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Comprehensive Psychiatry 49 (2008) 514–522
www.elsevier.com/locate/comppsych
Psychometric characteristic of the Italian version of the Temperament and
Character Inventory—Revised, personality, psychopathology,
and attachment styles
a b, a b
Giovanni Martinotti , Laura Mandelli ⁎, Marco Di Nicola , Alessandro Serretti ,
Andrea Fossatid, Serena Borronid, C. Robert Cloningerc, Luigi Janiria
aDepartment of Psychiatry, Catholic University Medical School, 00168 Rome, Italy
bInstitute of Psychiatry, University of Bologna, 40123 Bologna, Italy
c
Center for Psychobiology of Personality, Department of Psychiatry, Washington University in St, Louis, School of Medicine, St. Louis, MO, USA
dFaculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy
Abstract
In this article, we described the psychometric characteristics of the revised version of the Cloninger's personality Temperament and
Character Inventory (TCI-R), Italian translation. Two independent samples, which were composed of 355 and 385 nonclinical mother-
language Italian subjects, respectively, completed the TCI-R. A further sample of psychiatric outpatients was compared with community
samples. We analyzed the internal consistency of each dimension, the test-retest reliability and the factorial structure of the questionnaire.
Furthermore, we explored the potential association between personality, psychopathologic indicators (evaluated by the Symptom Checklist-
90), behavior dyscontrol measures, and adaptive and maladaptive interpersonal styles. As a whole, the internal consistency of the TCI-R
scales was adequate, although some differences in Cronbach α values were observed between the 2 samples in some TCI-R subfacets. The
factorial structure was consistent with the original hypothesis of Cloninger and test-retest showed a good stability of the scores over the time.
Normal data for the Italian population were also calculated. Furthermore, the character dimensions of self-directedness and cooperativeness
were related with some psychopathologic domains in our sample and negatively with impulsiveness, anger, and hostility. Novelty seeking
wasassociated with impulsiveness, whereas harm avoidance was associated with anger and hostility. On the contrary, persistence and reward
dependence were inversely correlated with such traits. Harm avoidance, reward dependence, self-directedness, and cooperativeness were
strongly related with measures of attachment. Finally, significant differences were observed in both temperament and character traits between
community subjects and psychiatric outpatients.
In the present study, the validity of the Italian translation of the TCI-R is therefore supported. Personality features are also confirmed as
risk factors for specific psychopathologic domains, impulsivity, anger, and hostility. Furthermore, we found attachment styles of nonclinical
subjects correlated with personality features.
©2008 Elsevier Inc. All rights reserved.
1. Introduction persistence) and character dimensions (self-directedness
[SD], cooperativeness [C], self-transcendence [ST]). Tem-
The Temperament and Character Inventory (TCI) [1] is a peramental traits refer to automatic emotional responses to
226-item self-questionnaire developed to assess the 7 experiences that are moderately heritable and stable
dimensions of personality defined by the biosocial model throughout life. In contrast, character facets refer to self-
of personality. Cloninger and colleagues [2,3] developed this concepts and individual differences in goals and values and
modelofpersonalitybasedontemperament(harmavoidance they are moderately influenced by insight and learning and
[HA], novelty seeking [NS], reward dependence [RA], mature in progressive steps; however, some recent studies
showed some heritability also for character dimensions [4].
Temperament consists of 4 traits, so-called harm avoidance,
⁎ Corresponding author. Tel.: +39 051 6584233; fax: +39 051 521030. novelty seeking, reward dependence, and persistence. Harm
E-mail address: laura.mandelli@unibo.it (L. Mandelli). avoidance denotes the individual's inclination to behavioral
0010-440X/$ – see front matter © 2008 Elsevier Inc. All rights reserved.
doi:10.1016/j.comppsych.2007.11.002
G. Martinotti et al. / Comprehensive Psychiatry 49 (2008) 514–522 515
inhibition in front of potentially dangerous stimuli and to nosis and in differentiating the individual DSM-IV person-
anticipate negative effects; novelty seeking relates to ality disorder diagnoses [15].
