Validation and normative studies of the Brazilian Portuguese and American versions of the Temperament and Character Inventory — Revised (TCI-R)

Journal of Affective Disorders 124 (2010) 126–133

Contents lists available at ScienceDirect

Journal of Affective Disorders j o u r n a l h o m e p a g e : w w w. e l s ev i e r. c o m / l o c a t e / j a d

Research report

Validation and normative studies of the Brazilian Portuguese and American versions of the Temperament and Character Inventory — Revised (TCI-R) Daniel Maffasioli Goncalves a,⁎, C. Robert Cloninger b a b

Department of Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil Department of Psychiatry, Washington University School of Medicine, 660 South Euclid, St. Louis, MO 63110, United States

a r t i c l e

i n f o

Article history: Received 4 October 2009 Received in revised form 3 November 2009 Accepted 12 November 2009 Available online 25 November 2009 Keywords: Temperament Character Personality inventory Personality tests Validation studies

a b s t r a c t Background: The Temperament and Character Inventory (TCI) was first described in 1993. It was designed to measure the character and temperament dimensions of Cloninger's model of personality using a true–false response format. The revised TCI (TCI-R) uses a five-point-Likert format and has multiple subscales for persistence to improve its reliability. We tested the clinical validity of an original Brazilian–Portuguese translation of the TCI-R. Methods: The 595 volunteers completed the BrP version of TCI-R, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Satisfaction with Life Scale (SWLS). Results: The internal consistency was satisfactory for all dimensions (Cronbach alpha coefficients above 0.7). The cumulative variances for temperament and character were 58% and 60%. BAI was positively correlated with harm avoidance and negatively with persistence, self-directedness and cooperativeness. SWLS was correlated negatively with harm avoidance and positively with self-directedness and cooperativeness. The congruence coefficients between each facet of BrP TCI-R and the US TCI-R original data were 95% or higher (except NS1). Limitations: The main limitation of this study is the convenience sampling. Conclusions: The BrP version of the TCI-R had good psychometric properties regardless of the cultural and educational backgrounds of subjects. The present study supported the validity of the BrP translation of the TCI-R, which encourages its use in both clinical and general community samples. © 2009 Elsevier B.V. All rights reserved.

1. Introduction In 1986 Dr C. Robert Cloninger began his studies to deconstruct mental disorders into quantifiable components of personality that are natural building blocks of well-being and psychopathology. He identified the temperamental characteristics that distinguish healthy subjects from subjects with generalized anxiety disorder, somatoform disorders and substance abuse (Cloninger, 1987; Cloninger et al., 1991).

⁎ Corresponding author. Av Princesa Isabel 500 ap 341, Porto Alegre — RS — CEP 90620-000, Brazil. Tel.: +55 51 93085183. E-mail addresses: [email protected] (D.M. Goncalves), [email protected] (C.R. Cloninger). 0165-0327/$ – see front matter © 2009 Elsevier B.V. All rights reserved. doi:10.1016/j.jad.2009.11.007

Three temperament traits related to the immediate responses of human beings to basic stimuli (punishment, novelty and reward) were proposed: harm avoidance (HA), novelty seeking (NS) and reward dependence (RD). Reward dependence initially included persistence (PS) as a facet. However several studies showed that persistence is actually an independently heritable trait. As a result, persistence is now considered as the fourth temperament dimension (Stallings et al., 1996; Cloninger et al., 1993, 1994). Twin studies confirmed the genetic homogeneity and independence of the four temperament dimensions (Cloninger et al., 1994). The four temperament dimensions represent heritable biases that influence individual differences in procedural learning of habits. Harm avoidance measures anxiety-proneness, which is hypothesized to depend on individual differences in behavioral inhibition (the inhibition of behavior by

D.M. Goncalves, C.R. Cloninger / Journal of Affective Disorders 124 (2010) 126–133

signals of punishment or frustrative non-reward). Novelty seeking measures impulsivity, which is hypothesized to reflect individual differences in behavioral activation (the incentive to approach or initiate a behavior in response to novelty, complexity, or signals of reward). Reward dependence measures sociability, which depends on individual differences in sensitivity to signals of social approval. Persistence measures perseverance, which reflects individual differences in resistance to extinction of behavior following intermittent reinforcement (Cloninger et al., 1994, 1997; Cloninger, 1999). It has been demonstrated that extreme scores for each of the four temperament dimensions distinguish the classic clusters of personality disorders. Low reward dependence is characteristic of people in cluster A (odd or schizoid); high novelty seeking is characteristic of cluster B (impulsive); high harm avoidance is characteristic of cluster C (anxious); and high persistence is characteristic of cluster D (obsessive) when a fourth cluster is recognized (Svrakic et al., 1999; Goldman et al., 1994; Battaglia et al., 1996; de la Rie et al., 1998). The possible combinations of temperament differ in their average frequency of any personality disorder, but all temperament profiles occur in both people with personality disorders and those without any personality disorder. As a result, temperament alone has been considered as a tool to distinguish among subtypes of personality disorder but is not an adequate basis for the diagnosis of the presence or severity of personality disorder (Cloninger et al., 1993, 1994; Cloninger, 1999). The Temperament and Character Inventory (TCI) was first described in 1993. It was designed to measure character dimensions in addition to the four temperament dimensions (Cloninger et al., 1993, 1994). While temperament is based mainly on the emotional responses of an individual to internal and external stimuli, character traits described higher cognitive functions, such individual differences in goals and values. In other words, character traits reflect the self-concepts that influence the meaning or significance of what is experienced. Character measures individual differences in self-reported goals and values, so is hypothesized to reflect individual differences in facts and propositions encoded in semantic memory (Cloninger et al., 1994). The character domain of personality describes a person's self-concept, including their self-directed goals, their relationship with others, and their participation in the world as a whole. Character is measured by three dimensions: self-directedness (SD), cooperativeness (CO) and self-transcendence (ST). Selfdirectedness is based on a person's awareness of being an autonomous individual. It refers to the individual acting on the external world in a way to accomplish his or her aims, thereby being responsible, purposeful, and resourceful. Cooperativeness measures the extent to which a person recognizes himor her-self as an integral part of society. It reflects the person's empathic identification with others, leading a person to be socially tolerant, helpful, and compassionate. Lastly, selftranscendence measures the extent to which a person sees him- or her-self as an integral part of the universe. It involves the awareness of one's participation in a universal unity of being, as indicated by joyful experiences of inseparability, oceanic feelings, or spiritual connectedness to what is beyond one's individual self (Cloninger et al., 1994; Cloninger, 2004).

