholic patients: A randomized controlled trial

CONTEXT

Early-onset alcoholism differs from late-onset alcoholism by its association with greater serotonergic abnormality and antisocial behaviors. Thus, individuals with early-onset alcoholism may be responsive to treatment with a selective serotonergic agent.

OBJECTIVE

To test the hypothesis that drinking outcomes associated with early vs late-onset alcoholism are differentially improved by the selective 5-HT(3) (serotonin) antagonist ondansetron.

DESIGN

Double-blind, randomized, placebo-controlled clinical trial.

SETTINGS

University of Texas Health Science Center in Houston (April 1995-June 1998) and University of Texas Health Science Center in San Antonio (July 1998-December 1999).

PARTICIPANTS

A total of 321 patients with diagnosed alcoholism (mean age, 40.6 years; 70.5% male; 78.6% white) were enrolled, 271 of whom proceeded to randomization.

INTERVENTIONS

After 1 lead-in week of single-blind placebo, patients were randomly assigned to receive 11 weeks of treatment with ondansetron, 1 microg/kg (n = 67), 4 microg/kg (n = 77), or 16 microg/kg (n = 71) twice per day; or identical placebo (n = 56). All patients also participated in weekly standardized group cognitive behavioral therapy.

MAIN OUTCOME MEASURES

Self-reported alcohol consumption (drinks per day, drinks per drinking day, percentage of days abstinent, and total days abstinent per study week); and plasma carbohydrate deficient transferrin (CDT) level, an objective and sensitive marker of transient alcohol consumption.

RESULTS

Patients with early-onset alcoholism who received ondansetron (1, 4, and 16 microg/kg twice per day) compared with those who were administered placebo, had fewer drinks per day (1.89, 1.56, and 1.87 vs 3.30; P =.03, P =.01, and P =.02, respectively) and drinks per drinking day (4.75, 4.28, and 5.18 vs 6.90; P =.03, P =.004, and P =.03, respectively). Ondansetron, 4 microg/kg twice per day, was superior to placebo in increasing percentage of days abstinent (70.10 vs 50.20; P =.02) and total days abstinent per study week (6.74 vs 5.92; P =.03). Among patients with early-onset alcoholism, there was a significant difference in the mean log CDT ratio between those who received ondansetron (1 and 4 microg/kg twice per day) compared with those who received the placebo (-0.17 and -0.19 vs 0.12; P =.03 and P =.01, respectively).

CONCLUSION

Our results suggest that ondansetron (particularly the 4 microg/kg twice per day dosage) is an effective treatment for patients with early-onset alcoholism, presumably by ameliorating an underlying serotonergic abnormality. JAMA. 2000;284:963-971

Functional variant in the DRD2 receptor promoter region and subtypes of alcoholism

Dopaminergic pathway genes are considered as candidate genes for several neuropsychiatric diseases including severe alcoholism. Since 1990, there have been numerous reports of conflicting association studies of the Taq I A allele of the dopamine D2 receptor (DRD2) gene and alcoholism. Functional and structural variations in candidate genes offer more direct evaluation of their role in the development of a disorder. To determine the role of such variations in the DRD2 gene in the development of alcoholism subtypes, we screened a sample of 173 alcoholics and 88 normal controls with the A-241G and -141C Ins/Del variations in the promoter region and C311G variation in exon 7 of the DRD2 gene. Comparison of alcoholics with normal controls for allele frequency differences of these three variations was negative. Allele frequency differences of the two variations in the promoter region between type II alcoholics, alcoholics with medical complications, and normal controls were not significant. There was linkage disequilibrium only between -141 Ins/Del and Taq I D polymorphisms. We conclude that the functional and structural variations in DRD2 gene do not play a major role in the development of alcoholism subtypes in our sample.

