Personality dimensions measured by the Temperament and Character Inventory (TCI) in subjects with social phobia INA MARTEINSDOTTIR, MARIA TILLFORS, TOMAS FURMARK, ULLA MARIA ANDERBERG, LISA EKSELIUS Marteinsdottir I, Tillfors M, Furmark T, Anderberg UM, Ekselius L. Personality dimensions measured by the Temperament and Character Inventory (TCI) in subjects with social phobia. Nord J Psychiatry 2003;57:29 – 35. Oslo. ISSN 0803-9488. The present study investigated personality dimensions by means of the Temperament and Character Inventory (TCI) in subjects with social phobia with or without a co-existing avoidant personality disorder. Thirty-one individuals with social phobia were recruited through advertisement and diagnosed with the Structured Clinical Interview for DSM-IV I and II psychiatric disorders. Comorbid Axis I psychiatric disorders were diagnosed in 29% of the cases. Co-occurring personality disorders were present in 55.8% of the cases, and avoidant personality disorder in 48.4%. The social phobia subjects, as compared to healthy controls of the same age, scored significantly higher in the TCI dimension measuring Harm avoidance but significantly lower in Persistence, Self-directedness, Cooperativeness and Self- transcendence. Presence of avoidant personality disorders in the social phobia subjects was associated with significantly higher Harm avoidance, particularly on the subscale Shyness with strangers. In conclusion, individuals with social phobia were characterized by high comorbidity of avoidant personality disorder and deviations in TCI personality dimensions. Enhanced Harm avoidance was the most prominent personality trait. The observed devia- tions in TCI dimensions were primarily related to the social phobia itself and not to the presence of concurrent personality disorders. • Aoidant personality disorder, Personality dimensions, Social phobia, TCI. Ina Marteinsdottir, M.D., Department of Neuroscience, Psychiatry, University Hospital, SE- 751 85 Uppsala, Sweden. E-mail: ina.marteinsdottir@uaspsyk.uu.se; Accepted: 27 September 2001. S ocial phobia, also known as social anxiety disorder, is a disabling (1), lifelong disorder (2, 3) character- ized by fear of humiliation in social performance and/or interactional situations (4). Epidemiological studies show that social phobia is a common disorder with prevalence rates around 7 – 16% (e.g. 5, 6). Moreover, social phobia is accompanied by a high prevalence of other psychiatric disorders belonging to both Axis I and II (7–9). The reported prevalence rates of comor- bid personality disorders in social phobia have ranged from 37% to 100% (10–12), with the most common being avoidant personality disorder with rates ranging from 17% to 90% (10, 12–14). The considerable overlap between social phobia and personality disorders has been a topic of debate (15–17). Several lines of evi- dence suggest that social phobia and avoidant personal- ity disorder belong to the same category of psychopathology and reflect two points on a continuum of social anxiety (18–21). This notion is further sup- ported by a study using an inventory, the Karolinska Scales of Personality (KSP), focused on temperament traits, that demonstrated personality deviations in so- cial phobics that were only marginally affected by the presence of avoidant personality (7). Thus, on the KSP, the social phobics, as compared to a normative sample, were characterized by enhanced anxiety proneness, irri- tability, detachment and indirect aggression, but also lower socialization and social desirability. Higher scores on the scales for inhibition of aggression and psychic anxiety were the only significant measures that distin- guished social phobics with and without comorbid avoidant personality disorder. The presence of mal- adaptive personality traits in social phobia has also been demonstrated by application of the Temperament and Character Inventory (TCI), where high levels of harm avoidance and low levels of novelty seeking, self-directness and cooperativeness were shown in 20 individuals with social phobia (22). © 2003 Taylor & Francis 29