The association of affiliation and achievement personality styles with DSM-IV personality disorders

Investigators from theoretically diverse backgrounds have long described two personality styles associated with depression. The affiliation style describes individuals with interpersonal concerns; the achievement style describes individuals who have concerns with personal failure. Although primarily related to risk for depression, there has also been recognition that extreme forms of these styles are related to personality disorders (PDs). The current study examines the relation between the DSM-IV PDs and the two personality styles, assessing the latter using two approaches: (a) dependency/self-criticism (Blatt, 1974) and (b) sociotropy/autonomy (Beck, 1983). Results show that whereas the achievement style is associated with most PDs (except for the histrionic and dependent PDs), the affiliation style is associated only with histrionic, dependent, and depressive PDs. Controlling for shared PD variance leaves only two associations, affiliation with dependent PD and achievement with narcissistic PD. Results are discussed in the context of current efforts to capture personality psychopathology within a comprehensive dimensional framework.     

Sociotropy and autonomy: differential patterns of clinical presentation in unipolar depression

We examined the relations between sociotropy and autonomy and clinical features of depression. Beck (1983) proposed that sociotropy is related to a sense of deprivation and clinical features associated with reactive depression and that autonomy is related to a sense of defeat and clinical features associated with endogenous depression. Robins, Block, & Peselow (1989) found support for the hypothesis for sociotropy but not for autonomy, and they suggested that the autonomy scale may be problematic. We administered new measures of sociotropy and autonomy and a more comprehensive assessment of clinical features to 50 unipolar depressed inpatients. The results support the selective relations of both sociotropy and autonomy to the predicted sets of clinical features. This study adds to the growing evidence that these personality dimensions are important to the understanding of depression.     

Personality profiles and the prediction of categorical personality disorders

Personality disorders (PDs) are usually construed as psychiatric categories characterized by a unique configuration of traits and behaviors. To generate clinical hypotheses from normal personality trait scores, profile agreement statistics can be calculated using a prototypical personality profile for each PD. Multimethod data from 1,909 psychiatric patients in the People's Republic of China were used to examine the accuracy of such hypotheses in the Interpretive Report of the Revised NEO Personality Inventory. Profile agreement indices from both self-reports and spouse ratings were significantly related to PD symptom scores derived from questionnaires and clinical interviews. However, accuracy of diagnostic classification was only modest to moderate, probably because PDs are not discrete categorical entities. Together with other literature, these data suggest that the current categorical system should be replaced by a more comprehensive system of personality traits and personality-related problems.     

Sociotropy-dependency and autonomy as predictors of eating disturbance among Canadian female college students

The authors (a) tested the generalizability of A. Sugarman, D. Quinlan, and L. Devenis's (1982) psychodynamic account of eating disturbances, which posits that overt autonomy strivings associated with eating problems are a defense against unconscious dependency concerns, and (b) evaluated the degree to which autonomy and sociotropy had unique associations with eating disturbances. Canadian female college students (N= 286) completed self-report measures of autonomy, sociotropy, depression, and bulimia as well as the Rorschach Inkblot Test. Findings suggest, contrary to Sugarman and colleagues' psychodynamic account, that experiences of dependency related to self-reported eating pathology do not necessarily lie outside of conscious awareness. Moreover, reported bulimic symptoms were uniquely associated with sociotropy but not autonomy-self-criticism among the participants.     

Personal vulnerability, life events, and depressive symptoms: a test of a specific interactional model

We tested Beck's (1983) hypothesis that depressive symptoms occur when an individual experiences a negative life event that specifically matches the individual's personal motivational vulnerability. Ninety-eight undergraduates completed measures of depression level, recent life events, and sociotropic and autonomous achievement motivations. Consistent with the theory, sociotropy was associated with depression level and also served as a moderator of the relations between depression and frequency of recent negative social events. However, sociotropy also demonstrated nonpredicted interactive effects with negative events categorized a priori as autonomy related. Autonomy was unrelated to depression and showed no evidence of being a vulnerability to any type of life event. The findings generally support the value of examining the role in depression of interactions between personality characteristics and life events, although they do not support the specific matching predictions.     

