Temperament and Character Adaptations to Addictions Treatment

1. Temperament and Character Adaptations to Addictions Treatment Daniel Angres, M.D.¹ &Stephanie Bologeorges, B.A.¹ ¹ Resurrection Behavioral Health-Addiction Services • Measures • Temperament and Character Inventory-Revised: The TCI-R is a 240 item self-report questionnaire consisting of 5-point Likert scale items. The measure yields four temperament dimensions (Novelty Seeking, Harm Avoidance, Reward Dependence, and Persistence) and three dimensions of character (Self-Directedness, Cooperativeness, and Self-Transcendence). Reliability and validity of the instrument have been established (Cloninger et al., 1993). • Introduction • Interest in personality patterns among those afflicted with addiction has long been under review., and many measures of personality are often used to identify dysregulatory personality patterns that may negatively impact addiction. • One prominent measure, the Temperament and Character Inventory (TCI-R; Cloninger, 1993) has been used to describe typologies in terms of both biologically driven aspects of personality (Temperament) as well as behavioral and experience-driven components (Character). The developer of the measure, C. R. Cloninger, posits that biologically influenced temperament traits have a central role in addictions, which is consistent with the disease model of addiction (Cloninger, 1987). • The TCI-R measures 4 dimensions of temperament, posited to reflect an individual’s natural born tendencies: Novelty Seeking, Harm Avoidance, Reward Dependence, and Persistence. • Novelty Seeking is described as a tendency to seek out new and exciting experiences, which has been linked to the construct of sensation-seeking in the literature (Zuckerman, 1994). A temperaments high in novelty seeking have been extensively linked as a factor increasing both risk for substance abuse and other risk-taking behaviors, and such excitement seeking has been consistently associated with substance abuse in a number of populations (e.g. Teracciano et al., 2008). The literature also supports novelty seeking most consistently as a predictor of alcohol abuse across both setting and population (George et al., 2010). • Harm Avoidance is a construct associated with anxiety, with low levels being indicative of fearlessness and higher levels indicative of anxiety and distress (Cloninger, 1987). • Reward Dependence reflects the degree to which an individual is dependent on others (low), or can function autonomously (high). • Aims of the Present Investigation • Discussion • Results • Methods • Participants • A clinical sample of health care professionals (N = 116) were patients at a tailored intensive substance abuse hospital day-treatment program with associated supervised independent living in a therapeutic community. Participants were 68.1% male and 31.9% female. Inclusion criteria for admission required medical stabilization, a diagnosis of current alcohol or drug dependence, and occupation as a health care professional. The mean age of the sample was 43.5 years, with no significant difference in age between gender. Professional breakdown of the sample included 56 physicians, 28 nurses, 21 pharmacists, and 11 other health care professionals (dentists, optometrists, physician’s assistants, and advanced medical students) • Procedure • Participants completed a tailored professional’s treatment program with respect to personality. The program was abstinence-based, 12-step oriented, and tailored in duration ranging from 6-10 weeks. Within one week of admission, participants completed the TCI-R and the MCMI-III self-report instruments. Two-year sobriety status was obtained through self-disclosure in a facilitated 2-year AfterCare program consisting of weekly caduceus groups, as well as through reports by post-discharge coordinators. Status was biologically confirmed through urine monitoring. References