C.

Robert Cloninger

C. Robert Cloninger
C. Robert Cloninger

Born

April 4, 1944 Beaumont, TX American Psychology Psychiatry Genetics Washington University in St. Louis Genetics of Alcoholism Psychobiology of Personality Science of Well-Being

Nationality Fields

Institutions Knownfor

Claude Robert Cloninger, M.D. (born April 4, 1944) is a psychiatrist and geneticist noted for his pioneering research on the biological, psychological, social, and spiritual foundation of both mental health and mental illness.[1][2] He is Wallace Renard Professor of Psychiatry, Professor of Psychology and of Genetics, and Director of the Center for Well-Being at Washington University in St. Louis.[3][4] Cloninger is a member of the evolutionary, neuroscience, and statistical genetics programs of the Division of Biology and Biomedical Sciences at Washington University,[3] and is recognized as an expert clinician in the treatment of general psychopathology, substance dependence, and personality disorders.[4][5] Cloninger is known for his research on the genetics, neurobiology, and development of personality and personality disorders.[6][7] He identified and described heritable personality traits predictive of vulnerability to alcoholism and other mental disorders in prospective studies of adoptees reared apart from their biological parents.[8][9][10] Cloninger also carried out the first genome-wide association and linkage study of normal personality traits,[11] and has developed two widely used tools for measuring personality: the Tridimensional Personality Questionnaire (TPQ) and the Temperament and Character Inventory (TCI).[12][13] A expert in the science of well-being, in 2004 he published Feeling Good: The Science of Well-Being.[14] Cloninger serves as Director of the Anthropedia Institute, which is the research branch of the Anthropedia Foundation. In collaboration with Anthropedia, he has helped develop the Know Yourself DVD series.[15]

C. Robert Cloninger Cloninger has earned lifetime achievement awards from many academic and medical associations, and is a member of the Institute of Medicine of the National Academy of Sciences.[16] He has authored or co-authored eight books and nearly four hundred articles, and is among the most highly cited psychiatrists and psychologists recognized by the ISI.[2] He has been editor or associate editor of journals, including Behavior Genetics and American Journal of Human Genetics, and served on the editorial board of many other journals, including Archives of General Psychiatry, Comprehensive Psychiatry.[2][16], and the Mens Sana Monographs[17]

Education and Early Research

Cloninger was born in Beaumont, Texas in 1944.[16][18][19] His father Morris Cloninger was a former English teacher and a successful businessman, and his mother Concetta was a former actress who directed the local community theater.[16][18] He attended the University of Texas in Austin from 1962-1966 in the Plan II Honors program.[14][16][20] In addition to pre-medical studies, he pursued studies in philosophy, cultural anthropology, and psychology for which he received honors.[16] Cloninger attended a research-intensive medical school at Washington University in St. Louis from 1966 to 1970, and has remained on the faculty there throughout his career.[16] In addition to regular medical training, he did a research fellowship in preventive medicine and public health. He began research in psychiatry in 1969 under the guidance of Samuel Guze.[21] Cloninger wanted to understand why antisocial personality disorder, substance dependence, and somatization disorder were so often found together in the same individual and in the same family. This question led to longitudinal studies of people with each of these disorders and then family and adoption studies.[10][22] In order to better quantify and test hypotheses about the inheritance of psychiatric disorders, he studied quantitative genetics with Theodore Reich in St. Louis and with Newton Morton and D.C. Rao of the Population Genetics Lab of the University of Hawaii.[23] During the late 70s, Cloninger worked on modeling complex patterns of inheritance using path analysis to allow for both genetic and cultural inheritance.[24] He extended path analysis with the introduction of the "copath" to facilitate the analysis of assortative mating and cultural inheritance.[25] He worked to develop methods for disentangling genetic, cultural, and other environmental influences on mental disorders until he concluded that such statistical modeling would never convince skeptics or provide precise estimates when biological parents also reared their own children.[26] His clinical studies of psychiatric disorders also revealed much complexity in the clinical features of mental disorders: people often had multiple overlapping syndromes and changed over time in unpredictable ways.[27] As a result, he shifted his efforts after 1980 to more compelling experimental designs, such as adoption and linkage studies.