exploratory behaviors and activation in response to novel Starting from these considerations, the aim of the present
stimuli; reward dependence concerns relational and affective study was to confirm and extend the psychometric properties
skills but also others dependencies; and finally, persistence of Italian translation of the TCI-R also in 2 nonclinical Italian
characterizes industrious, hard working, and stable despite samples. Furthermore, we aim to investigate the potential
frustration and fatigue individuals. Character consists of 3 association between personality and indicators of psycho-
dimensions: SD, C, and ST. Self-directedness expresses the pathology, of behavior dyscontrol, adaptive, and maladap-
individual's competence toward autonomy, reliability, and tive interpersonal styles. Finally, we will perform a
maturity; cooperativeness is related to social skills, such as comparison between scores obtained in the community
support, collaboration, and partnership; and finally, self- sample with those obtained in a sample of patients affected
transcendence denotes the aptitude toward mysticism, by psychiatric disorders already investigated in a previous
religion, and idealism. study [15].
The TCI has been used extensively in research studies
worldwide during the past 15 years; it provides quantitative
measures of personality that are clinically useful in 2. Materials and methods
psychiatry and psychology [5] and it is a reliable instrument 2.1. Subjects
to assess personality disorders: lower SD and cooperative-
ness (C) scores have been found consistently in individuals The investigation was performed on 2 independent
with personality disorders [6,7]. The Italian version of the community samples of adult (older than 18 years)
TCI was validated by Fossati et al [8], in both clinical and volunteers. The first sample was composed of 355 Italian
nonclinical samples. mother-language subjects from the community (mostly
Recently, Cloninger developed a revised version of the members of the hospital staff), recruited at the “Agostino
TCI(TCI-R)[9]introducing2majormodifications.First,the Gemelli” Hospital, Catholic University of Rome (Italy),
original TCI was a true-false questionnaire, whereas in the who volunteered to take part in the study after signing a
TCI-R, participants must respond on a 5-point Likert scale written informed consent form. The sample was com-
ranging from 1 (definitively false) to 5 (definitively true) to posed by 150 males (42.3%) and 205 females (57.7%);
enhancetheprecisionofmeasurementforsubscales.Second, subjects had a mean age of 36.2 ± 14.2 years (range, 18-
in the original TCI, Persistence was measured by only one 86 years), and they were mainly employed (60.7%,;
short scale, whereas in the TCI-R, this dimension has 35 29.2% of them were students, 8.9% homemaker or
items and 4 subscales to improve its description and retired, and 1.2% unemployed.
measurement. In addition, the TCI-R adds a new subscale The second sample was composed of 385 Italian mother-
for RA. language participants living in Milan urban or suburban
Until recently, few data have been available about the areas whovolunteeredtotakepartinthestudyaftersigninga
TCI-R. The TCI-R has been reported structurally equivalent written informed consent form; they were mostly members
to the TCI and the TCI-R; a good internal consistency and of the San Raffaele of Hospital of Milan staff. One hundred
factorial structure for the TCI-R have been replicated in sixty-three (42.3%) participants were male and 222 (57.7%)
Belgian [10], Sweden [11], German [11], Spanish [12], female; participants' mean age was 32.59 ± 9.26 years. Three
French[13],andCzech[14]populations.Recently,Fossatiet hundred seven participants (79.7%) were active community
al [15] showed that the Italian translation of the TCI-R was workers, whereas 78 participants (20.3%) were under-
provided with adequate reliability and validity data in a graduate college students. Among active community work-
sample of 504 consecutively admitted Italian psychiatric ers, the most frequent professions were white-collar (n = 119.
outpatients. Internal consistency reliabilities ranged from 38.8%), housewife (n = 20, 6.5%), teacher (n = 17. 5.6%),
0.79 (RA) to 0.91 (persistence) for the main TCI-R and blue-collar (n = 15. 4.9%). In both samples, subjects
dimensions. In this study, 1-month test-retest reliabilities were not screened for psychiatric disorders or other medical
ranged from 0.52 (NS) to 0.80 (ST), suggesting a moderate- conditions. To be included in the study, subjects should
to-good stability of TCI-R scores also in treated psychiatric possess an education level equal to or grater than elementary
outpatientts. Both multiple-group component and Procrustes school. All subjects were white.