127

TCI was originally validated in samples representative of the general community in the USA in 1993 and 1995. Subsequently, translations have been validated in many other countries, including Japan, Germany, China, France, Sweden and others (Cloninger et al., 1994). The convergent and concurrent validities of the TCI were evaluated by the comparison of TCI with other personality models such as those of Millon (Bayon et al., 1996), Coolidge (Griego et al., 1999), Rorschach (Fassino et al., 2003) and various forms of five-factor models (MacDonald et al., 2000; Ramanaiah et al., 2002). The TCI and its translations have been used in thousands of peer-reviewed publications with many reproducible findings regarding genetics, neurobiology, brain imaging, learning, psychopharmacology, and clinical psychopathology (de la Rie et al., 1998). It has been repeatedly confirmed that low scores on selfdirectedness and cooperativeness indicate the presence of personality disorders (Svrakic et al., 1999), supporting the notion that a personality disorder indicates impairment in working and loving. The TCI works well for the description of personality profile, and most research has relied upon its seven higher order scale scores, not its 25 subscales. Clinical experience suggested that the subscales contained valuable distinctions, so there was growing interest in enhancing the measurement of the TCI subscales. Another important concern was the persistence dimension, which was measured by only one short subscale in the TCI and consequently had only moderate internal consistency. The TCI was revised to correct these limitations. The main modifications in revised TCI (TCI-R) in relation to the TCI are the following: a. The facets were modified, with an increase in the subscales that measure reward dependence and persistence, without changing the conceptual construct of any of the TCI's seven major dimensions. This is the main modification. b. The total number of items in TCI and TCI-R are the same, but only 199 items are duplicates. 37 items from the TCI were eliminated and 41 new items were introduced in the TCI-R, including 5 validity items. c. The response format was modified: TCI-R has a 5-pointLikert scale (1. definitely false; 2. mostly false; 3. not true, nor false; 4. mostly true; and 5. definitely true). This response format increases the reliability of the answers because graded responses are possible. Pelissolo et al. (2005) compared the psychometric characteristics and normative data of the French version of TCI and TCI-R. The study found higher reliability coefficients using the 5-point-Likert format of the TCI-R in comparison to the true–false format of the TCI. All dimensions obtained higher Cronbach alpha coefficients for the TCI-R than for the TCI, similar of the results from the Belgium French-speaker sample from another validation study (Hansenne et al., 2005). Likewise Gutierrez-Zotes et al. (2003) conducted a validation study for the Spanish version of the TCI-R. He found higher reliability coefficients for all TCI-R dimensions than for the TCI. Pelissolo et al.'s (2005) study also confirmed that the overall factorial structure of the TCI-R preserved that of the TCI, having four distinct dimensions of temperament and three dimensions of character. The factor loadings for reward dependence and persistence were improved with the addition

128

D.M. Goncalves, C.R. Cloninger / Journal of Affective Disorders 124 (2010) 126–133

of subscales for these dimensions. Persistence, for example, strongly predicts the post-treatment relapse of alcoholic patients (Sellman et al., 1997) and has a significant correlation with brain activity (Cloninger, 1991). The test–retest reliability for TCI-R was verified by Pelissolo et al. (2005) and Martinotti et al. (2008), who found intra-class correlation coefficients for subscales ranged from 0.60 to 0.93 and from 0.68 to 0.88, respectively. The main purpose of this study is to validate the Brazilian Portuguese (BrP) version of the TCI-R by evaluating its psychometric characteristics. The second aim is to explore the correlations between TCI-R scores and other variables, including gender, age, scores on the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Satisfaction With Life Scale (SWLS). Third, the results of the Brazilian validation study will be compared with the original validation study of the TCI-R in the USA. 2. Methods 2.1. Sample The sample was recruited by convenience from two cities in the South of Brazil: 111 members from the school system of Garibaldi; 189 members from the staff of the health and school systems of Santa Cruz do Sul; and 295 people from the community of both cities. The study was proposed by teachers, in the case of the school system, and health professionals, in the case of people from the community and health system. The scale in general is stable for use in adolescents, as demonstrated by Martinotti et al. (2008). All subjects (n = 595) were volunteers and did not receive compensation for their participation. Despite an effort to achieve gender balance in the sample, because the populations cited above are predominantly female, 60.8% were women (N = 362). The sample ranged in age from 15 to 83; the average age was 32.46 with a standard deviation of 12.39. The sample is composed of 52 (8.8%) subjects with less than 8 years of education, 190 (31.9%) with 8 years of education, and 353 (59.3%) with more than 8 years of education. 2.2. Instruments 2.2.1. TCI-R translation process The translation to Brazilian Portuguese (BrP) was done in several steps following classical guidelines. First, the TCI-R was translated from English to Portuguese by two bilingual clinicians; second, the instrument was back-translated to English by a professional translator with extensive experience; third, the back-translation was submitted for technical review and comment by Dr Cloninger. Fourth, after the suggested modifications were made, a pilot study was carried out with a pilot sample of 30 subjects to check their understanding of the translation. Expressions were evaluated in relation to the cultural aspects. 2.2.2. Beck Depression Inventory (BDI) The BDI is a widely used self-report scale designed to measure the severity of depression and consists of 21 items, each scored from 0 to 3. For each item a higher score indicates greater severity of the symptom, comprising somatic, cogni-