Stockholm Adoption Study

The answer to the need for better data about separation experiments came in the form of a long-term collaboration between Cloninger and Michael Bohman, the head of child psychiatry at the University of Umea in Sweden.[28] Bohman had read some of Cloninger's papers on the analysis of separation experiments and asked for Cloninger's assistance in his own research. For several years, Bohman had been studying the behavior of a large birth cohort of children born in Stockholm. The children had been separated from their biological parents at birth and reared in adopted homes. Extensive data about alcohol abuse, criminality, and physical and mental complaints to physicians were available in Sweden as a result of the extensive health and social records for all people in the country. Cloninger developed methods for what he called a "cross-fostering" analysis. Information about the genetic background of adoptees was measured by data about their biological parents. Information about their rearing environment was measured by data about their adoptive parents and home environment. This permitted study of the independent contributions of the genetic and environmental backgrounds independently and in combination in a sample of thousands of adoptees. Their first joint paper on a cross-fostering analysis of the inheritance of alcoholism in men[8] became an ISI Science Citation Classic that convinced most scientists that vulnerability to alcoholism was

C. Robert Cloninger genetically heritable in part.[2] Cloninger, Bohman, and Soren Sigvardson distinguished two subtypes of alcoholism that differed in their clinical features and pattern of inheritance: type 1, associated with anxiety proneness and loss of control over alcohol intake after age 25; and type 2, associated with impulsivity and antisocial behavior before age 25.[8][29] Cloninger proposed that the differences between these two groups of people were explained by personality traits that were observable in childhood, long before any exposure to alcohol. He confirmed this by measuring the personality of boys when they were in the fourth grade, about 10 years of age, based on detailed interviews with their teachers and without any knowledge of their drinking status as adults.[9] The personality ratings of Cloninger were based on his tridimensional model of temperament.[12] The personality model also helped the team to understand other findings they obtained about the inheritance of criminal behavior, somatization (i.e., many physical complaints), anxiety, and depressive disorders.[10] The original findings were later confirmed by a replication study using the same methods conducted in Gothenburg, Sweden.[30] Overall, these adoption studies provided strong evidence for the contribution of both genetic and environmental influences on vulnerability to alcoholism, somatization, criminality, anxiety, and depressive disorders.

Temperament and Character Inventory

Observations about personality provided Cloninger a practical way to predict vulnerability to mental disorders. In the mid-1980s, he developed a general model of temperament based on genetic, neurobiological, and neuropharmacological data, rather than using factor analysis of behavior or self-reports as has usually been done by personality psychologists.[12][31] He focused on the structure of learning abilities within the person, as has long been desired by social-cognitive psychologists.[32] To test the adequacy of his structural model, Cloninger compared his model of development within the individual (i.e., ontogeny) to the evolution of learning abilities in animal phylogeny.[33][34] Initially he described three dimensions of temperament that he suggested were independently inherited and measured by his Tridimensional Personality Questionnaire (TPQ):[12][31] 1. Harm Avoidance (anxious, pessimistic vs. outgoing, optimistic) 2. Novelty Seeking (impulsive, quick-tempered vs. rigid, slow-tempered) 3. Reward Dependence (warm, approval-seeking vs. cold, aloof) Studies quickly showed that Persistence (persevering, ambitious vs. easily discouraged, underachieving) was a fourth independently-inherited temperament dimension with specific brain circuitry, rather than a facet of Reward Dependence.[14][35] These temperament dimensions proved to be a powerful way to distinguish subtypes of personality disorders and vulnerability to a wide range of mental disorders.[36][37] Cloninger was initially criticized for reducing personality to emotional drives. For example, in his book Listening to Prozac, Peter Kramer called the temperament model of personality "a humanist's nightmare."[38] Likewise, Cloninger and his colleague Dragan Svrakic found that temperament alone did not capture the full range of personality. They found that, by itself, temperament could not reveal whether a person was mature or had a personality disorder.[14] On average, there were differences in the probability of personality disorder in people with different temperament configurations, but every configuration could be found in people who were mentally healthy as well as in people who had personality disorders.[14][38] Consequently, Cloninger identified a second domain of personality variables, using character traits to measure a person's humanistic and transpersonal style: 1. Self-Directedness (reliable, purposeful vs. blaming, aimless) 2. Cooperativeness (tolerant, helpful vs. prejudiced, revengeful) 3. Self-Transcendence (self-forgetful, spiritual vs. self-conscious, materialistic). These character dimensions measure the components of an individual's mental self-government and can strongly measure the presence and severity of personality disorder.[35] Cloninger often cites Immanuel Kant, who defines character as "what people make of themselves intentionally."[39] Character dimensions have strong relations with recently-evolved regions of the brainsuch as the frontal, temporal, and parietal neocortexthat regulate learning