factor analyses suggested a close correspondence between The 2 samples did not differ in sex distribution (χ2 =
1
the theoretical and the empirical 7-factor structure of the 0.003, P = .096), although the second sample was slightly
TCI-R facets also in a large sample of Italian outpatients. but significantly younger (t = 4.11, P b .0001). Some
738
Logistic regression analyses showed that the Italian transla- differences were observed also in other demographic
tion of the TCI-R was efficient both in discriminating characteristics; in particular, the first sample included a
subjects with any Diagnostic and Statistical Manual of significantly higher proportion of students than the second
Mental Disorders, Fourth Edition (DSM-IV) personality sample (χ2 = 13.1, P b .0001), although the effect size of
1
diagnosis from subject with no personality disorder diag- this difference was at best slight (ϕ = 0.13).
516 G. Martinotti et al. / Comprehensive Psychiatry 49 (2008) 514–522
Table 1
Mean scores and Cronbach α coefficients for TCI-R dimensions and subfacets in sample 1 and sample 2
No. Sample 1 Sample 2
of Mean ± St dev α Mean ± St dev α
item
NS 35 100.5 ± 21.3 .84 98.5 ± 12.9 .78
Exploratory excitability (NS1) 10 30.3 ± 7.1 .28 28.7 ± 5.0 .55
Impulsiveness (NS2) 9 23.5 ± 6.5 .42 24.4 ± 5.3 .71
Extravagance (NS3) 9 27.6 ± 7.5 .07 26.25 ± 5.2 .72
Disorderliness (NS4) 7 19.1 ± 4.8 .24 19.3 ± 3.75 .45
HA 33 92.2 ± 22.1 .88 96.4 ± 14.4 0.85
Anticipatory worry (HA1) 11 30.3 ± 8.1 .43 31.8 ± 5.8 0.74
Fear of uncertainty (HA2) 7 21.5 ± 5.2 .47 22.5 ± 3.9 0.50
Shyness (HA3) 7 19.1 ± 6.2 b.01 20.4 ± 4.85 0.78
Fatigability (HA4) 8 21.4 ± 6.4 .23 21.7 ± 5.1 0.72
RA 30 100.0 ± 19.7 .82 101.4 ± 13.0 .83
Sentimentality (RD1) 8 26.8 ± 5.9 .37 27.0 ± 4.2 .59
Openness to warm communication (RD2) 10 34.8 ± 8.0 .26 34.8 ± 5.7 .75
Attachment (RD3) 6 19.3 ± 5.7 .17 19.5 ± 4.8 .78
Dependence (RD4) 6 19.2 ± 4.5 .42 20.1 ± 3.4 .36
Persistence (P) 35 111.3 ± 23.3 .89 116.3 ± 14.4 .87
Eagerness of effort (P1) 9 30.3 ± 6.7 .76 30.6 ± 3.8 .65
Work hardened (P2) 8 27.3 ± 6.2 .58 27.65 ± 4.5 .62
Ambitious (P3) 10 28.5 ± 6.9 .79 31.8 ± 5.9 .80
Perfectionist (P4) 8 25.6 ± 7.4 .36 26.3 ± 4.8 .64
SD 40 136.8 ± 27.7 .82 139.1 ± 16.5 .85
Responsibility (SD1) 8 29.2 ± 7.7 .51 29.6 ± 4.8 .72
Purposeful (SD2) 6 21.6 ± 5.6 b.01 21.8 ± 3.8 .63
Resourcefulness (SD3) 5 18.5 ± 6.1 .47 18.2 ± 3.0 .59
Self-acceptance (SD4) 10 28.9 ± 8.3 .50 30.2 ± 7.0 .77
Enlightened second nature (SD5) 11 39.2 ± 8.7 .48 39.3 ± 5.6 .66
C 36 132.1 ± 24.0 .86 134.9 ± 13.9 .85
Social acceptance (C1) 8 28.9 ± 6.3 .02 29.5 ± 4.5 .76
Empathy (C2) 5 18.0 ± 4.1 .13 17.9 ± 2.7 .45
Helpfulness (C3) 8 29.1 ± 6.8 .18 17.9 ± 3.7 .57
Compassion (C4) 7 26.3 ± 5.6 b.01 26.8 ± 4.1 .62