tive, mood or behavioral aspects of depression. Scores can range from 0 to a maximum of 63 (Beck et al., 1961). In previously published research, this scale has been shown to have good internal reliability and to be valid for use with both patients and non-patients (Blumberry et al., 1978). 2.2.3. Beck Anxiety Inventory (BAI) The BAI is a widely used self-report scale (Steer et al., 1993) consisting of 21 items, scored on a scale of 0 to 3 for each item, as mild (0), moderate (1), severe (2), or extreme (3). Thus, scores can range from 0 to a maximum of 63. For studies with TCI and TCI-R, it is important to measure depressive and anxiety symptoms because the harm avoidance dimension is influenced by depression and anxiety states, with a variation up to about 10% (Svrakic et al., 1992; Joffe et al., 1993). Likewise scores for self-directedness and cooperativeness are lower during depressive episodes (Cloninger, 2004), indicating that these three dimensions have trait components and also some state-dependence. 2.2.4. Satisfaction with Life Scale (SWLS) Research has identified two broad aspects of subjective well-being: an affective component, which is usually further divided into positive and negative, and a cognitive component, which is referred to as life satisfaction (Diener, 1984). The affective and cognitive components are not completely independent, but they are somewhat distinctive and can provide complementary information when assessed separately. In this research the affective component was measured by BDI and BAI, and the cognitive by SWLS. As life satisfaction forms a separate dimension and correlates with predictor variables in a unique way, it seemed worthwhile to separately assess this construct. The SWLS is a short, self-reported, five-item scale designed to assess a person's global judgment of life satisfaction, which is theoretically predicted to depend on a comparison of life circumstances to one's standards. The scale is based on two main assumptions. First, the level of satisfaction with life is a subjective issue. Second, it is taken as a general concept without subscales (Diener, 1984; Diener et al., 1985). Although there may be some agreement about the important components of “the good life”, such as health and successful relationships, individuals are likely to assign different weights to these components. Individuals are also likely to have their own criteria for good life as well as different standards for “success” in each of these areas of their lives. Thus, it is necessary to assess an individuals' global judgment of his or her life rather than only his or her satisfaction with specific domains. The SWLS has a 7-point-Likert scale for five statements (1. strongly agree; 2. agree; 3. partially agree; 4. neither agree, nor disagree; 5. partially disagree; 6. disagree; and 7. strongly disagree). The scores are reversed and given in a range from 5 to 35, from poorly satisfied to highly satisfied, with 20 as the neutral point. We evaluated the psychometric features of SWLS in this sample. A very satisfactory Cronbach alpha of 0.82 was obtained, the same obtained by Ed Diener in the original normative data study. Also, a principal components analysis indicated that the items formed a single factor. That factor has an eigenvalue of 2.99 and explains 59.7% of the variance. The

D.M. Goncalves, C.R. Cloninger / Journal of Affective Disorders 124 (2010) 126–133

factor loadings of the 5 items are respectively 0.78, 0.74, 0.84, 0.8 and 0.71, which was similar to the original validation study (Diener et al., 1985). Another validation study in Brazil showed Cronbach alpha of 0.72 and a single factor accounting for 53.2% of variance (Gouveia et al., 2003). The one-factor solution has been replicated in several cross-national studies into many different languages and cultures (Pavot and Diener, 1993). The SWLS has significant association with depressive and anxiety symptoms (Gonçalves and Kapczinski, 2008). 2.3. Statistical analysis All statistical analyses were conducted using SPSS, version 16. Means, standard deviations and Cronbach alpha coefficients were calculated for each of the TCI-R dimensions and facets. Gender differences for the 7 main TCI-R scales were examined using t-tests (no correction for multiple comparisons was deemed necessary). Age association with TCI-R dimensions was assessed by Pearson correlations. Pearson correlations were also calculated among scores on the TCI-R, SWSL, BDI and BAI. Factor structure was assessed by a principal component analysis with a Promax rotation. Temperament and Character were analyzed separately, as is recommended with the TCI because of strong non-linear interactions between the two domains. The original version of the TCI-R was validated with 962 subjects in St. Louis, MO, USA, in order to standardize the changes in relation to TCI among users. We used Procrustes Rotation Correlations (Schumacker and Beyerlein, 2000) with congruence coefficients to compare the results obtained in the BrP version with the original version. Pearson correlations between the BDI, BAI and SWLS scores with the TCI-R dimension scores were performed to provide an indication of convergent and criterion validity for the TCI-R. The significance level adopted in all statistical tests was 0.01. All subjects signed a consent term. Confidentiality was assured. The survey was approved by the Ethics Research Committee of Universidade de Santa Cruz do Sul. 3. Results Women had higher scores in harm avoidance (99.8 vs 92.3, t = 5.42 p b 0.001), reward dependence (104.5 vs 99.3, t = 4.53 p b 0.001) and cooperativeness (138.2 vs 132.1, t = 4.47 p b 0.001) than men, but lower scores in persistence (119.0 vs 123.1, t = −2.9 p = 0.004). Novelty seeking (r = −0.15) and self-transcendence (r = 0.17) demonstrated significant associations with age. 3.1. TCI-R means and internal consistency In spite of the cultural differences between the US and Brazil and the fact that almost half of our sample was composed of subjects with low to intermediary education level, no serious misunderstanding seemed to occur in completing the TCI-R. As shown in Table 1, the Cronbach alpha coefficients for all dimensions were above 0.70, which demonstrates strong internal consistency. This is particularly noteworthy for reward dependence (0.77) and persistence (0.86) because