C. Robert Cloninger of facts and propositions.[14][40][41][42] By contrast, the temperament dimensions have strong relations with the older cortico-striatal and limbic systems that regulate habits and skills.[42][43][44][45] These three character dimensions have been found to be as heritable as the four temperament dimensions, each with about 50% heritability in twin studies.[46] All seven dimensions of temperament and character have been found to have unique genetic determinants[46] and to be regulated by different brain systems as measured by functional brain imaging.[14][40][41][42][43][44][45] Each dimension is influenced by complex interaction between many genetic and environmental variables, so personality develops as a complex adaptive system.[14] Cloninger's temperament and character inventories have been extensively used in a wide variety of clinical and research purposes, and cited in thousands of peer-reviewed publications.[47] The construction of the inventories on the basis of genetic and neurobiological considerations challenges the traditional statistical assumptions of factor analytically derived inventories,[48] which have been targeted by social and cognitive psychologists for many years.[32] Fortunately, in terms of overall statistical information, there is extensive overlap among the TCI and other multidimensional personality inventories, except that other inventories lack the dimension of Self-Transcendence.[49][50]

Self-Transcendence & Science of Well-Being

Self-Transcendence refers to the interest people have in searching for something elevated, something beyond their individual existence.[14] According to Cloninger's model, self-transcendence can manifest as an intuitive understanding of elevated aspects of humanity, like compassion, ethics, art, and culture. Others who experience it may also describe an awareness of a divine presence. People scoring high in TCI Self-Transcendence report frequent experiences of boundlessness and inseparability.[14][51][52] They lose awareness of their separateness when absorbed in what they love to do or when appreciating the wonders and mysteries of life. Cloninger observes that such experiences of self-forgetfulness and transpersonal identification correspond to what Freud called "oceanic feelings,"[53] which is different from intellectual adherence to particular religious dogmas or rituals. The TCI Self-Transcendence scale is often used as a measure of spirituality.[41][51][52] Cloninger proposed that the psyche is the aspect of a human being that motivates the search for self-transcendence and underlies the human capacities for self-awareness, creativity, and freedom of will.[14] As suggested by transpersonal psychologists and other psychiatrists like Carl Jung and Viktor Frankl, Cloninger has emphasized that self-transcendence is an essential component in the processes of integration and maturation of personality.[14] He found that when people who score high on all three character traits are compared to others, they have the highest level of well-being, as measured by presence of positive emotions, absence of negative emotions, satisfaction with life, or virtuous conduct.[14] The capacity for love and work have long been recognized as important for well-being, but Cloninger also observed that people need to experience self-transcendence in order to cope well with suffering and to enjoy life's wonders and mysteries fully. In his book Feeling Good: The Science of Well-Being, Cloninger describes the impetus for his new work:

I think it is important that we bring a scientific basis to psychiatry and psychology at a level that goes beyond the level of description. In order for us to advance systematically, as for instance chemistry and physics have done, we need a specific theory of the person and our nature of being. As a result of that I have tried to work out such a systematic model, and have progressed by stages to more and more inclusive theoretical frameworks. The basic position I have now is that we have to see the whole person as more than a collection of disease states: a person is composed of multiple elements of body, mind, and spirit. Each of these has to be carefully defined and measurable, so that we can avoid fantasy and speculation and have testable models....What has become increasingly clear to me is that man has a natural integrative tendency that leads to health, and that disease emerges whenever there is a block. Blocks can come from a genetic predisposition that [54] interferes with natural development, from social learning, or from prior experiences that are unique to the individual.