Family-based study of the association of the dopamine D2 receptor gene (DRD2) with habitual smoking

A recent study showed an association between the dopamine D2 receptor gene (DRD2) and smoking. The purpose of this study was to determine if the familial transmission of smoking is linked to variation at the DRD2 locus in a genetically informative sample. Subjects were identified in alcohol treatment centers and their relatives were recruited for study. All subjects were interviewed to assess alcohol dependence, smoking habits, and psychiatric disorders. Two polymorphisms within the DRD2 gene were analyzed, including the TaqIA polymorphism. The sample consisted of 138 nuclear families with at least one offspring with habitual smoking, and analysis was by the transmission disequilibrium test (TDT), which avoids problems due to population stratification. There was no significant difference in the frequency between DRD2 alleles transmitted and not transmitted to habitual smokers. There also was no evidence for unequal transmission of DRD2 alleles for the phenotypes "ever smoker" or comorbid alcohol dependence and habitual smoking. This study does not support linkage of the DRD2 with smoking.

Family-based study of the association of the dopamine D2 receptor gene (DRD2) with habitual smoking

A recent study showed an association between the dopamine D2 receptor gene (DRD2) and smoking. The purpose of this study was to determine if the familial transmission of smoking is linked to variation at the DRD2 locus in a genetically informative sample. Subjects were identified in alcohol treatment centers and their relatives were recruited for study. All subjects were interviewed to assess alcohol dependence, smoking habits, and psychiatric disorders. Two polymorphisms within the DRD2 gene were analyzed, including the TaqIA polymorphism. The sample consisted of 138 nuclear families with at least one offspring with habitual smoking, and analysis was by the transmission disequilibrium test (TDT), which avoids problems due to population stratification. There was no significant difference in the frequency between DRD2 alleles transmitted and not transmitted to habitual smokers. There also was no evidence for unequal transmission of DRD2 alleles for the phenotypes "ever smoker" or comorbid alcohol dependence and habitual smoking. This study does not support linkage of the DRD2 with smoking.

Suggestive linkage of chromosome 10p to schizophrenia is not due to transmission ratio distortion

The genome scan of the European-American schizophrenia families from the Human Genetics Initiative of the National Institute of Mental Health (NIMH) reported a suggestive linkage to chromosome 10p. Subsequently, Paterson and Petronis [1999] reported evidence for transmission ratio distortion on 10p to females. They suggested that transmission ratio distortion to females might have created spurious evidence for linkage to 10p. To address this issue, we reanalyzed our 10p data using only male-male affected sibling pairs. The two chromosome 10p markers that gave the most evidence for linkage in our prior report continued to show evidence for linkage: D10S1423 (NPL Z = 3.0, P = 0.001) and its neighbor D10S582 (NPL Z = 2.9, P = 0.002). These data suggest that our prior report of suggestive linkage of schizophrenia to markers on 10p cannot be attributed to the transmission ratio distortion to females reported by Paterson and Petronis. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 88:607-608, 1999.

Relationship between serotonin and the temperament and character inventory

The unified biosocial theory of personality, proposed by Cloninger, conceptualises personality as a combination of heritable, neurobiologically based traits (temperament dimensions), and traits reflecting sociocultural learning (character dimensions). The temperament dimensions are thought to be related to activity in specific central neurotransmitter systems. The relationship of the dimensions of the Temperament and Character Inventory, particularly harm avoidance (HA), and platelet 5-HT2 receptor sensitivity was investigated in a sample of undergraduate student volunteers (N = 49). Serotonin-receptor binding results in Ca2+ release from intracellular stores. The concentration of serotonin required to produce half maximal Ca2+ response (EC50) is indicative of 5-HT2 receptor sensitivity such that the lower the EC50 serotonin concentration, the greater the 5-HT2 receptor sensitivity. A significant inverse correlation was found between HA and EC50 (r = -0.644, P < 0.001). Self-directedness was also significantly correlated with EC50 (r = 0.391, P = 0.005). Novelty seeking, a personality trait similar to sensation seeking, was not significantly correlated with serotonin.