Pure-hearted conscience (C5) 8 30.1 ± 6.4 b.01 31.2 ± 4.3 .60
ST 26 65.6 ± 18.5 .82 69.9 ± 14.5 .84
Self forgetful (ST1) 10 26.1 ± 8.2 .78 27.7 ± 6.9 .74
Transpersonal identification (ST2) 8 19.4 ± 7.7 .80 20.4 ± 5.6 .71
Spiritual acceptance (ST3) 8 20.4 ± 6.0 .41 21.9 ± 5.5 .64
A third sample was compared with the community calculation method indicated by Cloninger [9]. To estimate
sample. The sample has been already analyzed by Fossati test-retest reliability of the TCI-R and its stability over
et al [15]. Subjects were all outpatients, affected by anxiety time, 48 subjects in the first sample were asked to fill in
disorders (16.7%), substance abuse/dependence disorders the questionnaire twice, after a minimum of 6 months till a
(20.8%), eating disorders (11.1%), mood disorders (28,
5.6%), and other DSM-IVAxis I diagnosis (sleep disorders,
sexual disorders, somatoform disorders, etc) (3.6%). A large
part of the sample received a diagnosis of personality Table 2
disorder (65.9%). For further details, the reader can refer to Cronbach α coefficients for TCI-R dimensions in males, females and
the article of Fossati et al [15]. stratified for three cohort of age
Cronbach Cronbach Cronbach α Cronbach α Cronbach α
α (males) α (females) (age ≤24 y) (age 25-49 y) (age ≥50 y)
2.2. Measures NS 0.81 0.86 0.91 0.75 0.83
All subjects filled in the TCI-R; no serious acceptability HA 0.87 0.88 0.92 0.84 0.84
or comprehension difficulties appeared in the completion. RD 0.79 0.83 0.93 0.71 0.72
P 0.88 0.90 0.91 0.87 0.90
The Italian version of the TCI-R was translated by M SD 0.84 0.83 0.91 0.82 0.77
Battaglia, a professional English translator who evaluated C 0.86 0.90 0.95 0.81 0.87
its adequacy to its respective English version through a ST 0.80 0.86 0.91 0.78 0.78
back-version. TCI-R was analyzed in accordance with the P indicates persistence.
G. Martinotti et al. / Comprehensive Psychiatry 49 (2008) 514–522 517
Table 3 analysis of covariance controlling for sex and age and
Test-retest reliability: ICC (n = 48) post hoc by the contrast analysis.
Time 1 Time 2 ICC ABonferroni correction was systematically applied when
NS 99.5 ± 16.2 100.5 ± 15.1 0.81 analyzing SCL-90, BIS-11, AQ, and ASQ scores. Overall, α
HA 93.0 ± 14.3 91.8 ± 14.4 0.88 levels ranged from 0.001 to 0.0009. With these parameters,
RD 74.2 ± 16.7 72.0 ± 15.1 0.87 weobtained a sufficient power of 0.80 to detect small effect
P 114.1 ± 17.4 114.5 ± 17.5 0.83 sizes (r = 0.235) for correlations between TCI-R and SCL
SD 143.1 ± 19.3 146.5 ± 20.6 0.80 scores; between TCI-R, BIS-11, and AQ scores (r = 0.21);
C 139.5 ± 12.8 140.0 ± 13.7 0.68
ST 69.3 ± 16.1 68.7 ± 17.2 0.76 and between TCI-R and ASQ scores (r = 0.20).
