Interpersonal variability in dependent personality

The interpersonal circumplex (IPC) was recommended as a personality trait dimensional model with good potential to identify the phenomenological scope of personality disorders whose core dysfunction involves maladaptive expression of interpersonal traits. The IPC was then applied to the reconceptualization of dependent personality and dependent personality disorder. In Study 1, Pincus and Gurtman's (1995) three interpersonal vectors of dependency were validated via factor analyses conducted on two large samples (N = 921; N = 472) and a reliable self-report measure, the 3 Vector Dependency Inventory (3VDI) was constructed. In Study 2, two samples (N = 103; N = 122) of individuals identified as predominantly endorsing submissive dependence, exploitable dependence, or love dependence, or who were low in aspects of dependency were compared via ANOVA and chi-square analyses on parental representations, adult attachment styles, loneliness, and pathological attachment. Submissive dependence was associated with higher scores on maladaptive constructs (fearful attachment, pathological attachment, and loneliness) and was also associated with lower parental affiliation and higher maternal control. Love dependence was associated with lower scores on maladaptive constructs and higher scores on secure attachment and parental affiliation. Variability in dependent phenomenology was related to its three component traits. Multiple perspectives on integrating love dependence, exploitable dependence, and submissive dependence into a reconceptualization of dependent personality disorder were articulated.     

A Five-Factor Measure of Dependent Personality Traits

This study provides convergent, discriminant, and incremental validity data for a new measure of dependent personality traits from the perspective of the five-factor model (FFM). Dependent personality trait scales were constructed as maladaptive variants of FFM facets (e.g., Gullibility as a maladaptive variant of FFM trust). Based on responses from 383 undergraduates, the convergent validity of the Five-Factor Dependency Inventory (FFDI) scales was tested with respect to 2 measures of the FFM, 6 dependency trait scales, and 4 measures of dependent personality disorder. Discriminant validity was tested with respect to FFM facets from alternative domains. Incremental validity was tested with respect to the ability of the FFM dependent personality trait scales to account for variance in 2 established measures of dependency, after variance accounted for by respective FFM facet scales and other measures of DPD was first removed. The results of this study provided support for the validity of the FFDI assessment of dependency from the perspective of the FFM.     

A five-factor measure of dependent personality traits

This study provides convergent, discriminant, and incremental validity data for a new measure of dependent personality traits from the perspective of the five-factor model (FFM). Dependent personality trait scales were constructed as maladaptive variants of FFM facets (e.g., Gullibility as a maladaptive variant of FFM trust). Based on responses from 383 undergraduates, the convergent validity of the Five-Factor Dependency Inventory (FFDI) scales was tested with respect to 2 measures of the FFM, 6 dependency trait scales, and 4 measures of dependent personality disorder. Discriminant validity was tested with respect to FFM facets from alternative domains. Incremental validity was tested with respect to the ability of the FFM dependent personality trait scales to account for variance in 2 established measures of dependency, after variance accounted for by respective FFM facet scales and other measures of DPD was first removed. The results of this study provided support for the validity of the FFDI assessment of dependency from the perspective of the FFM.     

The depressive personality disorder inventory and current depressive symptoms: implications for the assessment of depressive personality

The Depressive Personality Disorder Inventory (DPDI; Huprich, Margrett, Barthelemy, & Fine, 1996; see Appendix) was created to assess Depressive Personality Disorder in clinical and nonclinical samples. Since its creation, the DPDI has been used in multiple studies, and the psychometric properties of the measure have generally supported its reliability, convergent validity, and construct validity; however, evidence for the measure's discriminant validity has been mixed. Specifically, the DPDI tends to correlate highly with measures of current depressive symptoms, which limits its efficacy in differentiating current depressive symptoms from a depressive personality structure. A principal components analysis of 362 individuals who completed both the DPDI and Beck Depression Inventory (BDI-II; Beck, Steer, & Brown, 1996) found that 49% of the variance was accounted for in two components. Seven items from the DPDI loaded more strongly on the first component composed of many BDI-II items. These items were removed in order to create a measure believed to assess DPD without the confounding influence of current depressive symptomology. Principal components analysis of the revised measure yielded three components, accounting for 46% of the variance. The revised DPDI was used to calculate convergent, discriminant, and construct validity coefficients from measures used in former studies. Virtually no improvement in the validity coefficients was observed. It is concluded that assessing DPD via self-report is limited in its utility.     