MMPI screening scales for somatization disorder

44 items on the MMPI were identified which appear to correspond to some of the symptoms in nine of the 10 groups on the Perley-Guze checklist for somatization disorder (hysteria). This list was organized into two scales, one reflecting the total number of symptoms endorsed and the other the number of organ systems with at least one endorsed symptom. Full MMPIs were then obtained from 29 women with primary affective disorder and 37 women with somatization disorder as part of a follow-up study of a consecutive series of 500 psychiatric clinic patients seen at Washington University. Women with the diagnosis of somatization disorder scored significantly higher on the somatization disorder scales created from the 44 items than did women with only major depression. These new scales appeared to be slightly more effective in identifying somatization disorder than the use of the standard MMPI scales for hypochondriasis and hysteria. Further development is needed.

The Junior Temperament and Character Inventory: preliminary validation of a child self-report measure

A preliminary effort to validate the Junior Temperament and Character Inventory with a convenience sample of 322 children ages 9 to 12 years is described.

Relationships of plasma tryptophan availability to course of illness and clinical features of alcoholism: a preliminary study

RATIONALE

Serotonergic (5-HT) mechanisms may be involved in impulse control (including antisocial behavior) across psychiatric syndromes. Age of onset may differentiate alcoholics on psychopathological characteristics associated with impulse control, especially mood disturbance, hostility, and a broad range of antisocial behaviors. Thus, there may be a predictable relationship between markers of 5-HT function and age of onset-related characteristics.

OBJECTIVE

We tested the hypothesis that there would be a predictable relationship between the ratio of plasma tryptophan to large neutral amino acids (i.e. TRYP/LNAA ratio), a marker of 5-HT function, age of onset and related psychopathological characteristics associated with impulse control.

METHODS

Fifty-eight male and female DSM-IV diagnosed alcoholics attending an outpatient treatment center completing a comprehensive psychopathological assessment, and from whom blood samples were obtained.

RESULTS

Plasma TRYP/LNAA ratio was positively correlated with symptoms of dysphoria, and negatively associated with harm avoidance on Cloninger's Temperament and Character Inventory. Low tryptophan availability was associated with antisocial-type personality characteristics. Interestingly, the few (nine) subjects who had both early onset alcoholism and antisocial personality disorder had a higher plasma tryptophan but similar TRYP/LNAA ratio to the others.

CONCLUSIONS

These data suggest that a low plasma TRYP/LNAA ratio is associated with susceptibility to anxiety, antisocial-type personality characteristics, and an early age of onset for alcoholism. In contrast, a high plasma TRYP/LNAA ratio is associated with a later onset of alcoholism and dysphoria.

A new conceptual paradigm from genetics and psychobiology for the science of mental health

OBJECTIVE

The assumptions and goals underlying current systems of classification are critically examined.

METHOD

Current systems of classification are based on assumptions that health can be adequately defined as the absence of disorders and that psychiatric disorders are discrete disease entities that can be categorically defined. These assumptions appear to be inconsistent with available knowledge of the psychobiology, genetics, development and evolution of thoughts, emotions, and behaviour.

RESULTS

An alternative psychobiologically based paradigm is described based on the model that mental health and its disorders are emergent properties of complex interactions among multidimensional neuroadaptive systems.

CONCLUSIONS

This permits an explicit definition of optimum mental health and a descriptive system that is more effective for professionals, individuals, and society in understanding and achieving increased adaptive fitness.

Temperament, character, and personality disorders

This study compares two self-report instruments--the Dutch version of Cloninger's Temperament and Character Inventory (TCI) and the Questionnaire on Personality Traits (VKP)--in a Dutch sample of 148 people in a healthy population. The aims of this study are to create a norm group for the Dutch TCI, to investigate the psychometric properties of the TCI, and to examine the relationship between temperament, character (as measured by the TCI), and personality disorders (as measured by the VKP). The Dutch TCI has a good internal consistency. Some scales do intercorrelate. Seven factors can be identified with principal components analysis. T-tests show differences between the mean score of this Dutch population and Cloninger's community sample. According to the results of correlations and multiple regression of the TCI and the VKP, the self-directedness scale can predict the presence or absence of a personality disorder. Other scales might predict the type of personality disorder. It is concluded that the TCI can be a useful aid in the assessment of personality disorders.