C. Robert Cloninger
Encyclopedia
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. 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. Cloninger is a member of the evolutionary, neuroscience, and statistical genetics programs of the Division of Biology and Biomedical Sciences at Washington University, and is recognized as an expert clinician in the treatment of general psychopathology, substance dependence
Substance dependence
The section about substance dependence in the Diagnostic and Statistical Manual of Mental Disorders does not use the word addiction at all. It explains:...

, and personality disorders.

Cloninger is best known for his ground-breaking research on the genetics, neurobiology, and development of personality and personality disorders. 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. Cloninger also carried out the first genome-wide association and linkage study of normal personality traits, and has developed two widely used tools for measuring personality: the Tridimensional Personality Questionnaire
Tridimensional Personality Questionnaire
Tridimensional Personality Questionnaire is a personality test.It was devised by C. Robert Cloninger.A newer version of the questionnaire is called Temperament and Character Inventory....

 (TPQ) and the Temperament and Character Inventory
Temperament and Character Inventory
Temperament and Character Inventory is an inventory for personality traits devised by Cloninger et al.It is closely related to and an outgrowth of Tridimensional Personality Questionnaire ,...

 (TCI).

A leading expert in the science of well-being, in 2004 he published Feeling Good: The Science of Well-Being. 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.

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. 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. 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., and the Mens Sana Monographs
Mens Sana Monographs
The Mens Sana Monographs is an open-access peer-reviewed medical journal-cum-monographic series. It is Devoted to the Understanding of Medicine, Mental Health, Mind, Man and their Matrix. The Mens Sana Monographs (MSM) is an open-access peer-reviewed medical journal-cum-monographic series. It is...


Education and Early Research

Cloninger was born in Beaumont, Texas in 1944. 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. He attended the University of Texas in Austin from 1962-1966 in the Plan II Honors program. In addition to pre-medical studies, he pursued studies in philosophy, cultural anthropology, and psychology for which he received honors.

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. 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
Samuel guze
Samuel Barry Guze was a psychiatrist, medical educator, and researcher. He was one of the most influential psychiatrists in the contemporary world. He was on faculty at Washington University in St. Louis. Along with Eli Robins, Guze advanced psychiatry by establishing criteria for diagnosis...

. Cloninger wanted to understand why antisocial personality disorder
Antisocial personality disorder
Antisocial personality disorder is described by the American Psychiatric Association's Diagnostic and Statistical Manual, fourth edition , as an Axis II personality disorder characterized by "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood...

, 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.

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. During the late 70s, Cloninger worked on modeling complex patterns of inheritance using path analysis to allow for both genetic and cultural inheritance. He extended path analysis with the introduction of the "copath" to facilitate the analysis of assortative mating and cultural inheritance. 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. 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. 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. 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 became an ISI Science Citation Classic that convinced most scientists that vulnerability to alcoholism was genetically heritable in part.

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. 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. The personality ratings of Cloninger were based on his tridimensional model of temperament. 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. The original findings were later confirmed by a replication study using the same methods conducted in Gothenburg, Sweden. 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. He focused on the structure of learning abilities within the person, as has long been desired by social-cognitive psychologists. 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. Initially he described three dimensions of temperament that he suggested were independently inherited and measured by his Tridimensional Personality Questionnaire
Tridimensional Personality Questionnaire
Tridimensional Personality Questionnaire is a personality test.It was devised by C. Robert Cloninger.A newer version of the questionnaire is called Temperament and Character Inventory....

 (TPQ):
  1. Harm Avoidance
    Harm avoidance
    In psychology, harm avoidance is a personality trait characterized by excessive worrying; pessimism; shyness; and being fearful, doubtful, and easily fatigued...

     (anxious, pessimistic vs. outgoing, optimistic)
  2. Novelty Seeking
    Novelty seeking
    In psychology, novelty seeking is a personality trait.It is measured in the Tridimensional Personality Questionnaire as well as the later version Temperament and Character Inventory.NS has been suggested to be related to low dopaminergic activity....

     (impulsive, quick-tempered vs. rigid, slow-tempered)
  3. Reward Dependence
    Reward dependence
    In psychology, Reward Dependence is a moderately heritable personality trait which is stable throughout life. It is an inherited neurophysiological mechanism that drives our perception of the environment and society...

     (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. These temperament dimensions proved to be a powerful way to distinguish subtypes of personality disorders and vulnerability to a wide range of mental disorders. 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."