129

Table 1 Mean, standard deviation and internal consistency (Cronbach alpha) for temperament and character scales and subscales. Dimension/facet Temperament Novelty seeking (NS) Exploratory excitability (NS1) Impulsiveness (NS2) Extravagance (NS3) Disorderliness (NS4) Harm avoidance (HA) Anticipatory worry (HA1) Fear of uncertainty (HA2) Shyness (HA3) Fatigability (HA4) Reward dependence (RD) Sentimentality (RD1) Openness to warm communication (RD2) Attachment (RD3) Dependence (RD4) Persistence (PS) Eagerness of effort (PS1) Work harm avoidancerdened (PS2) Ambitious (PS3) Perfectionist (PS4) Character Self-directedness (SD) Responsibility (SD1) Purposeful (SD2) Resourcefulness (SD3) Self-acceptance (SD4) Enlightened second nature (SD5) Cooperativeness (CO) Social acceptance (CO1) Empathy (CO2) Helpfulness (CO3) Compassion (CO4) Pure-hearted conscience (CO5) Self-transcendence (ST) Self-forgetful (ST1) Transpersonal identification (ST2) Spiritual acceptance (ST3)

No. of Mean Standard Cronbach items deviation alpha 35 10 9 9 9 33 11 7 7 8 30 8 10

98.8 13.8 31.8 5.7 22.6 5.2 26.9 6.9 17.5 4.2 96.8 16.7 30.3 6.2 24.1 5.0 21.4 5.4 21.0 5.8 102.5 13.8 28.0 4.7 34.9 6.1

0.71 0.48 0.59 0.74 0.42 0.84 0.65 0.59 0.72 0.71 0.77 0.51 0.68

6 6 35 9 8

20.0 5.2 19.5 4.1 120.6 17.1 30.3 4.9 29.4 5.1

0.69 0.48 0.86 0.56 0.65

10 8

40 8 6 5 10 11 36 8 5 8 7 8 26 10 8 8

33.5 27.4

6.2 5.0

0.71 0.61

143.9 20.0 29.4 5.7 23.8 4.1 18.7 3.8 32.2 7.1 39.8 6.3 135.8 16.4 30.5 5.0 18.1 3.3 30.2 3.9 26.3 5.9 30.7 4.9 78.3 15.4 29.8 6.5 24.2 6.1

0.87 0.71 0.63 0.64 0.72 0.69 0.83 0.69 0.45 0.48 0.80 0.49 0.84 0.68 0.73

24.3

6.5

0.72

they have more subscales and better reliability in this version than in the original TCI (Cloninger et al., 1994). In relation to facets, the Cronbach alpha coefficients ranged from 0.42 (disorderliness; 4th facet of novelty seeking — NS4) to 0.80 (compassion; 4th facet of cooperativeness — CO4). 3.2. Factor analysis The correlation matrices for the seven main dimensions are shown in Table 2. The highest correlations were for selfdirectedness with cooperativeness (0.62), harm avoidance with self-directedness (−0.55) and reward dependence with cooperativeness (0.51). Moderate correlations were obtained for persistence with self-transcendence (0.34) and harm avoidance with persistence (− 0.39). Separate exploratory factor analyses were performed for temperament and character. We identified four factors in the principal component analysis of temperament. These factors account respectively for 25.2%, 13.2%, 11.3% and 8.6% of the

130

D.M. Goncalves, C.R. Cloninger / Journal of Affective Disorders 124 (2010) 126–133

Table 2 Correlation matrices of the seven main dimensions. NS

NS

HA RD PS SD CO ST

− 0.28 0.16 − 0.02 − 0.1 − 0.11 − 0.01

HA

RD

PS

Table 4 Principal component analysis of character facets (Promax with Kaiser Normalization). SD

CO Facets

− 0.16 − 0.39 − 0.55 − 0.29 − 0.01

0.26 0.26 0.51 0.22

0.28 0.28 0.34

0.62 − 0.11

0.18

Correlations with p-values b0.01 and abs(r) N 0.30 are shown in bold. NS = novelty seeking; HA = harm avoidance; RD = reward dependence; PS = persistence; SD = self-directedness; CO = cooperativeness; ST = selftranscendence.

variance, with the cumulative variance of 58.1%. The standardized factor loadings following Promax rotation in a fourfactor solution are presented in Table 3. It shows robust values for novelty seeking, harm avoidance, reward dependence and persistence. Contrary to expectation, NS1 (exploratory excitability; 1st facet of novelty seeking) loaded negatively on harm avoidance and positively on reward dependence. For character, we identified three factors in the principal component analysis, accounting respectively for variances of 33.6%, 17.3% and 8.8%, with 59.6% of cumulative variance. Table 4 shows the standardized factor loadings following Promax rotation in a three-factor solution. The values for character are in strong concordance with theoretical prediction except that SD4 (self-acceptance = 4th facet of selfdirectedness) loaded positively on cooperativeness and CO2 (empathy; 2nd facet of cooperativeness) loaded positively on self-transcendence. 3.3. Correlation among TCI-R dimensions We observed moderate to strong positive correlations for reward dependence with cooperativeness (0.51) and selfdirectedness with cooperativeness (0.62), and moderate Table 3 Principal component analysis of temperament facets (Promax with Kaiser Normalization). Facets

NS1 NS2 NS3 NS4 HA1 HA2 HA3 HA4 RD1 RD2 RD3 RD4 PS1 PS2 PS3 PS4

Component 1

2

3

4

− 0.03 − 0.08 − 0.17 0.01 − 0.1 − 0.01 0.01 − 0.27 0.36 0.16 − 0.15 − 0.23 0.76 0.71 0.8 0.81

− 0.52 0.06 − 0.06 − 0.13 0.75 0.7 0.67 0.59 0.53 − 0.08 − 0.14 − 0.04 0.08 − 0.18 − 0.08 − 0.08

0.48 0.05 0.41 − 0.04 − 0.05 0.24 − 0.23 − 0.12 0.52 0.75 0.81 0.42 0.08 0.04 − 0.1 − 0.05

0.06 0.72 0.53 0.69 0.03 − 0.21 0.03 0.07 0.09 0.08 − 0.06 − 0.51 0.01 − 0.11 0.12 − 0.11

Loadings with absolute values of 0.4 or more are shown in bold. NS = novelty seeking; HA = harm avoidance; RD = reward dependence; PS = persistence.