Socio-demographic conditions, subjective somatic health, Axis I disorders and personality disorders in the common population: the relationship to quality of life

Quality of life (QOL) was studied in a population of 2,065 subjects in Norway. A broad concept of QOL was applied, including subjective well-being, self-realization, negative life events, and a number of interpersonal relationships. The assessment of QOL, based on interview, was related to a number of socio-demographic variables, subjectively experienced somatic health, the most common Axis I disorders, and all Axis II personality disorders (PDs). The results of multivariate analyses showed that being female and living with a partner in the outskirts of a city and having good physical health are important positive correlates of QOL. Controlling for all these variables, major depression, dysthymic disorder, and somatoform disorders were the Axis I disorders that have a negative statistical effect on global QOL. Specific anxiety disorders did not add to the effects. Among the PDs, avoidant, schizotypal, paranoid, and schizoid PD traits were the most important statistical negative determinants of QOL, followed by borderline, dependent, antisocial, and also self-defeating and narcissistic PDs, restricted to some specific sub-indexes of QOL. The study also showed that our results vary and are sometimes the opposite, depending on the sub-index of QOL examined. The study showed that it is necessary to apply a broad concept of QOL to disclose the real nature or the relationship between mental disorders and QOL. Furthermore, demographic variables, subjectively experienced somatic health, Axis I disorders, and PD traits appeared to be independently associated with QOL.     

Evaluation of the SCID-II personality disorder traits for DSM-IV: coherence, discrimination, relations with general personality traits, and functional impairment

The utility of the DSM personality disorder (PD) system remains a concern. The strategy employed represents one approach designed to evaluate and improve the diagnostic efficiency of the SCID-II PDs. Using a sample of 203 patients, SCID-II PD items-based on the criterion sets of the 10 DSM-IV PDs-were evaluated with respect to (a) convergent validity; (b) divergent validity; (c) relation to general personality traits; and (d) association with functional impairment. Only Borderline PD items were satisfactory on all four evaluation criteria. Histrionic and Obsessive-Compulsive PD items met criteria for convergent and divergent validity and relation to personality dimensions of the Five-Factor Model of Personality (FFM) but were not related to functional impairment, suggesting they might be reconsidered as disorders. Schizotypal PD items met three of the four criteria but showed no relation to FFM dimensions, suggesting that it may be a candidate for reassignment to Axis I.     

Dependency,impulsivity, and self-harm: traits hypothesized to underlie the association between cluster B personality and substance use disorders

Cluster B personality disorders (PDs) (i.e., antisocial, borderline, histrionic, and narcissistic) typically show a high degree of comorbidity with substance use disorders (SUDs). Previous research suggests that the broad-based personality domains of Disinhibition and Negative Temperament/Neuroticism may be common factors to both types of disorders. Using a two-phase process (i.e., screening and follow-up), this study examined three lower-order personality traits (i.e., dependency, impulsivity, and self-harm) that fall within the Disinhibition and Neuroticism domains. The study evaluated the hypotheses that these traits (a) are related both to cluster B PDs and to SUDs; and (b) underlie the association between the two types of disorders. Results indicate that impulsivity and self-harm play a significant role in cluster B PDs and SUDs, as well as in their association with each other. However, dependency was not associated with either type of disorder. These results indicate that sets of individual traits can be of significant utility in understanding the comorbidity between PDs and SUDs.     

Using a general model of personality to understand sex differences in the personality disorders

In the present study, a general model of personality was used to evaluate sex bias in the personality disorders (PD). This present study compared observed sex differences among the personality disorders (PD) with differences expected based on the Five Factor Model of personality functioning (FFM). Observed sex differences were obtained by metaanalyzing over 30 reports. Expected sex differences were computed using what is known about sex differences in the FFM traits and how these traits relate to the PDs. Agreement between observed and expected sex differences was quite good for eight of ten PDs. For histrionic PD, the obtained sex difference was larger than expected; for schizotypal personality disorder, an expected sex difference was not obtained. Implications of understanding sex differences in terms of the FFM are discussed and suggestions for future research are provided.     