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. 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. 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. Cloninger often cites Immanuel Kant, who defines character as "what people make of themselves intentionally." Character dimensions have strong relations with recently-evolved regions of the brain—such as the frontal, temporal, and parietal neocortex—that regulate learning of facts and propositions. By contrast, the temperament dimensions have strong relations with the older cortico-striatal and limbic systems that regulate habits and skills.

These three character dimensions have been found to be as heritable as the four temperament dimensions, each with about 50% heritability in twin studies. All seven dimensions of temperament and character have been found to have unique genetic determinants and to be regulated by different brain systems as measured by functional brain imaging. Each dimension is influenced by complex interaction between many genetic and environmental variables, so personality develops as a complex adaptive system. 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. The construction of the inventories on the basis of genetic and neurobiological considerations challenges the traditional statistical assumptions of factor analytically derived inventories, which have been targeted by social and cognitive psychologists for many years. Fortunately, in terms of overall statistical information, there is extensive overlap among the TCI
TCI
-Medicine:*Transient Cerebral Ischaemic attack, see Transient ischemic attack*Tricyclic antidepressant medication*Target Controlled Infusion, a method for controlling intravenous infusions.-Psychology:*Theme-Centered Interaction, a method of psychotherapy by Dr...

 and other multidimensional personality inventories, except that other inventories lack the dimension of Self-Transcendence.

Self-Transcendence & Science of Well-Being

Self-Transcendence refers to the interest people have in searching for something elevated, something beyond their individual existence. 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. 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," 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. 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. As suggested by transpersonal psychologists and other psychiatrists like Carl Jung
Carl Jung
Carl Gustav Jung was a Swiss psychiatrist and the founder of Analytical Psychology. Jung is considered the first modern psychiatrist to view the human psyche as "by nature religious" and make it the focus of exploration. Jung is one of the best known researchers in the field of dream analysis and...

 and Viktor Frankl
Viktor Frankl
Viktor Emil Frankl M.D., Ph.D. was an Austrian neurologist and psychiatrist as well as a Holocaust survivor. Frankl was the founder of logotherapy, which is a form of Existential Analysis, the "Third Viennese School of Psychotherapy"...

, Cloninger has emphasized that self-transcendence is an essential component in the processes of integration and maturation of personality. 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. 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:
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." 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, including certain meditations that enhance mindfulness and spirituality. He describes examples of such exercises in detail in a DVD series called Know Yourself, which was developed with the Anthropedia Foundation. The Know Yourself series is intended for use as a self-help tool or as an adjunct in psychotherapy.

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. 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. 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." 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. Cloninger is working with the World Psychiatric Association to advance a more integrated approach to mental health and well-being. The American Psychiatric Association
American Psychiatric Association
The American Psychiatric Association is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential worldwide. Its some 38,000 members are mainly American but some are international...

 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
American Psychiatric Association
The American Psychiatric Association is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential worldwide. Its some 38,000 members are mainly American but some are international...



2003 Lifetime Achievement Award, International Society of Psychiatric Genetics

2000 Annual Award for Lifetime Achievement, American Society of Addiction Medicine
American Society of Addiction Medicine
The American Society of Addiction Medicine is a physician society with a focus on addiction and its treatment.- History :ASAM has its roots in research and clinical traditions that pre-date its founding in the early 1950s, when Ruth Fox, M.D. began regular meetings with other physicians interested...



1993 Adolf Meyer Award, American Psychiatric Association
American Psychiatric Association
The American Psychiatric Association is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential worldwide. Its some 38,000 members are mainly American but some are international...



1993 Samuel Hamilton Award, American Psychopathological Association
American Psychopathological Association
The American Psychopathological Association is an organization, "devoted to the scientific investigation of disordered human behavior, and its biological and psychosocial substrates."The association was founded in 1910...



1989- Institute of Medicine, National Academy of Sciences
United States National Academy of Sciences
The National Academy of Sciences is a corporation in the United States whose members serve pro bono as "advisers to the nation on science, engineering, and medicine." As a national academy, new members of the organization are elected annually by current members, based on their distinguished and...

, USA

1988 Edward A. Strecker Award, Institute of Pennsylvania Hospital

1983 Honorary Doctor of Medicine (M.D. hc), University of Umea, Sweden

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., Eisenman 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. 159–182). 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.

  • 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.

External links

The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
x
OK