SD1 SD2 SD3 SD4 SD5 CO1 CO2 CO3 CO4 CO5 ST1 ST2 ST3

Component 1

2

3

0.77 0.85 0.87 − 0.07 0.78 0.29 0.32 0.05 − 0.09 − 0.03 − 0.07 0.05 − 0.12

0.07 − 0.08 − 0.06 0.74 0.01 0.49 0.25 0.7 0.78 0.69 − 0.2 0.05 0.22

− 0.22 0.09 − 0.08 − 0.39 0.01 0.08 0.41 0.08 0.13 0.06 0.81 0.83 0.69

Loadings with absolute values of 0.4 or more are shown in bold. SD = self-directedness; CO = cooperativeness; ST = self-transcendence.

negative correlation between harm avoidance and selfdirectedness (− 0.55). 3.4. Correlations among BDI, BAI, SWLS and TCI-R The means and standard deviations for BDI (n = 482), BAI (n = 501) and SWLS (n = 523) were, respectively, 7.5 (SD 7.4), 9.3 (SD 9.6) and 24.8 (SD 5.4). In average the sample is composed of subjects reporting low scores of depression and anxiety, and a moderate score of satisfaction with life. BDI and BAI resulted in a moderate to strong positive correlation (r = 0.65), which indicates positive correspondence of depression and anxiety symptoms. BDI and BAI were also negatively correlated with SWLS (r = −0.4 and r = −0.26). In Table 5, we can see a moderate positive correlation between BDI and harm avoidance (r = 0.43), and an inverse moderate correlation between BDI and self-directedness (r = −0.42). Reward dependence, persistence and cooperativeness demonstrated weak inverse correlations with BDI (r = −0.18, r = −0.23 and r = −0.27, respectively). In summary, high scores in harm avoidance are associated with more depressive symptoms, whereas high scores in reward dependence, persistence, self-directedness and cooperativeness imply fewer depression symptoms. BAI showed a moderate positive correlation with harm avoidance (r = 0.43) and a moderate inverse correlation with Table 5 Correlations between TCI-R (Temperament and Character Inventory — Revised) domains and BDI (Beck Depression Inventory), BAI (Beck Anxiety Inventory) and SWLS (Satisfaction With Life Scale). Dimension

BDI

BAI

SWLS

Novelty seeking Harm avoidance Reward dependence Persistence Self-directedness Cooperativeness Self-transcendence

− 0.07 0.43 − 0.18 − 0.23 − 0.42 − 0.27 − 0.04

− 0.01 0.43 − 0.11 − 0.15 − 0.40 − 0.22 0.05

0.06 − 0.44 0.20 0.23 0.46 0.35 − 0.01

Correlations with p-values b0.01 are shown in bold.

D.M. Goncalves, C.R. Cloninger / Journal of Affective Disorders 124 (2010) 126–133

self-directedness (r = − 0.4). Persistence and cooperativeness resulted in weaker inverse correlations with BAI (r = −0.15 and r = − 0.22, respectively). This indicates that high scores in harm avoidance are associated with more anxiety symptoms, whereas high scores in self-directedness, persistence and cooperativeness are associated with fewer anxiety symptoms. In Table 5, SWLS is shown to have a moderate inverse correlation with harm avoidance (r = −0.44) and moderate positive correlations with self-directedness (r = 0.46) and cooperativeness (r = 0.35). Reward dependence and persistence resulted in weaker positive correlations with SWLS (r = 0.2 and r = 0.23, respectively). In summary, high scores in harm avoidance are associated with poorer life satisfaction, whereas higher scores in persistence, reward dependence, self-directedness and cooperativeness are associated with greater life satisfaction. 3.5. Procrustes Rotation The congruence coefficients between each facet of BrP TCIR and the US TCI-R were calculated by Procrustes Rotation. As we can see in Table 6, the congruence was significant except for NS1 (exploratory excitability; 1st facet of novelty seeking). We obtained congruence values of 95% or higher for

Table 6 Procrustes Rotation with congruence coefficients for TCI-R (Temperament and Character Inventory — Revised) facets. Temperament facets

PS

HA

RD

NS

Cong

NS1 NS2 NS3 NS4 HA1 HA2 HA3 HA4 RD1 RD2 RD3 RD4 PS1 PS2 PS3 PS4 FactCong

0.00 − 0.07 − 0.17 0.03 − 0.11 − 0.03 0.01 − 0.28 0.34 0.15 − 0.16 − 0.25 0.76 0.71 0.80 0.81 0.96

− 0.55 0.13 − 0.05 − 0.06 0.75 0.65 0.69 0.60 0.49 − 0.15 − 0.22 − 0.14 0.08 − 0.18 − 0.05 − 0.07 0.92

0.37 − 0.07 0.30 − 0.18 0.03 0.36 − 0.15 − 0.07 0.56 0.71 0.76 0.50 0.10 0.06 − 0.10 − 0.03 0.97

0.18 0.72 0.60 0.68 − 0.05 − 0.21 − 0.07 0.00 0.14 0.22 0.22 − 0.41 0.01 − 0.11 0.09 − 0.13 0.93