Depressive personality disorder: rates of comorbidity with personality disorders and relations to the five-factor model of personality

Depressive personality disorder (DPD) is listed in the DSM-IV as one of the "Disorders for Further Study." In this investigation we examined (1) the rates of comorbidity of DPD with the 10 personality disorders (PDs) in the main text of DSM-IV, and (2) the convergent and discriminant validity of DPD in its relation to the 30 facet traits of the Five-Factor Model of personality (FFM). One hundred and sixty-nine participants with psychiatric diagnoses were interviewed with the Structured Clinical Interview for DSM-IV Personality Disorders Questionnaire (SCID-II) and completed the Revised NEO Personality Inventory (NEO PI-R). A total of 26 (15%) of the participants met diagnostic criteria for at least one of the 10 main text PDs, and 15 (9%) met criteria for DPD. Of those who met criteria for DPD, 10 (59%) of the participants also met criteria for one or more of the 10 main text PDs. Regression analyses indicated a four-facet trait set derived from the NEO PI-R thought to be uniquely associated with DPD accounted for a significant amount of variance in DPD SCID-II PD scores and was significantly larger for DPD than it was for the 9 of the 10 main text PDs; the sole exception was for avoidant PD. Diagnostically, DPD overlaps significantly with other PDs but is distinguishable in its unique relation with traits from the FFM.     

Multidimensional perfectionism and the DSM-5 personality traits

Encouraging further research on the dimensional assessment of personality disorders (PDs), Section III of the DSM-5 introduced a hybrid model for the assessment of six PDs employing self-reports on 25 maladaptive personality traits (“DSM-5 personality traits”). Following suggestions that multidimensional perfectionism is an important characteristic across various personality disorders (Ayearst, Flett, & Hewitt, 2012), the present study investigated how personal (self-oriented) and interpersonal (other-oriented and socially prescribed) forms of perfectionism predicted the DSM-5 personality traits in a sample of 311 university students. Multiple regressions (controlling for the overlap between the different forms of perfectionism) showed that socially prescribed perfectionism positively predicted the traits defining schizotypal, borderline, avoidant, and obsessive-compulsive PD; other-oriented perfectionism positively predicted the traits defining narcissistic PD; and both socially prescribed and other-oriented perfectionism positively predicted the traits defining antisocial PD. In contrast, self-oriented perfectionism positively predicted only one of the four traits defining obsessive-compulsive PD (rigid perfectionism). Showing that multidimensional perfectionism predicted all DSM-5 traits defining the personality disorders of Section III, the findings suggest that future DSM-5 updates may profit from including interpersonal aspects of perfectionism as a diagnostic criterion.     

The boundaries between attachment and personality: Localized versus generalized effects in daily social interaction

A diary study examined the effects of romantic attachment (avoidance, anxiety) and autonomous and sociotropic personality on levels of sociability within social interactions across relational contexts (N = 89 undergraduates). As expected, the effects of domain-specific romantic attachment avoidance and anxiety on sociability were localized to social interactions with romantic partners, whereas the effects of autonomy and sociotropy were generalized across relational contexts (i.e., across social interactions with romantic partners, family members, friends, and acquaintances/others). Furthermore, the effects of both autonomy and sociotropy on sociability were partially mediated by domain-specific attachment in domain-congruent (romantic) but not domain-incongruent (non-romantic) relational contexts: romantic avoidance partially mediated the effects of autonomy on sociability toward romantic partners, whereas romantic anxiety partially mediated the effects of sociotropy. These results suggest that autonomy and sociotropy summarize global regularities in relational responding that correspond to those described by attachment avoidance and anxiety—although (unlike attachment) they do so across relational contexts. Domain-specific attachment representations, in contrast, govern responding within context-congruent domains and act as a mechanism through which personality guides social interaction within these domains.     

