Toward a More Nuanced Perspective on Detachment: Differentiating Schizoid and Avoidant Personality Styles through Qualities of the Self-Representation

Avoidant personality disorder was introduced in DSM-III (American Psychiatric Association [APA], 1980), and debate persists regarding the utility of having two separate variants of the "detached personality." The present study addressed this issue through ratings of open-ended self-descriptions provided by community adults with high scores on schizoid versus avoidant personality traits (N = 229). The self-concept of individuals with avoidant personality style reflected a lack of positive self-regard and low self-efficacy/agency. Regarding schizoid personalities, neither positive nor negative self-regard, self-complexity, or self-efficacy/agency was found. Examination of specific variables yielded a relationship between avoidant personality styles, depression, and anxiety, consistent with literature noting simultaneous desire and fear of interpersonal relationships in avoidant patients (APA, 1980; Sheldon & West, 1990). Similarly, examination of individual variables yielded a negative association between schizoid personality styles and tolerance for contradictory aspects of the self, consistent with theoretical writings in this area (Kernberg, 1976; McWilliams, 2006). Results support the argument that these two personality styles represent distinct constructs. Findings support the utility of self-concept assessment to assist treatment planning and differential diagnosis. Treatment implications include using open-ended descriptions of patients' self-concepts to explore changes that may not be accessible via more structured forms of patient self-report.

The smartphone as a "significant other": interpersonal dependency and attachment in maladaptive smartphone and social networks use

Smartphones are increasingly widespread throughout the world and, although smartphones provide various benefits, excessive and maladaptive use is often reported. Given the penetration of smartphones in the individual's daily life, it is relevant to identify the mechanisms sustaining their use, including the affective bond that the owner may develop with the device. The aim of the current study is to test a novel model to explain smartphone and Social Network Sites (SNS) use from an interpersonal perspective. We hypothesized that adult attachment style and interpersonal patterns (i.e., features of interpersonal dependency) generalize to the emotional bond with the mobile device, interacting with psychological correlates and background factors to predict smartphone and SNS consumption. 341 nonclinical adults (57.2% females; age M = 35.5, SD = 14.6) completed a battery consisting of the Attachment Style Questionnaire, the Relationship Profile Test, the Rosenberg Self-Esteem Scale, the Toronto Alexithymia Scale, the Young Adult Attachment to Phone Scale, and the Social Network Intensity and Social Network Access via Mobile phone Applications. A multi-mediation model supported the hypothesis regarding the influence of interpersonal style in the relationship of the individual with their smartphone and use of SNS. A parallel between attachment style and the emotional bond with the smartphone emerged, with anxious attachment style and destructive overdependence being potential risk factors for maladaptive smartphone use especially in individuals involved in a romantic relationship. Findings are discussed in terms of theoretical implications and intervention strategies towards smartphone dependency.

Assessing the Impact of Relationship Profile Test Scores, Self-Identified Ethnic Group, and Gender on Adult Attachment Style

Research shows that the subscales of the Relationship Profile Test (RPT) are related to adult attachment. Gender differences have been implicated, but findings are inconsistent in terms of replication. A limited amount of research has been conducted on ethnic differences in the context of interpersonal dependency. This study aims to bridge the gap in the literature in terms of using the RPT to predict attachment styles and to assess gender and ethnic group differences in RPT scores. Four samples from various treatment settings were combined to yield a heterogeneous group of ethnically diverse men and women (N = 470) with a mean age of 31.96. No gender differences were observed; however, ethnic differences were noted, with the RPT scales predicting unique variance in secure and insecure attachment styles. This study evidences the incremental validity of the RPT scales when predicting adult attachment style with consideration of ethnic group differences, which can help inform the treatment and assessment process.

A Multimethod Investigation of Sex, Romantic Relationships, and Interpersonal Dependency

An individual's level of interpersonal dependency influences the way they engage with others, and researchers have achieved a comprehensive understanding of the interplay between dependency and interpersonal relationships across an array of social situations. This knowledge has improved the efficacy of medical and psychotherapeutic work with dependent clients and has informed approaches taken to reduce the societal costs of dependent personality disorder (e.g., increased risk for suicide and self-harm, perpetration of child abuse, perpetration of domestic violence, victimization by a partner, and physical illness). Relatively little research, however, has explored dependency's links to sexual activity and sexual functioning, the findings of which stand to offer knowledge valuable to sex counseling, couples therapy, sexual health, and our overall understanding of sexuality. The current study utilized a multimethod research design to explore dependency as it relates to sexual and romantic relationships and sexual activity. Multiple associations emerged between dependency, both interpersonal dependency and a healthy variant of dependency, and sexual activity. Based upon these findings and contemporary literature, an initial discussion of some of the therapeutic implications of this knowledge and suggestions for working with dependent clients are offered.

Italian Version of the Relationship Profile Test (RPT-I): Temporal Stability, Construct Validity, and Cross-Cultural Comparison

This study presents the adaptation to the Italian context of the Relationship Profile Test (RPT; Bornstein & Languirand), a self-report measure of Destructive Overdependence (DO), Dysfunctional Detachment (DD), and Healthy Dependency (HD). The RPT was administered to a community sample of 661 nonclinical Italian adults together with the Attachment Style Questionnaire, the Relational-Interdependent Self-Construal Scale, the Rosenberg Self-Esteem Scale, the Self-Compassion Scale, the Positive Affect-Negative Affect Scale, and the Toronto Alexithymia Scale. A randomly selected subset of participants (n = 67) completed the RPT again approximately 5 months after the first administration. The factor structure of the RPT obtained in the main sample was compared with that obtained in a sample of 603 adult participants from the US and was found to be similar. Internal consistency for DO, DD, and HD scores in the Italian sample fell between the acceptable to good range, and test-retest reliability coefficients were all above .70. The three scales yielded the expected pattern of correlations with theoretically related constructs, documenting good criterion validity. Findings are discussed in light of the literature on the RPT as a measure of interpersonal dependency and detachment. Suggestions for future research are offered.