Assessment of dysfunctional beliefs in borderline personality disorder

This study had two aims: to test the hypothesis that borderline personality disorder (BPD) patients hold numerous dysfunctional beliefs associated with a variety of Axis II disorders, and to construct a BPD belief scale which captures these beliefs. Beliefs were measured using the Personality Belief Questionnaire (PBQ) which is designed to assess beliefs associated with various personality disorders, although not specifically BPD. Eighty-four BPD patients and 204 patients with other personality disorders (OPD) were randomly split into two study samples. Fourteen PBQ items were found to discriminate BPD from OPD patients in both samples. These items came from the PBQ Dependent, Paranoid, Avoidant, and Histrionic scales and reflect themes of dependency, helplessness, distrust, fears of rejection/abandonment/losing emotional control, and extreme attention-seeking behavior. A BPD beliefs scale constructed from these items showed good internal consistency and diagnostic validity among the 288 study patients. The scale may be used to assist in diagnosis and cognitive therapy of BPD.     

Chronic, low-grade depression in a nonclinical sample: depressive personality or dysthymia?

Depressive personality disorder (DPD) is being considered for inclusion in future editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM). However, there is substantial conceptual and empirical overlap between DPD and dysthymic disorder (Dysthymia) criteria, suggesting that these two constructs may not be distinct. Confirmatory factor analysis of the DPD traits and dysthymia symptoms in a large, nonclinical sample (N = 368) indicated that a two-factor model was a better fit than a one-factor model. However, binary diagnostic analysis revealed that over half of the individuals meeting criteria for DPD also met criteria for dysthymia and that the best-fitting model allowed the psychological symptoms of dysthymia to load on both DPD and dysthymia latent factors. All of the individuals with DPD alone failed to meet criteria for dysthymia because they did not report chronic depressed mood. Our results suggest that although DPD is not synonymous with Dysthymia, it may be a milder subtype.     

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.     

Differentiating avoidant and depressive personality disorders

The purpose of this study was to test a priori predictions about the way in which avoidant personality disorder (APD) can be differentiated from depressive personality disorder (DPD) in a clinical population. Psychiatric outpatients were administered two measures of DPD, including the SCID-II for other DSM-IV Axis II personality disorders, along with criterion measures upon which the two disorders would be differentiated. APD was found to be most strongly associated with state and trait measures of anxiety, while DPD was most strongly associated with state and trait measures of hostility. Individuals with DPD had higher mean scores on measures of hostility than those without DPD, and individuals with APD had higher mean scores on measures of anxiety than those without APD. However, DPD measures were also significantly correlated with state and trait measures of anxiety and APD with measures of depressive symptoms. Furthermore, anxiety was found to be higher in some groups of individuals with DPD than those with APD. It is concluded that the level of hostility in this DPD population appears to be an important symptom by which to differentiate the two disorders and that a reconsideration of including DPD criterion #4 -- prone to brooding and worrying -- may be justified. Furthermore, the SCID-II interview may be better at differentiating DPD and APD than a self-report measure of DPD.     

Deconstructing dependency in a five-factor world: a meta-analytic review

Meta-analysis of studies assessing the relation between interpersonal dependency test scores and five-factor model (FFM) domain scores revealed that dependency scores are positively correlated with FFM Neuroticism and Agreeableness scores and negatively correlated with FFM Extraversion, Openness, and Conscientiousness scores. The magnitudes of these correlations were all in the small-to-moderate range, and comparable score intercorrelations were obtained when participants' dependency levels were assessed by means of a trait dependency questionnaire, dependent personality disorder questionnaire, or dependent personality disorder interview. These findings have implications for researchers' efforts to deconstruct dependency into its basic trait elements and for the dimensional approaches to personality disorders being considered for future versions of the Diagnostic and Statistical Manual of Mental Disorders.     

The construct validity of depressive personality disorder

This study examined the construct validity of depressive personality disorder (DPD: American Psychiatric Association, 1994). Adult psychiatric outpatients (N = 900) underwent comprehensive Axis I and II evaluations and provided data on 4,768 of their 1st-degree relatives. Despite modest overlap, DPD was not redundant with any Axis I or II disorder. Participants with DPD exhibited more Axis I and Axis II comorbidity, and greater psychosocial dysfunction, than participants without DPD. Relatives of participants with DPD had higher rates of mood disorders, alcohol abuse, and antisocial personality. Results are consistent with findings of several other similar investigations. The authors argue that DPD is a valid construct and should be conceptualized as a personality disorder as opposed to a mood disorder.     

