title: Temperament and character personality profiles and personality disorders in chronic pain patients.
abstract: In his psychobiological model of personality, Cloninger developed a novel approach concerning the relationships between psychopathological syndromes and personality. We investigated 207 chronic pain patients (CPPs) and compared them to 105 pain-free control subjects. Participants were assessed using the Temperament and Character Inventory (TCI), the Structured-Clinical-Interview-II, the Beck Depression Inventory and the Spielberger Anxiety Inventory. The CPPs scored higher on the depression and state anxiety scales and 41% fulfilled the criteria of having at least one personality disorder (PD). We used a covariance analysis to control for depression and state anxiety and found that the CPPs scored higher on the Harm Avoidance Temperament Dimension and lower on the Self-Directedness and Cooperativeness Character Dimensions. In CPPs, the symptom counts of all PD subtypes were significantly related to low Self-Directedness and, to a lesser degree, low Cooperativeness. The PD symptoms in Cluster A were related to low Reward Dependence, those in Cluster B were related to high Novelty Seeking and the PD symptoms in Cluster C were related to high Harm Avoidance. In multiple hierarchical regression analyses, controlling for age, gender, depression and state anxiety, TCI scales predicted on average 23% in PD symptom counts. The Self-Directedness and Cooperativeness personality traits appeared to be significant predictors in determining the presence or absence of a PD by correctly classifying 75.8% of CPPs. The TCI provides further insight into the mechanisms underlying the development of chronic pain. This useful diagnostic instrument helps to economically and validly facilitate the identification of core PD features.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany. Rupert.Conrad@ukb.uni-bonn.de
authors.forename: Rupert
authors.initials: R
authors.lastname: Conrad
authors.forename: Guntram
authors.initials: G
authors.lastname: Schilling
authors.forename: Christiane
authors.initials: C
authors.lastname: Bausch
authors.forename: Joachim
authors.initials: J
authors.lastname: Nadstawek
authors.forename: Hans Christian
authors.initials: HC
authors.lastname: Wartenberg
authors.forename: Ingo
authors.initials: I
authors.lastname: Wegener
authors.forename: Franziska
authors.initials: F
authors.lastname: Geiser
authors.forename: Katrin
authors.initials: K
authors.lastname: Imbierowicz
authors.forename: Reinhard
authors.initials: R
authors.lastname: Liedtke
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000150:complications*; D010551:Personality; D010554:Personality Disorders / Q000209:etiology*; D010555:Personality Inventory / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D018709:Statistics, Nonparametric; D013694:Temperament / Q000502:physiology*