0.71 0.93 0.89 0.99 0.96 0.99 0.99 0.97 0.96 0.95 0.98 0.90 0.93 0.96 0.99 0.98 0.95

Character facets

CO

SD

ST

Cong

SD1 SD2 SD3 SD4 SD5 CO1 CO2 CO3 CO4 CO5 ST1 ST2 ST3 FactCong

0.11 − 0.04 − 0.02 0.74 0.05 0.50 0.26 0.70 0.77 0.69 − 0.21 0.04 0.20 0.98

0.78 0.85 0.88 − 0.08 0.78 0.27 0.28 0.01 − 0.14 − 0.06 0.03 − 0.00 − 0.18 0.98

− 0.17 0.14 − 0.03 − 0.39 0.06 0.10 0.44 0.09 0.13 0.07 0.82 0.83 0.68 0.99

0.96 0.99 0.98 0.99 0.97 0.93 0.98 0.96 1.00 0.96 1.00 1.00 0.99 0.98

NS = novelty seeking; HA = harm avoidance; RD = reward dependence; PS = persistence; SD = self-directedness; CO = cooperativeness; ST = selftranscendence.

131

NS2 (impulsiveness; 2nd facet of novelty seeking), NS3 (extravagance; 3rd facet of novelty seeking) and CO5 (purehearted conscience; 5th facet of cooperativeness). For all other facets, the congruence values were higher than 99%.

4. Discussion 4.1. TCI-R internal consistency Overall we obtained good psychometric features for the BrP version of the TCI-R. Internal consistency was satisfactory for all dimensions, with Cronbach alpha coefficients above 0.80, except for novelty seeking and reward dependence with coefficients of 0.71 and 0.77, respectively. The associations found with gender and age were in accord with prior experience with the scale (Pelissolo et al., 2005; Hansenne et al., 2005; Gutierrez-Zotes et al., 2003; Fossati et al., 2007; Preiss et al., 2007; Martinotti et al., 2008; Farmer and Goldberg, 2008). In the six other trans-cultural validation studies (Pelissolo et al., 2005; Hansenne et al., 2005; Gutierrez-Zotes et al., 2003; Fossati et al., 2007; Preiss et al., 2007; Martinotti et al., 2008) and the second validation study with US subjects (Farmer and Goldberg, 2008), the alpha coefficients ranged from 0.77 (novelty seeking) in the Spanish validation study (Gutierrez-Zotes et al., 2003) to 0.92 (harm avoidance and persistence) in the French validation study (Pelissolo et al., 2005). The exception occurred in both Italian validation studies (Martinotti et al., 2008; Fossati et al., 2007) that found the lowest reliability for reward dependence. In our study, the lowest reliability was novelty seeking (0.71) and the higher reliability was self-directedness (0.87) followed by persistence (0.86). The lowest reliability was obtained for the novelty seeking dimension in almost all studies, including ours, largely because NS1 (exploratory excitability = NS1; 1st facet of novelty seeking) appears to be reduced when people are anxious or depressed. The addition of subscales for reward dependence and persistence resulted in improved reliabilities for these dimensions without any deviation in the overarching constructs. In relation to facets, the reliabilities ranged from 0.42 (disorderliness; 4th facet of novelty seeking = NS4) to 0.80 (compassion; 4th facet of cooperativeness = CO4). In the Belgium and French validation studies the reliability for facets ranged, respectively, from 0.45 (dependence; 4th facet of reward dependence = RD4) to 0.88 (CO4), and 0.45 (purehearted conscience; 5th facet of cooperativeness = CO5) to 0.85 (shyness; 3rd facet of harm avoidance = HA3). In the Fossatti et al.'s Italian validation study, the reliabilities for facets ranged from 0.49 (RD4) to 0.81 (ambitious; 3rd facet of persistence = PS3) and in the Farmer et al.'s US study from 0.58 (RD4 and CO5) to 0.90 (spiritual acceptance; 3rd facet of self-transcendence = ST3). The Martinotti et al.'s (2008) study do not present the reliability for the facets. Cloninger has recently provided a detailed theoretical basis for the clinical significance of facets in personality assessment (Cloninger, 2004). The good reliability obtained for all facets encourages their use in future research and clinical practice, providing more refined understanding of the psychobiological basis of mental health and its disorders.

132

D.M. Goncalves, C.R. Cloninger / Journal of Affective Disorders 124 (2010) 126–133

