Substance Use & Misuse, Early Online:1–9, 2013 Copyright C  2013 Informa Healthcare USA, Inc. ISSN: 1082-6084 print / 1532-2491 online DOI: 10.3109/10826084.2013.841250 ORIGINAL ARTICLE Direct and Indirect Symptom Severity Indicators of Alcohol Dependence and the Personality Concept of the Biosocial Model B´ alint And ´ o 1 ,S´ andor R ´ ozsa 2 , Eszter Kurgyis 1,2 , Andrea Szkaliczki 1 , Ildik ´ o Demeter 1 , Petronella Szikszay 3 , Zsolt Demetrovics 4 , Zolt ´ an Janka 1 and P ´ eter Z ´ Almos 1 1 Department of Psychiatry, University of Szeged, Szeged, Hungary; 2 Institute of Psychology, E¨ otv¨ os Lor´ and University, Budapest, Hungary; 3 Addiction Rehabilitation Center, Hospital of Szigetv´ ar, Szigetv´ ar, Hungary; 4 Department of Clinical Psychology and Addiction, Institute of Psychology, E¨ otv¨ os Lor´ and University, Budapest, Hungary Temperament and character factors are strongly related to the developmental, clinical, and treatment aspects of alcohol dependence. This study had the aim of revealing the underlying personality structure and individual differences in the symptoms of alcohol dependence measured by multiple severity indicators. Patients with alcohol dependence exhibited higher levels of novelty seeking and harm avoidance, and lower levels of persistence, self-directedness, and coop- erativeness. Especially novelty seeking was connected with more severe alcohol dependence. These charac- teristics could be useful targets of interventions and Temperament and Character Inventory is therefore a useful measurement to identify patients with more severe alcohol-related problems. Keywords Alcohol dependence, Temperament and Character Inventory (TCI), novelty seeking, severity of alcohol-related problems ABBREVIATIONS: ADPs = alcohol-dependent patients; NS = novelty seek- ing; HA = harm avoidance; RD = reward dependence; P = persistence; SD = self-directedness; C = cooperative- ness; ST = self-transcendence; TCI-R = Temperament and Character Inventory-Revised; AUDIT = Alcohol Use Disorders Identification Test; AUDIT-LC = AUDIT level of consumption subscale; AUDIT-D = AUDIT signs of dependence subscale; AUDIT-C = AUDIT adverse con- sequences of drinking subscale; AUDIT-T = total score of AUDIT; SADQ = Severity of Alcohol Dependence This work was supported by “T ´ AMOP-4.2.1/B-09/1/KONV-2010-0005 – Creating the Center of Excellence at the University of Szeged” grant received from the European Union and co-financed by the European Regional Development Fund. The study was also supported by the European Union and Hungary, co-financed by the European Social Fund in the framework of “T ´ AMOP 4.2.4.A/2-11-1-2012-0001 National Excellence Program.” Zsolt Demetrovics acknowledges the financial support of the J´ anos Bolyai Research Fellowship by the Hungarian Academy of Sciences. Address correspondence to Dr. Zsolt Demetrovics, PhD, Department of Clinical Psychology and Addiction, Institute of Psychology, E¨ otv¨ os Lor´ and University, Izabella utca 46, Budapest 1064, Hungary; E-mail: demetrovics@t-online.hu. Questionnaire; MAC-R = MacAndrew Alcoholism Scale-Revised; APS = Addiction Potential Scale. INTRODUCTION Alcoholism is a complex phenomenon clinically, with a great deal of heterogeneity within the diagnostic group (Babor et al., 1992; Cloninger, Bohman, & Sigvardsson, 1981). A complex set of standardized indicators helps in the characterization and operationalization of the symp- toms of alcohol addiction and hence in a more accurate determination of the addiction severity. An assessment of the relationship between personality and the symptoms of alcohol dependence can be useful as concerns the aim of improving the effectiveness of the treatment of alcohol dependence. Cloninger’s biosocial model of personality is based on four temperament factors (novelty seeking [NS], harm avoidance [HA], reward dependence [RD], and persistence [P]) and three character dimensions (self-directedness [SD], cooperativeness [C], and self- transcendence [ST]). Temperament factors are moderately inherited and relatively stable throughout life. NS is de- fined as a tendency to respond actively to novel stimuli. HA is a hereditary tendency to inhibit or interrupt behavior in order to avoid punishment and nonreward. RD involves the maintenance or continuation of behavior previously associated with reinforcement. P is a tendency to the perseverance of behavior, despite frustration and fatigue. Character dimensions develop during life through social experience and influenced by learning. SD expresses an individual’s competence regarding autonomy, reliability, and maturity. C is related to individual differences in the 1 Subst Use Misuse Downloaded from informahealthcare.com by 84.0.12.226 on 10/04/13 For personal use only.