Temperament and Character Inventory in the Diagnosis of Personality Disorder

Introduction: The Temperament and Character Inventory (TCI) is a self-report questionnaire that is theoretically able to provide both a categorical and a dimensional diagnosis of personality disorder. In keeping with Cloninger’s theoretical model, according to which there is a linkage between personality disorders and character dimensions, (1) we investigated the relationships of TCI dimensions with personality disorders. Then (2) we tested the diagnostic accuracy of the TCI in the categorical diagnosis of any personality disorders using Cloninger’s proposed cutoff. Finally, (3) we evaluated the efficiency of alternatives cutoffs. Method: Through a retrospective observational study, a sample of 159 outpatients was assessed with the TCI, the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II), and the Mini International Neuropsychiatric Interview Plus version. Results: Self-Directedness and Cooperativeness were meaningfully associated with the presence of personality disorders, although personality disorders were not exclusively explained by character dimensions. We found adequate agreement between TCI and the SCID-II diagnosis of personality disorders. Discussion: In our sample personality disorders were better identified when a measure of impairment of the self, Self-Directedness, was combined with a measure of impairment of the interpersonal functioning, namely Cooperativeness or RewardDependence. Our results support the use of the TCI to assess personality pathology in both a categorical and a dimensional framework.