An MCMI-II item-level component analysis: personality and clinical factors

The Millon Clinical Multiaxial Inventory, Version 2 (MCMI-II) was released to replace the MCMI-I. Research into the factor structure of the items of the MCMI-I showed components consistent with the underlying construction theory. No such work has been done with the new MCMI-II. For this study, we analyzed the personality disorder and clinical syndrome items across two subject samples. For 579 Veterans Administration patients and 492 normal college students, six personality factors were identified. The samples shared Hostility, Histrionic/Schizoid, Dependent, Compulsive, and a Sadistic variant. For the clinical syndrome items, eight factors were isolated for veterans and seven for normals. Depression, Alcohol Abuse, Drug Abuse, Crying, and Mania were shared factors. Most of the factors were found to be highly consistent with MCMI-II scale keyings.     

An MCMI-II Item-Level Component Analysis: Personality and Clinical Factors

The Milton Clinical Multiaxial Inventory, Version 2 (MCMI-II) was released to replace the MCMI-I. Research into the factor structure Of the items of the MCMI-I showed components consistent with the underlying construction theory. No such work has been done with the new MCMI-II. For this study, we analyzed the personality disorder and clinical syndrome items across two subject samples. For 579 Veterans Administration patients and 492 normal college students, six personality factors were identified. The samples shared Hostility, Histrionic/ Schizoid, Dependent, Compulsive, and a Sadistic variant. For the clinical syndrome items, eight factors were isolated for veterans and seven for normals. Depression, Alcohol Abuse, Drug Abuses Crying, and Mania were shared factors. Most of the factors were found to be highly consistent with MCMI-II scale keyings.     

Dependent personality disorder: comparing an expert generated and empirically derived five-factor model personality disorder count

Assessment of the Diagnostic and Statistical Manual of Mental Disorders (4th Ed.; DSM-IV ) personality disorders (PDs) using five-factor model (FFM) prototypes and counts has shown substantial promise, with a few exceptions. Miller, Reynolds, and Pilkonis suggested that the expert-generated FFM dependent prototype might be misspecified in relation to the DSM-IV because of the overemphasis of high Agreeableness and underemphasis of low Conscientiousness in the experts' conception. A meta-analytic review of the relations between the FFM facets and Dependent PD (DPD) was conducted and used to create a revised, empirically based FFM DPD profile and count. The revised profile and count were more strongly correlated with DSM and non-DSM conceptualizations of maladaptive dependency. In addition, the revised FFM DPD profile was able to recreate the patterns of comorbidity typically found when using DSM-IV measures of DPD. Possible explanations for the discrepancy between the expert ratings and the meta-analytic results are offered.     

Gender bias in diagnostic criteria for personality disorders: an item response theory analysis

The authors examined gender bias in the diagnostic criteria for Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision; American Psychiatric Association, 2000) personality disorders. Participants (N=599) were selected from 2 large, nonclinical samples on the basis of information from self-report questionnaires and peer nominations that suggested the presence of personality pathology. All were interviewed with the Structured Interview for DSM-IV Personality (B. Pfohl, N. Blum, & M. Zimmerman, 1997). Using item response theory methods, the authors compared data from 315 men and 284 women, searching for evidence of differential item functioning in the diagnostic features of 10 personality disorder categories. Results indicated significant but moderate measurement bias pertaining to gender for 6 specific criteria. In other words, men and women with equivalent levels of pathology endorsed the items at different rates. For 1 paranoid personality disorder criterion and 3 antisocial criteria, men were more likely to endorse the biased items. For 2 schizoid personality disorder criteria, women were more likely to endorse the biased items.     

Differences between traits: properties associated with interjudge agreement

The present study concerns the relation between properties of personality traits and the agreement with which they are applied to real individuals. Subjects rated the 100 personality items of the California Q-Set on nine subjective dimensions, six of which loaded highly on a first principal component. This factor was interpreted as reflecting each trait's "easy visibility" to an outside observer. Actual interjudge agreement in applying each trait to real individuals was assessed in two ways: Self-other agreement was assessed in two independent samples, and interpeer agreement was assessed in three samples. Impressive and stable agreement was found for most Q items. The traits that were applied to individuals with the greatest interjudge agreement were the same ones that seemed most easily visible and tended to be positively relevant to extraversion and negatively relevant to neuroticism (identified through a factor analysis by McCrae, Costa, & Busch, 1986). The results suggest that traits defining extraversion are revealed relatively directly in social behavior and, therefore, are easy to judge, that traits defining neuroticism are less visible and, so, are judged less accurately, and that lay perceivers of personality are generally sensitive to this difference between traits.     