The role of depressogenic personality and attachment in the intergenerational similarity of depressive symptoms: a study with early adolescents and their mothers

Parental depression has been identified as a risk factor for psychopathology in children, and for child depression in particular. Increasingly, research is addressing the underlying psychological processes that may explain the intergenerational similarity of depressive symptoms. In the present study, we aim to investigate the role of two theoretically relevant vulnerability factors in this intergenerational similarity, that is, (a) dimensions of depressogenic personality (i.e., sociotropy and autonomy) and (b) dimensions of attachment (i.e., anxiety and avoidance). Results in a sample of early adolescents and their mothers show significant intergenerational similarity in both sets of vulnerabilities. Moreover, the intergenerational similarity of both vulnerability factors was found to account for the association between mothers' and children's depressive symptoms. Within each generation there were also meaningful and specific associations between dimensions of depressogenic personality and dimensions of attachment, with sociotropy being primarily related to anxiety and with autonomy being primarily related to avoidance.     

The Collaborative Longitudinal Personality Disorders Study (CLPS): overview and implications

The Collaborative Longitudinal Personality Disorders Study (CLPS; Gunderson et al., 2000) was developed to fill gaps in our understanding of the nature, course, and impact of personality disorders (PDs). Here, we review published findings to date, discuss their implications for current conceptualizations of PDs, and raise questions that warrant future consideration. We have found that PDs are more stable than major depressive disorder, but that meaningful improvements are possible and not uncommon. We have confirmed also that PDs constitute a significant public health problem, with respect to associated functional impairment, extensive treatment utilization, negative prognostic impact on major depressive disorder, and suicide risk. At the same time, we have demonstrated that dimensional models of PDs have clinical validity that categories do not, especially greater temporal stability. Furthermore, dimensional personality traits appear to be the foundation of behaviors described by many PD criteria. Taken together, our results lead us to hypothesize that PDs may be reconceptualized as hybrids of stable personality traits and intermittently expressed symptomatic behaviors.     

The boundaries between attachment and personality: Associations across three levels of the attachment network

This research examined the associations between measures of sociotropic and autonomous personality, romantic attachment anxiety and avoidance, and corresponding attachment ratings across a range of different specific relationships with people whom participants regularly interacted (including romantic partners, friends, family members, and colleagues). Analyses using hierarchical linear modeling showed that sociotropy and autonomy were directly associated with respective ratings of relationship-specific anxiety and avoidance within non-romantic relationships. In contrast, domain-specific romantic attachment predicted relationship-specific attachment with romantic (but not non-romantic) partners, and, as hypothesized, mediated the associations between sociotropy and autonomy and relationship-specific attachment within this domain. Implications for the operationalization of sociotropy and autonomy as broad-bandwidth (personality-level) measures that assess more global summaries of regularities in the same dual dimensions identified in the attachment literature (i.e., attachment anxiety and avoidance) are discussed.     

Are personality disorder criteria ethnically biased? A card-sort analysis

On the basis of methodology used in previous research on sex criterion bias, this study examined ethnicity criterion bias of personality disorders (PDs) defined in the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., Rev.) and included examination of sex as well as ethnicity. A card-sort analysis using undergraduate college students as sorters indicated that criteria for all of the PDs were applied disproportionately by ethnicity, resulting in particular ethnic groups receiving diagnoses for specific PDs. Criteria were sorted systematically such that diagnoses of antisocial and paranoid PDs were assigned to African Americans, schizoid PD was assigned to Asian Americans, and schizotypal PD was assigned to Native Americans. All other PDs were assigned to European Americans, whereas none of the criteria were sorted resulting in any PD diagnosis being applied to Latinos. Implications for clinicians, methodological considerations, and recommendations for future research are discussed.