4.2. Factor analysis Recent studies have demonstrated that there are no one-toone relationship between the configurations of temperament dimensions and the configuration of character dimensions. In fact there is extensive equifinality (i.e., different temperament configurations are associated with the same character configuration) and multifinality (i.e., one temperament configuration is associated with different character configurations). As a result of this non-linearity, factor analysis of the TCI-R has been performed by separate principal component analyses for the temperament and character domains. The variances in the BrP version for temperament and character (58.14% and 59.63%) were similar to the other validation studies where the same factor analysis procedure was adopted: the French version (Pelissolo et al., 2005) (64.2% and 55.6%), the Belgium version (Hansenne et al., 2005) (60% and 57%) and the Martinotti et al.'s (2008) Italian validation study (73.8% and 67.5%). All facets in the BrP translation loaded on factors as expected with three exceptions: NS1 (exploratory excitability; 1st facet of novelty seeking), SD4 (self-acceptance= 4th facet of selfdirectedness) and CO2 (empathy; 2nd facet of cooperativeness). NS1 and SD4 have customarily loaded in other factors than in their rationally defined dimensions in TCI, and, more recently, TCI-R (Pelissolo et al., 2005; Hansenne et al., 2005; Martinotti et al., 2008). In relation to SD4, which loaded positively on cooperativeness, a correlation between the selfacceptance and cooperativeness concepts is expected because acceptance of oneself is crucial for acceptance of others. However, unlike prior TCI-R validation studies, CO2 (empathy; 2nd facet of cooperativeness) loaded on self-transcendence. One possible explanation for this divergent finding is that empathy could have a different cultural significance in Brazil. Alternatively the finding about empathy may be related to the low educational background of many of our subjects. 4.3. Correlations among TCI-R dimensions We observed moderate to strong positive correlations for reward dependence with cooperativeness, for self-directedness with cooperativeness, and a moderate negative correlation between harm avoidance and self-directedness. Although the correlation between self-directedness and cooperativeness is unusually high in our volunteers, this pattern of correlations has been found since the original TCI validation, as well as in the TCI-R validation studies. 4.4. Correlations among BDI, BAI, SWLS and TCI-R scores The findings with the BDI and BAI indicate that depression symptoms are moderately correlated with anxiety symptoms, as expected. The correlations for BDI and BAI with harm avoidance (positive) and with self-directedness (inverse) are in accordance with other studies, demonstrating that depression and anxiety symptoms are correlated with high scores on harm avoidance and low scores on self-directedness (Pelissolo et al., 2005; Hansenne et al., 2005). Work with non-psychotic siblings of major depressives and of schizophrenics has shown that these dimensions contribute to vulnerability to psychopathology, as well as having a state-dependent component.

In relation to SWLS, the moderate inverse correlation with BDI and BAI is the same as reported in the literature as well as the association of lower SWLS scores with mental disorders (Diener et al., 1985; Gonçalves and Kapczinski, 2008). SWLS correlated positively and moderately with self-directedness and cooperativeness. Both findings confirm the relationship between satisfaction with life and TCI-R scores. The higher the scores in self-directedness and cooperativeness are, the higher will be the scores for life satisfaction. Consequently higher self-directedness and cooperativeness scores are associated with a reduced risk of mental disorder, including personality disorders and other clinical syndromes. Our study also shows significant positive correlations for SWLS with reward dependence and persistence and a negative correlation of SWLS with harm avoidance. This finding supports the hypothesis that reward dependence and persistence facilitate the development of a mature character, which also implies greater life satisfaction (Cloninger, 2004). 4.5. Procrustes Rotation The Procrustes Rotation was used in this study to verify the congruence strength between the BrP version and the US original version. The results confirmed high congruence level, except for NS1 (exploratory excitability; 1st facet of novelty seeking), showing the correspondence of BrP version of TCI-R and the original version. 4.6. Study Limitations The main limitation of the study is its convenience sampling. Our sample was composed exclusively of volunteers, many of whom had limited education and no prior experience with personality testing. Nevertheless, we found that the BrP version of the TCI-R was well accepted and understood in Brazilian general population. The similarities of results obtained with similar studies in other countries indicate that the structure and reliability of the TCI-R are highly robust to sampling variations. 4.7. Summary and conclusions We evaluated the BrP version of Cloninger's TCI-R, and found it had good psychometric properties, including strong internal consistency of the scales and a seven dimensional structure like the original English TCI-R. In spite of cultural and educational differences, the results obtained are in strong concordance with the other validated versions of TCI-R. In addition, we explored the relationship of the TCI-R with depression symptoms, anxiety symptoms and the level of satisfaction with life. We found that the TCI-R has strong relationships with both positive and negative emotions, confirming prior work. Our findings indicate that this Brazilian translation can be used successfully in both clinical and research settings. Role of the funding source Sansone Family Center for Well-Being (non-governmental funds).

Conflict of interest No conflict declared.

D.M. Goncalves, C.R. Cloninger / Journal of Affective Disorders 124 (2010) 126–133

Acknowledgement We thank Thomas Przybeck, PhD for his assistance with data analysis. References Battaglia, M., Przybeck, T.R., Bellodi, L., Cloninger, C.R., 1996. Temperament dimensions explain the comorbidity of psychiatric disorders. Compr. Psychiatry 37, 292–298. Bayon, C., Hill, K., Svrakic, D.M., Przybeck, T.R., Cloninger, C.R., 1996. Dimensional assessment of personality in an out-patient sample: relations of the systems of Millon and Cloninger. J. Psychiatr. Res. 30, 341–352. Beck, A.T., Ward, C.H., Mendelson, M., Mock, J., Erbaugh, J., 1961. An inventory for measuring depression. Arch. Gen. Psychiatry 4, 561–571. Blumberry, W., Oliver, J.M., McCclure, J.N., 1978. Validation of the Beck Depression Inventory in a university population using psychiatric estimate as the criterion. J. Consult. Clin. Psychol. 46, 150–155. Cloninger, C.R., 1987. A systematic method for clinical description and classification of personality variants. Arch. Gen. Psychiatry 44, 573–588. Cloninger, C.R., 1991. Brain networks underlying personality development. In: Carrol, B.J., Barret, J.E. (Eds.), Psychopathology and the Brain. Raven Press, NY, pp. 183–208. Cloninger, C.R., 1999. A new conceptual paradigm from genetics and psychobiology for the science of mental health. Aust. NZ J. Psychiatry 33, 174–186. Cloninger, C.R., 2004. Feeling Good. The Science of Well-Being. Oxford University Press, New York, NY. Cloninger, C.R., Przybeck, T.R., Svrakic, D.M., 1991. The Tridimensional Personality Questionnaire: U.S. normative data. Psychol. Rep. 69, 1047–1057. Cloninger, C.R., Svrakik, D.M., Przybeck, T.R., 1993. A psychological model of temperament and character. Arch. Gen. Psychiatry 50, 975–990. Cloninger, C.R., Przybeck, T., Svrakic, D.M., Wetzel, R., 1994. The Temperament and Character Inventory: A Guide to its Development and Use. Center for Psychobiology of Personality, Washington University, St Louis, MO. Cloninger, C.R., Svrakic, N.M., Svrakic, D., 1997. Role of personality selforganization in development of mental order and disorder. Dev. Psychopathol. 9, 881–906. de la Rie, S.M., Duijsens, I.J., Cloninger, C.R., 1998. Temperament, character, and personality disorders. J. Pers. Disord. 12, 362–372. Diener, E., 1984. Subjective well-being. Psychol. Bull. 95, 542–575. Diener, E., Emmoms, R.A., Larsen, R.J., Griffin, S., 1985. The Satisfaction with Life Scale. J. Pers. Assess. 49, 71–75. Farmer, R.F., Goldberg, L.R., 2008. A psychometric evaluation of the revised Temperament and Character Inventory (TCI-R) and the TCI-140. Psychol. Assess. 20, 281-91-94. Fassino, S., Amianto, F., Levi, M., Rovera, G.G., 2003. Combining the Rorschach test and the Temperament Character Inventory: a new perspective on personality assessment. Psychopathology 36, 84–91. Fossati, A., Cloninger, C.R., Villa, D., Borroni, S., Grazioli, F., Giarolli, L., Battaglia, M., Maffei, C., 2007. Reliability and validity of the Italian version of the Temperament and Character Inventory—Revised in an outpatient sample. Compr. Psychiatry 48, 380–387.

