The role of temperament and character in the anxiety-depression spectrum among Korean adults.

Background: Temperament and character are useful in risk assessment and therapy of individuals in the anxiety-depression spectrum but understudied in South Korea.

Objective: The study aimed to identify the temperament and character features associated with anxiety and/or depression in individuals with clinical disorders and in the general population.

Methods: A representative sample of 1384 Korean adults over 18 years old (58 % female) were assessed with the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Temperament and Character Inventory (TCI). Multivariate analyses, including structural equation modeling and complex systems analysis, evaluated how personality influenced risk and resilience for anxiety and/or depression.

Results: The three groups with anxiety and/or depression were strongly distinguished by temperament and character: (i) In AD (n = 58), Harm Avoidance and Reward Dependence were higher than in DD, and Self-directedness was higher than in AD+DD; (ii) In DD (n = 90), Persistence, Self-Directedness and Cooperativeness were higher than in AD+DD; and (iii) In AD+DD (n = 101), Harm Avoidance was highest and Persistence and Self-directedness were lowest (i.e., they were lowest in Resilience). Structural equation models confirmed these risk relations with strong character development reducing the adverse effects of emotional hyperreactivity from extreme temperaments.

Limitations: Self-reports were measured only at one point in time, requiring collateral experimental data to support causal interpretation.

Conclusions: Interactions of temperament and character are strongly predictive of risk and resilience to anxiety and/or depression by regulating both positive and negative affect. Character mediates the adverse effects of extreme temperaments on affect.