Cloninger has also suggested that not only is there a natural integrative tendency, but that "all human beings have spontaneous needs for happiness, self-understanding and love."[14] He describes practices that improve character development and satisfy these strong basic needs. Just as people can become stronger in the body through physical exercise, he has found they can become mentally and spiritually healthier with mental and spiritual exercises,

C. Robert Cloninger including certain meditations that enhance mindfulness and spirituality. He describes examples of such exercises[14][15] in detail in a DVD series called Know Yourself, which was developed with the Anthropedia Foundation.[55] The Know Yourself series is intended for use as a self-help tool or as an adjunct in psychotherapy.[55][56] The mental exercises described by Cloninger are intended to stimulate character development and self-awareness, thereby fostering a healthy way of living with three sets of goals and values: 1. Working in the Service of Others, thereby increasing love and Cooperativeness 2. Letting Go of fighting and worrying, thereby increasing hope and Self-Directedness 3. Growing in Awareness, thereby increasing faith and Self-Transcendence. Cloninger's approach combines principles of cognitive-behavioral therapy, person-centered therapy, and positive psychology with personality assessment and meditative practices that enhance mindfulness and self-awareness of the cognitive schemas that organize and direct our attention and motivation in different situations.[56] His approach differs from other forms of psychotherapy by its emphasis on integration of a person's awareness of their body, thoughts, and psyche. He suggests that the separation of biomedical, psychosocial, and spiritual approaches interferes with the development of well-being, whereas their integration has been shown to reduce drop-out, relapse, and recurrence rates in randomized controlled trials of well-being therapy.[14][56] Cloninger's integrative approach is intended to synthesize work done in the mental health field, fostering what Juan Mezzich of the World Psychiatric Association has called "psychiatry for the person."[57] Several studies show that psychotherapy, alone or in combination with medications, can help people with mental disorders recover faster and stay well longer, but that a declining number of psychiatrists are providing psychotherapy to their patients.[58] Cloninger is working with the World Psychiatric Association to advance a more integrated approach to mental health and well-being.[15] The American Psychiatric Association has recognized Cloninger for his contributions to better understanding the biopsychosocial basis of mental health and illness with its 2009 Judd Marmor Award.

Honors and awards

Selected Honors and Awards 2009 Judd Marmor Award, American Psychiatric Association 2003 Lifetime Achievement Award, International Society of Psychiatric Genetics 2000 Annual Award for Lifetime Achievement, American Society of Addiction Medicine 1993 Adolf Meyer Award, American Psychiatric Association 1993 Samuel Hamilton Award, American Psychopathological Association 1989- Institute of Medicine, National Academy of Sciences, USA 1988 Edward A. Strecker Award, Institute of Pennsylvania Hospital 1983 Honorary Doctor of Medicine (M.D. hc), University of Umea, Sweden

C. Robert Cloninger

Selected publications
Books
Cloninger, C. R. (2004). Feeling good: The science of well-being. New York: Oxford University Press. (Italian translation with foreword by Mario Maj, Rome, CIC Edizioni Internationali, 2006). Hallett M., Fahn S., Jankovic J.J., Lang A.E., Cloninger C.R., Yudofsky S.C. (Eds.) (2005). Psychogenic movement disorders: neurology and neuropsychiatry. Philadelphia: Lippincott Williams & Wilkins. Cloninger, C. R., (Ed.) (1999). Personality and psychopathology. Washington, D.C.: American Psychiatric Press. Cloninger C.R., Przybeck T.R., Svrakic D.M., Wetzel R.D., Richter J., Eisemann M., Richter G. (1999). Das Temperament und Charakter Inventar (TCI) manual. Frankfurt: Swets Test Services. Gershon E.S. and Cloninger C.R. (Eds.) (1994). Genetic approaches in mental disorders. Washington, D.C.: American Psychiatric Press. Cloninger C.R., Przybeck T.R., Svrakic D.M., Wetzel R.D. (1994). The temperament and character inventory (TCI): A guide to its development and use. St. Louis: Washington University Center for Psychobiology of Personality. Cloninger C.R. and Begleiter H. (Eds.) (1991). Genetics and biology of alcoholism. Banbury Reports 33. Plainview, N.Y.: Cold Spring Harbor Laboratory Press. Maser J.D. and Cloninger C.R. (Eds.) (1990). Comorbidity in anxiety and mood disorders. Washington, D.C., American Psychiatric Press.