133

Goldman, R.G., Skodal, A.E., McGrath, P.J., Oldhan, J.M., 1994. Relationship between the Tridimensional Personality Questionnaire and DSM-III-R personality traits. Am. J. Psychiatry 151, 274–276. Gonçalves, D.M., Kapczinski, F., 2008. Mental disorder, demographic variables and life satisfaction [Transtorno mental, indicadores demográficos e satisfação com a vida]. Rev. Saúde Pública 42, 1060–1066. Gouveia, V.V., Chaves, S.S.S., Oliveira, I.C.P., Dias, M.R., Gouveia, R.S.V., Andrade, P.R., 2003. The use of the GHQ-12 in a general population: a study of its construct validity [A Utilização do QSG-12 na População Geral: Estudo de sua Validade de Construto]. Psic. Teor. e Pesq. 19, 241–248. Griego, J., Stewart, S.E., Coolidge, F.L., 1999. A convergent validity study of Cloninger's Temperament and Character Inventory with the Coolidge Axis II Inventory. J. Personal. Disord. 13, 257–267. Gutierrez-Zotes, J.A., Bayon, C., Montserrat, C., 2003. Temperament and Character Inventory revised (TCI-R). Standardization and normative data in a general population. Actas Esp. Psiquiatr. 32, 8–15. Hansenne, M., Delhez, M., Cloninger, C.R., 2005. Psychometric proprieties of the Temperament and Character Inventory—Revised (TCI-R) in a Belgium sample. J. Pers. Assess. 85, 40–49. Joffe, R.T., Bagby, R.M., Levitt, A.J., Regan, J.J., Parker, J.D., 1993. The tridimensional personality questionnaire in major depression. Am. J. Psychiatry 150, 959–960. MacDonald, D.A., Gagnier, J.J., Friedman, H.L., 2000. The self-expansiveness level form: examination of its validity and relation to the NEO Personality Inventory—Revised. Psychol. Rep. 86, 707–726. Martinotti, G., Mandelli, L., Di Nicola, M., Serretti, A., Fossati, A., Borroni, S., Cloninger, C.R., Janiri, L., 2008. Psychometric characteristic of the Italian version of the Temperament and Character Inventory—Revised, personality, psychopathology, and attachment styles. Compr. Psychiatry 49, 514–522. Pavot, W., Diener, E., 1993. Review of Satisfaction with Life Scale. Psychol. Assess. 5, 164–172. Pelissolo, A., Mallet, L., Baleyte, J.M., Michel, G., Cloninger, C.R., Allilaire, J.F., 2005. The Temperament and Character Inventory—Revised (TCI-R): psychometric characteristics of the French version. Acta Psychiatr. Scand. 112, 126–133. Preiss, M., Kucharová, J., Novák, T., Stepánková, H., 2007. The Temperament and Character Inventory—Revised (TCI-R): a psychometric characteristics of the Czech version. Psychiatr. Danub. 19, 27–34. Ramanaiah, N.V., Rielage, J.K., Cheng, Y., 2002. Cloninger's Temperament and Character Inventory and the NEO Five-Factor Inventory. Psychol. Rep. 90, 1059–1063. Schumacker, R.E., Beyerlein, S.T., 2000. Confirmatory factor analysis with different correlation types and estimation methods. Struct. Equ. Modeling 7, 629–636. Sellman, J.D., Mulder, R.T., Sullivan, P.F., Joyce, P.R., 1997. Low persistence predicts relapse in alcohol dependence following treatment. J. Stud. Alcohol 58, 257–263. Stallings, M.C., Hewitt, J.K., Heath, H.C., Eaves, L.J., 1996. Factor structure of the Tridimesional Personality Questionnaire: four temperament dimensions? J. Pers. Soc. Psychol. 70, 127–140. Steer, R.A., Rissmiller, D.J., Ranieri, W.F., Beck, A.T., 1993. Structure of the computed-assisted Beck Anxiety Inventory with psychiatric patients. J. Pers. Assess. 60, 532–542. Svrakic, D.M., Przybeck, T.R., Cloninger, C.R., 1992. Mood states and personality traits. J. Affect. Disord. 24, 217–226. Svrakic, D.M., Whitehead, C., Przybeck, T.R., Cloninger, C.R., 1999. Differential diagnosis of personality disorders by the seven-factor model of temperament and character. Arch. Gen. Psychiatry 50, 991–999.