Interpersonal analysis of grandiose and vulnerable narcissism

This article examines the validity of grandiose and vulnerable subtypes of narcissistic character styles through an analysis of personality disorder criteria, interpersonal problems, and adult attachment styles in a nonclinical population. The grandiose personalities in this sample were rated high in the dramatic traits associated with narcissistic, antisocial, and histrionic personality disorders based on a diagnostic interview, and they reported domineering and vindictive interpersonal problems. However, despite the observation of narcissistic personality pathology, they denied interpersonal distress related to their interpersonal problems and the majority reported adult attachment styles reflective of positive self-representations (Secure, Dismissive). Vulnerable narcissistic individuals were represented by high ratings on avoidant personality disorder based on a diagnostic interview. They reported high interpersonal distress and greater domineering, vindictive, cold, and socially avoidant interpersonal problems. The majority reported adult attachment styles reflective of negative self-representations (Fearful, Preoccupied). The validity of grandiose and vulnerable narcissism based upon the results of this study was discussed in terms of clinical theory and with reference to the implications of two subtypes of narcissism for diagnosis and treatment.     

A Meta-Analysis of the Dependency–Eating-Disorders Relationship: Strength, Specificity, and Temporal Stability

Meta-analysis of studies examining the dependency–eating-disorders relationship revealed that (1) there is a positive association between interpersonal dependency levels and eating disorder symptoms/diagnoses (r = .25); (2) this relationship is comparable in anorexic and bulimic participants; (3) although dependent personality disorder symptoms are elevated in eating-disordered participants, so are the symptoms of several other personality disorders; and (4) when eating disorder symptoms remit, dependency levels decrease. Conclusion: There is a statistically significant link between interpersonal dependency and eating disorders, but this relationship is modest in magnitude, nonspecific, and varies with eating disorder symptom levels. Clinical, empirical, and theoretical implications of these findings are discussed.     

Response–reinforcer dependency and resistance to change

The effects of the response–reinforcer dependency on resistance to change were studied in three experiments with rats. In Experiment 1, lever pressing produced reinforcers at similar rates after variable interreinforcer intervals in each component of a two‐component multiple schedule. Across conditions, in the fixed component, all reinforcers were response‐dependent; in the alternative component, the percentage of response‐dependent reinforcers was 100, 50 (i.e., 50% response‐dependent and 50% response‐independent) or 10% (i.e., 10% response‐dependent and 90% response‐independent). Resistance to extinction was greater in the alternative than in the fixed component when the dependency in the former was 10%, but was similar between components when this dependency was 100 or 50%. In Experiment 2, a three‐component multiple schedule was used. The dependency was 100% in one component and 10% in the other two. The 10% components differed on how reinforcers were programmed. In one component, as in Experiment 1, a reinforcer had to be collected before the scheduling of other response‐dependent or independent reinforcers. In the other component, response‐dependent and ‐independent reinforcers were programmed by superimposing a variable‐time schedule on an independent variable‐interval schedule. Regardless of the procedure used to program the dependency, resistance to extinction was greater in the 10% components than in the 100% component. These results were replicated in Experiment 3 in which, instead of extinction, VT schedules replaced the baseline schedules in each multiple‐schedule component during the test. We argue that the relative change in dependency from Baseline to Test, which is greater when baseline dependencies are high rather than low, could account for the differential resistance to change in the present experiments. The inconsistencies in results across the present and previous experiments suggest that the effects of dependency on resistance to change are not well understood. Additional systematic analyses are important to further understand the effects of the response–reinforcer relation on resistance to change and to the development of a more comprehensive theory of behavioral persistence.     

Genetic and environmental contributions to the co-occurrence of depressive personality disorder and DSM-IV personality disorders

One of the main controversies with regard to depressive personality disorder (DPD) concerns the co-occurrence with the established DSM-IV personality disorders (PDs). The main aim of this study was to examine to what extent DPD and the DSM-IV PDs share genetic and environmental risk factors, using multivariate twin modeling. The DSM-IV Structured Interview for Personality was applied to 2,794 young adult twins. Paranoid PD from Cluster A, borderline PD from Cluster B, and all three PDs from Cluster C were independently and significantly associated with DPD in multiple regression analysis. The genetic correlations between DPD and the other PDs were strong (.53-.83), while the environmental correlations were moderate (.36-.40). Close to 50% of the total variance in DPD was disorder specific. However, only 5% was due to disorder-specific genetic factors, indicating that a substantial part of the genetic vulnerability to DPD also increases the vulnerability to other PDs.