Selected Articles
Cloninger, C. R. (2009). On Well-Being: Current Research Trends And Future Directions. Editorial. Mens Sana Monographs, 6(1), 3-9. Cloninger, C. R. (2006). The science of well-being: An integrated approach to mental health and its disorders. World Psychiatry, 5, 71-76. Cloninger, C. R., Svrakic, D.M., Przybeck, T.R. (2006) Can personality assessment predict future depression? A twelve-month follow-up of 631 subjects. J Affective Disorder, 92 (1), 35-44. Cloninger, C. R. (2003). Completing the psychobiological architecture of human personality development: Temperament, Character, & Coherence. In U. M. Staudinger & U. E. R. Lindenberger (Eds.), Understanding human development: Dialogues with lifespan psychology (pp.159182). Boston: Kluwer Academic Publishers. Cloninger, C. R. (2002). The discovery of susceptibility genes for mental disorders. Proceedings of the National Academy of Sciences USA, 99(21), 13365-13367. Cloninger, C. R. (2000). Biology of personality dimensions. Current Opinions in Psychiatry, 13, 611-616. Cloninger, C. R. (1999). A new conceptual paradigm from genetics and psychobiology for the science of mental health. Australian and New Zealand Journal of Psychiatry, 33, 174-186. Cloninger, C. R., Svrakic, N. M., & Svrakic, D. M. (1997). Role of personality self-organization in development of mental order and disorder. Development and Psychopathology, 9, 881-906. Cloninger, C. R. (1994). The genetic structure of personality and learning: a phylogenetic perspective. Clinical Genetics, 46, 124-137. Cloninger, C. R., Svrakic, D. M., & Przybeck, T. R. (1993). A psychobiological model of temperament and character. Archives of General Psychiatry, 50, 975-990. Cloninger, C. R., Przybeck, T. R., & Svrakic, D. M. (1991). The tridimensional personality questionnaire: U. S. normative data. Psychological Reports, 69, 1047-1057.

C. Robert Cloninger Hansenne, M., Delhez, M., Cloninger, C.R. (2005). Psychometric properties of the Temperament and Character Inventory-Revised in a Belgian sample. J Person Assess, 85, 40-49. Gillespie, N.A., Cloninger, C.R., Heath, A.C., Martin, N.G. (2003). The genetic and environmental relationship between Cloninger's dimensions of temperament and character. Personality and Individual Differences, 35, 1931-1946. Grucza, R.A., Przybeck, T.R., Cloninger, C.R. (2005). Personality as a mediator of demographic risk factors for suicide attempts in a community sample. Comprehensive Psychiatry, 46, 214-222. Sullivan, S., Cloninger, C.R., Przybeck, T.R., Klein, S. (2007). Personality characteristics in obesity and relationship with successful weight loss. Int J Obes (Lond.), 31, 667-674.

