Objective
The Psychopathy Checklist Revised (PCL-R) and Temperament and Character Inventory (TCI) have been used extensively in research of personality disorders; however, no previous study has investigated the relation between psychopathy factors and temperament and character traits in patients with antisocial personality disorder (ASPD). Our aim was to fill this gap in the literature.
Methods
The PCL-R Factor scores and the TCI temperament and character scores were evaluated in 68 men with ASPD and 65 healthy male controls.
Results
The ASPD cases had significantly higher PCL-R Factor 1, Factor 2, and Total scores, as well as significantly higher TCI Novelty Seeking and Harm Avoidance scores, whereas the control group had higher TCI Reward Dependence, Persistence, Self-Directedness, and Cooperativeness scores. Correlation analysis revealed that, in the whole study group, PCL-R Factor 1, Factor 2, and Total scores were positively correlated with Novelty Seeking and Harm Avoidance scores and negatively correlated with Reward Dependence, Persistence, Self-Directedness, and Cooperativeness scores. When each group was analyzed separately, the correlations were not significant. Regression analysis supported the main findings.
Antisocial personality disorder (ASPD) is characterized by hallmark features of pervasive violation of rights of other people, irresponsibility, impulsiveness, aggressiveness, deceitfulness, and lack of remorse [1]. Psychopathy is a closely related but somewhat different concept. The Hare Psychopathy Checklist-Revised (PCL-R) is the most frequently used instrument to measure psychopathy [2] and [3]. To rate PCL-R items, data obtained by semistructured interview and case history are used. The 4 subgroup scores that PCL-R provide are Interpersonal, Affective, Lifestyle, and Antisocial subgroups, in that order. The Interpersonal and Affective subgroups compose Factor 1, and the Lifestyle and Antisocial subgroups compose Factor 2. The Total score is obtained by simply adding Factor 1 and Factor 2. A Total score more than 29 has been accepted as an indication of significant psychopathy.
From a critical point of view, it is still unclear how to describe personality disorders best. Previously, it has been suggested that personality may better be conceptualized as interacting domains of character and temperament [4]. To quantify temperament and character dimensions of personality, the Temperament and Character Inventory (TCI) has been used extensively [5]. Temperament traits (Novelty Seeking, Harm Avoidance, Reward Dependence, Persistence) represent stable, heritable, neurobiological dispositions to learn automatic behavioral reactions in response to specific environmental stimuli (danger, novelty, and reward) [6], whereas character traits change with maturation and are more closely associated with higher cognitive processes including interpretation and formal construction. As one may expect, poorly developed character traits are common in all personality disorders [6].
One common feature of Cluster B personality disorders (ASPD, borderline personality disorder, histrionic personality disorder) is high Novelty Seeking trait. Among them, ASPD has especially been reported to reflect high Novelty Seeking, low Harm Avoidance, and low Reward Dependence traits, whereas “impulsive” borderline personality disorder reflects high Novelty Seeking, high Harm Avoidance, and low Reward Dependence traits [7]. This latter condition is also described as “secondary psychopathy” by Cloninger.
One recent study interestingly reported high Harm Avoidance in ASPD subjects with alcohol abuse [8]. These authors found that offenders with low Harm Avoidance committed less impulsive violence, whereas Harm Avoidance was high in subjects with either ASPD or borderline personality disorder. The authors came to the hypothesis that low Harm Avoidance might be associated with high PCL-R Factor 1 score. It is worth to note that although PCL-R and TCI have been extensively used in researches about personality disorders, no previous study has investigated the relation between psychopathy factors and temperament and character traits in patients with ASPD. Our aim was to explore this relation in male patients with ASPD and in healthy control subjects.