3. Results
maximum of 8 months from the first administration. In the
first sample, 235 subjects were also evaluated for Meanscores of main dimensions and facets of the TCI-R
psychopathologic and general symptoms by the Symptom for samples 1 and 2 are shown in Table 1.
Checklist (SCL-90) [16]. Ninety-three subjects were also Because this new version of the TCI gives the choice to
investigated for psychiatric family history by the Family answer “neither true nor false,” or about equally “true or
Abbreviated Interview (FAI) [17]. Of 93, 62 subjects false” (response 3), it is of interest to know if some items
(66.7%) were positive for familiar psychiatric disorders; the frequently received this response. The item with the highest
most frequent familiar disorders were depression (41.9%) rates of this response in our samples was the 161 (47.1%, “I
and eating disorders (18.3%). Subjects with positive and think I will have very good luck in the future” from HA1),
negative family history for psychiatric disorders were not according to reference [13]. Other items that frequently
different for sex, gender, and social status. In the second scored 3 were the 81 (38.1% from HA4), 117 (40,6%, from
sample, to extend the construct validity data of the TCI-R, P3), 55 (42.5%, from P4), and 76 (39.8%, from P4).
all subjects were administered the Italian versions of the 3.1. Internal consistency
Barratt Impulsiveness Scale-11 (BIS-11 [18]), Aggression
Questionnaire (AQ [19]), and Attachment Style Question- The internal consistency of the main dimensions and
naire (ASQ [20]). The Italian versions of the BIS-11, AQ subfacets has been explored by the mean of the Cronbach α
and ASQ were provided with adequate reliability and coefficient on both samples and presented in Table 1. All
validity data [8,21,22]. TCI-R main dimensions showed adequate internal consis-
Data were analyzed by simple pairwise case deletion. In tency coefficients (≥70). At the facet level, almost all TCI-R
fact, in both samples, no other variable was missing in more facets showed adequate internal consistencies in sample 2,
than 5% of cases, except for the educational level in sample whereas low reliability values were observed in sample 1.
1. Nevertheless, by the missing value analysis, education
was missing completely at random and it did not affect any
other variable in the sample. Table 4
2.3. Statistical analysis Principal-component analysis of temperament subscales (Varimax
transformation including factors with eigenvalue of 1 or more)
The internal consistency of the scores and subscores of Factor 1 Factor 2 Factor 3 Factor 4
TCI-R was calculated through the Cronbach α coefficient. P HA NS RD
To explore the effect of sex and age on internal NS1 0.38 −0.05 0.64 0.40
consistency, we calculated the coefficient separately in NS2 0.09 0.12 0.84 0.08
men and women and in 3 different cohorts of age (divided NS3 0.11 0.12 0.72 0.38
according to lower and upper quartiles of the distribution NS4 0.18 0.17 0.78 0.16
of age). Exploratory principal-components analyses with HA1 0.12 0.87 0.12 −0.02
Varimax transformation were performed to analyze the HA2 0.19 0.84 0.06 0.18
factorial structure of the questionnaire; and to explore test- HA3 0.03 0.85 −0.01 −0.08
HA4 −0.10 0.79 0.19 0.10
retest reliability, intraclass correlation coefficients (ICCs) RD1 0.36 0.49 0.24 0.49
were calculated for each TCI dimension. Raw TCI-R RD2 0.41 0.02 0.30 0.77
scores were then converted to T scores (distribution's RD3 0.15 0.02 0.19 0.88
mean, 50; St dev, 10) to provide normal data. Association RD4 0.24 0.49 0.06 0.53
of TCI-R scores with age, sex, SCL-90, BIS-11, AQ, and PS1 0.82 0.13 0.17 0.23
ASQ scores and family history for psychiatric disorders PS2 0.85 0.08 0.15 0.21
PS3 0.81 0.00 0.26 0.21
(FAI) were explored by the correlation analysis and the PS4 0.83 0.11 −0.03 0.07
Student t test. The comparison between TCI-R scores in Explained variance (%) 21.07 21.23 16.36 15.12
community and PD subjects was performed by the Loadings with absolute values of 0.50 or more are shown in boldface type.
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