References
[1] [2] [3] [4] [5] Who's Who in the World 2009. Claude Robert Cloninger. 26th edition. New Providence, NJ. Marquis Who's Who, 2008. Highly Cited Researchers. Claude Robert Cloninger. Version 1.5, ISI Highly Cited.com. Institute for Scientific Information, 2008. Washington University, Division of Biology & Biomedical Sciences, http:/ / dbbs. wustl. edu Washington University Physicians, Department of Psychiatry, http:/ / wuphysicians. wustl. edu Hellinga G, van Luyn B, Dalwijk H-J (eds.). Personalities: Master clinicians confront the treatment of borderline personality disorder. Robert Cloninger (biography and interview). Northvale NJ and London: Jason Aronson, 2001, pp. 99-120. [6] Highly Cited Researchers. Claude Robert Cloninger. Version 1.5, ISI Highly Cited.com. Institute for Scientific Information, 2008. [7] 5. Hellinga G, van Luyn B, Dalwijk H-J (eds.). Personalities: Master clinicians confront the treatment of borderline personality disorder Robert Cloninger (biography and interview). Northvale NJ and London: Jason Aronson, 2001, pp. 99-120. [8] Cloninger CR, Bohman M, Sigvardsson S. Inheritance of alcohol abuse: cross-fostering analysis of adopted men. Archives of General Psychiatry 1981; 38:861-869. [9] Cloninger CR, Bohman M, Sigvardsson S. Childhood personality predicts alcohol abuse in young adults. Alcoholism: Clinical and Experimental Research 1988; 12:494-505. [10] Cloninger CR, von Knorring A-L, Sigvardsson S, Bohman M. Symptom patterns and causes of somatization in men. Genetic Epidemiology 1986; 3:171-185. [11] Cloninger CR, van Eerdewegh P, Goate A, et al. Anxiety proneness linked to epistatic loci in genome scan of human personality traits. Am J Med Genet 1998; 81:313-317. [12] Cloninger CR. A systematic method for clinical description and classification of personality variants. Arch Gen Psychiatry 1987; 44:573-588. [13] 11. Cloninger CR, Svrakic DM, Przybeck TR. A psychobiological model of temperament and character. Arch Gen Psychiatry 1993; 50:975-990. [14] Cloninger CR. Feeling good: The science of well-being. New York: Oxford University Press, 2004. [15] http:/ / anthropedia. org and http:/ / psychobiology. wustl. edu [16] Who's Who in the World 2009. Claude Robert Cloninger. 26th edition. New Providence, NJ. Marquis Who's Who, 2008. [17] Hon Int Adv Board Member, Mens Sana Monographs (http:/ / www. msmonographs. org/ aboutus. asp) [18] Hellinga G, van Luyn B, Dalwijk H-J (eds.). Personalities: Master clinicians confront the treatment of borderline personality disorder. Robert Cloninger (biography and interview). Northvale NJ and London: Jason Aronson, 2001, pp. 99-120. [19] Biographical report on Cloninger, in Bishop JE, Waldholz M, Genome. New York: Simon & Schuster, 1990, pp. 249-266. [20] Hellinga G, van Luyn B, Dalwijk H-J (eds.). Personalities: Master clinicians confront the treatment of borderline personality disorder Robert Cloninger (biography and interview). Northvale NJ and London: Jason Aronson, 2001, pp. 99-120. [21] Cloninger CR. In Memoriam Samuel B. Guze: 18 October 1923-19 July 2000. Am J Med Genet 2001; 105:1-3. [22] Cloninger CR, Reich T, Guze SB. The Multifactorial Model of Disease Transmission: III. Familial Relationship between Sociopathy and Hysteria (Briquet's Syndrome). Brit J Psychiatry 1975; 127:23-32. [23] CR Cloninger 2003 Lifetime Achievement Award: announcement and biographical citation. Am J Med Genet 2004; 126: 128. [24] Cloninger CR, Rice J, Reich T. Multifactorial inheritance with cultural transmission and assortative mating. II. A general model of combined polygenic and cultural inheritance. Am J Hum Genet 1979; 31:176-198. [25] Cloninger CR. Interpretation of intrinsic and extrinsic structural relations by path analysis: Theory and applications to assortative mating. Genetical Research, Cambridge 1980; 36:122-145. [26] Cloninger CR, Rice J, Reich T. Multifactorial inheritance with cultural transmission and assortative mating. III. Family structure and the analysis of separation experiments. Am J Hum Genet 1979; 31:366-388. [27] Maser JD & Cloninger CR (eds). Comorbidity of mood and anxiety disorders. Washington, D.C.: American Psychiatric Press, 1990. [28] http:/ / psychobiology. wustl. edu [29] Cloninger CR. Neurogenetic adaptive mechanisms in alcoholism. Science 1987; 236:410-416.

