Temperament, Character, and Suicidal Tendencies Among Croatian Psychiatric Outpatients with Post-traumatic Stress Disorder

Abstract

Introduction The occurrence of both civilian- and war-related post-traumatic stress disorder (PTSD) is related to greater frequency of suicidal thoughts and behaviors. Understanding factors present within individuals with PTSD that increase suicide risk may inform prevention efforts. Objectives The present study aimed to determine whether the dimensions of temperament and character, derived from Cloninger's psychobiological model of personality, are associated with various aspects of suicidality (i.e., lifetime suicidality, suicidal ideation over the past 12 months, threat of suicide attempt, and risk for future suicidal behavior) among patients with PTSD. Methods A sample of 67 psychiatric outpatients treated for either civilian- or war-related PTSD (68% male; mean age 45.52 years) completed the Temperament and Character Inventory - Revised (TCI-R) and the Suicidal Behaviors Questionnaire - Revised (SBQ-R). Results Zero-order analyses revealed that temperament dimension Harm avoidance and character dimension Self-directedness were moderately associated with the total risk for suicide (i.e., the SBQ-R total score), while Persistence and Cooperativeness showed significant but weaker relations. Different dimensions of suicidality were associated with different personality traits. Character dimension Self-transcendence was shown by linear regression to be uniquely and positively related to the total risk for suicide. Conclusions Notwithstanding some limitations of this study, such as relatively small sample size and heterogeneous types of trauma, these findings should help extend our understanding of the elevated suicide risk in PTSD. There is a need for detailed assessment of personality traits in order to facilitate prevention of various aspects of suicidality in this population.