The Tridimensional Personality
Questionnaire in Eating Disorder Patients
Timothy D. Brewerton
Lisa D. Hand
Emmett R. Bishop, Jr.
(Accepted 21 January 1993)
The Tridimensional Personality Questionnaire (TPQ) was developed to measure a variety of
personality variants on three hiosocial dimensions, harm avoidance (HA), novelty seeking
(NS), and reward dependence (RD), which are thought to be related to serotonin (5-HJ),
dopamine (DA), and norepinephrine (NE) function, respectively. Patients with eating disor-
ders have been reported to have abnormalities in all of these systems, as well as personality
variants described by these dimensions. We therefore administered the TPQ to 147 patients
with DSM-III-R defined eating disorders (1 W bulimia nervosa IBN], 27 with anorexia ner-
vosa [AN!, and 10 with BN+AN) and compared their scores to those of 350 female con-
trols. When significant, post hoc Bonferroni t tests were performed using alpha = COS. Al!
subtypes of eating disorder patients scored significantly higher on HA than controls (p <
.0001, analysis of variance. Only patients with BN (±AN) had significantly higher degrees
of NS (p ^ .0001), particularly on the impulsiveness subscale (NS2), although this may, in
part, be due to age. No significant differences in total RD were found, although BN patients
scored lower on RD3 (attachment vs. detachment) and higher on RD4 (dependence vs. in-
dependence) than controls. In addition, AN patients had significantly higher RD2 (persis-
tence vs. irresoluteness) subscale scores. These data support a theory of 5-HT dysregulation
in both types of eating disorders and suggest that further research be done on the role of DA
and NE in BN. © 1993 hy John Wik'v & Sons. Inc.
Psychiatrists and psychologists have long sought a tool that would not only character-
ize behavioral aspects of personality in certain diagnostic groups but also provide leads
to the neurobiological system involved. One such tool is the Tridimensional Personal-
ity Questionnaire (TPQ) that was developed to measure three fundamental dimensions
of personality suggested to correlate with specific neurotransmitter functions. These di-
Timothy D, Brewerton, M.D., is AswK:ifite Professor of h'sychJatry and Behavioral Sciences and Director, Eating
Disorders Program, Institute of f^sychtatry, Medical University of South Carolina. Lisa D. Hand, M.D., is Instructor
ot Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina. Emmett
R. Bishop, Jr., M.D., is Direclor, the Clark Center Eating Disorders Program, Memorial Medical Cenfer, Savannah,
Georgia. Address repriiU requests to Dr. Brewvrion af MUSCJInstitute nf Psychiatry, 171 Ashley Avenue, Charles-
ton, South Carolina 29425-0742.
International loumat of tating Disorders, Vol, 14, No. 2, 2n--218 (1993)
© 1993 by lohn Wiley & Sons, Inc, CCC 0276-3478/93/020213-06