C. Robert Cloninger
[30] Sigvardsson S, Bohman M, Cloninger CR. Replication of the Stockholm Adoption Study of alcoholism: Confirmatory cross-fostering analysis. Arch Gen Psychiatry 1996; 53:681-687. [31] Cloninger CR. A unified biosocial theory of personality and its role in the development of anxiety states. Psychiatric Developments 1986; 4:167-226. [32] Cervone D. The architecture of personality. Psychological Reviews 2004; 111:183-204. [33] Cloninger CR, Gilligan SB: Neurogenetic mechanisms of learning: a phylogenetic perspective. J Psychiatric Res. 1987; 21: 457-472. [34] Cloninger CR. The genetic structure of personality and learning: a phylogenetic model. Clin Genet 1994; 46 (1 Spec No): 124-137. [35] Cloninger CR, Svrakic DM, Przybeck TR. A psychobiological model of temperament and character. Arch Gen Psychiatry 1993; 50:975-990. [36] Svrakic DM, Whitehead C, Przybeck TR, Cloninger CR. Differential diagnosis of personality disorders by the seven factor model of temperament and character. Arch Gen Psychiatry 1993; 50:991-999. [37] Cloninger CR (ed). Personality and psychopathology. Washington, D.C.: American Psychiatric Press, 1999. [38] Cloninger CR, Svrakic NM, Svrakic DM. Role of personality self-organization in development of mental order and disorder. Development and Psychopathology 1997; 9:881-906. [39] Cloninger CR. Temperament and personality. Current Opinion in Neurobiology 1994; 4:166-173. [40] Kaasinen V, Maguire EA, Kurki T, et al. Mapping brain structure and personality in late adulthood. Neuroimage 2005; 24: 315-322. [41] Borg J, Andree B, Soderstrom H, Farde L. The serotonin system and spiritual experiences. Am J Psychiatry 2003; 160: 1965-1969. [42] Turner RM, Hudson IL, Butler PH, Joyce PR. Brain function and personality in normal males. Neuroimage 2003; 19:1145-1163. [43] Kaasinen V, Aalto S, Nagren K, Rinne JO. Insular dopamine D2 receptors and novelty seeking personality in Parkinson's disease. Movement Disorders 2004; 19: 1348-1351. [44] Tomer R, Aharon-Peretz J. Novelty Seeking and Harm Avoidance in Parkinson's disease: effects of asymmetric dopamine deficiency. J Neurol Neurosurg Psychiat 2004; 75:972-975. [45] Gusnard DA, Ollinger JM, Shulman GL, Cloninger CR, et al. Persistence and brain circuitry. Proc Nat Acad Sci USA 2003; 100: 3479-3484. [46] Gillespie NA, Cloninger CR, Heath AC, Martin NG. The genetic and environmental relationship between Cloninger's dimensions of temperament and character. Personality & Individual Differences 2003; 35:1931-1946. [47] PubMed listings available at http:/ / psychobiology. wustl. edu [48] Cloninger CR. The psychobiological theory of temperament and character: comment on Farmer and Goldberg. Psychological Assessment 2008; 20:292-304. [49] Zuckerman M, Cloninger CR. Relationships between Cloninger, Zuckerman, and Eysenck's dimensions of personality. Personality and Individual Differences 1996; 21: 283-285. [50] Grucza RA, Goldberg LR. The comparative validity of 11 modern personality inventories: predictions of behavioral acts, informant reports, and clinical indicators. J Pers Assess. 2007; 89: 167-187. [51] Hamer D. The God Gene: How faith is hardwired in our genes. New York, Doubleday, 2004. [52] The Quiz: How spiritual are you? Time Magazine cover story, October 17, 2004. [53] Freud S. Civilization and Its Discontents. New York, Jonathan Cape and Harrison Smith, 1929. [54] Hellinga G, van Luyn B, Dalwijk H-J (eds.). Personalities: Master clinicians confront the treatment of borderline personality disorder Robert Cloninger (biography and interview). Northvale NJ and London: Jason Aronson, 2001, pp. 99-120. [55] http:/ / anthropedia. org [56] Cloninger CR. The science of well-being: An integrated approach to mental health and its disorders: World Psychiatry 2006; 5: 71-76. [57] Mezzich J. Psychiatry for the person: Articulating medicine's science and humanism. World Psychiatry 2007; 6:65-67. [58] Psychiatric Times, November 1, 2008, The Decline of Psychotherapy (http:/ / www. psychiatrictimes. com/ display/ article/ 10168/ 1353217)

External links
The Anthropedia Foundation (http://www.anthropedia.org) Cloninger's Center for Well-Being website about the TCI and well-being therapy (http://psychobiology.wustl. edu) Washington University Division of Biology and Biomedical Sciences (http://dbbs.wustl.edu/dbbs/website. nsf/RIB/6A708AFF491D58F186256D4E005B2CE6) Washington University Physicians (http://wuphysicians.wustl.edu/physician2.aspx?Physnum=1026) Institute of Scientific Information ISI Highly Cited.com (http://hcr3.isiknowledge.com/author. cgi?id=1698&cb=57)

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