BLEND-A: blending internet treatment into conventional face-to-face treatment for alcohol use disorder - a study protocol

BACKGROUND

A major challenge to psychological treatment for alcohol use disorder (AUD) is patient non-compliance. A promising new treatment approach that is hypothesized to increase patient compliance is blended treatment, consisting of face-to-face contact with a therapist combined with modules delivered over the internet within the same protocol. While this treatment concept has been developed and proven effective for a variety of mental disorders, it has not yet been examined for AUD.

AIMS

The study described in this protocol aims to examine and evaluate patient compliance with blended AUD treatment as well as the clinical and cost effectiveness of such treatment compared to face-to-face treatment only.

METHODS

The study design is a pragmatic, stepped-wedge cluster randomized controlled trial. The included outpatient institutions (planned number of patients: n = 1800) will be randomized in clusters to implement either blended AUD treatment or face-to-face treatment only, i.e. treatment as usual (TAU). Both treatment approaches consist of motivational interviewing and cognitive behavioral therapy. Data on sociodemographics, treatment (e.g. intensity, duration), type of treatment conclusion (compliance vs. dropout), alcohol consumption, addiction severity, consequences of drinking, and quality of life, will be collected at treatment entry, at treatment conclusion, and 6 months after treatment conclusion. The primary outcome is compliance at treatment conclusion, and the secondary outcomes include alcohol consumption and quality of life at six-months follow-up. Data will be analyzed with an Intention-to-treat approach by means of generalized linear mixed models with a random effect for cluster and fixed effect for each step. Also, analyses evaluating cost-effectiveness will be conducted.

DISCUSSION

Blended treatment may increase treatment compliance and thus improve treatment outcomes due to increased flexibility of the treatment course. Since this study is conducted within an implementation framework it can easily be scaled up, and when successful, blended treatment has the potential to become an alternative offer in many outpatient clinics nationwide and internationally.

TRIAL REGISTRATION

Clinicaltrials.gov .: NCT04535258 , retrospectively registered 01.09.20.

Trait Activation Theory: A Review of the Literature and Applications to Five Lines of Personality Dynamics Research

Extending interactionist principles and targeting situational specificity of trait–performance linkages, trait activation theory (TAT) posits personality traits are expressed as valued work behavior in response to trait-relevant situational cues, subject to constraints and other factors, all operating at the task, social, and organizational levels. Review of 99 key sources citing TAT spanning 2011–2019 reveals diverse applications (e.g., bidirectionality, trait specificity, team building) and an overall 60% significance rate for 262 TAT-based moderator effects reported in 60 of 75 empirical studies. Applying five key aspects of TAT (e.g., behavior/performance distinction, need-based motivation) to five lines of personality dynamics research (e.g., personality states, self-regulation models of motivation) supports TAT as a vehicle for advancing understanding of within-person variability over brief and extended timelines. Critical research needs include personality-oriented work analysis, longitudinal study of trait-situation processes, trait activation in teams, within-job bidirectionality, and situation relevance as a unifying principle in advancing person–workplace fit.

Self-compassion mediates the link between dependency and depressive symptomatology in college students

Depression is highly prevalent among college students and is associated with significant morbidity and mortality. Dependency is among the known personality traits that predict an elevated risk for depression. Prior research has focused on the depressogenic role of self-critical thoughts among destructive overdependent (DO) individuals but has not considered other internal processes (such as self-compassion) that might influence mental health. The current report examined whether self-compassion had either moderating or mediating effects on the links between dependency and depression in college students. In a cross-sectional study, 85 college students completed measures of dependency, self-compassion, and depressive symptoms. Analyses suggested that self-compassion mediated both the effect of DO on depressive symptoms and the effect of healthy dependency (HD) on lower depressive symptoms; self-compassion did not moderate links between dependency and depressive symptoms. Our exploratory findings suggest that positive self-schema (in the form of self-compassion) may contribute to the downstream mental health effects of both adaptive HD and maladaptive DO.

Antecedents and Outcomes of Psychological Insecurity and Interpersonal Trust Among Chinese People

Psychological insecurity and interpersonal trust were empirically tested in a conceptual model in relation to several personality and social measures as theoretical antecedents, and to interpersonal relationships and feelings of life satisfaction as hypothesized outcomes. Questionnaire data from 301 Chinese adults showed psychological insecurity to be significantly and positively correlated with neuroticism and dependency, while negatively related to family emotional support, emotional intelligence, openness, and agreeableness; and the regression revealed neuroticism to be the strongest predictor of psychological insecurity. The results for interpersonal trust showed a significant negative correlation with psychological insecurity, and a pattern of correlations with all the other variables that were in the opposite direction of those for psychological insecurity; and the regression revealed agreeableness to be the strongest predictor of interpersonal trust. Interpersonal trust was also a significant predictor of coworker support and life satisfaction. The research identified behaviors that should be able to reduce psychological insecurity, and others that could increase interpersonal trust, with the overall results demonstrating the importance of being emotionally supportive and honest with other people to reduce feelings of psychological insecurity and increase interpersonal trust.

Development and Validation of a Six-Item Version of the Interpersonal Dependency Inventory

The Interpersonal Dependency Inventory (IDI) is a frequently used, 48-item measure of maladaptive dependency. Our goal was to develop and psychometrically evaluate a very brief version of the IDI. An exploratory factor analysis of the IDI in Study 1 ( N = 838) yielded a six-item IDI (IDI-6), with three items loading on an emotional dependency factor (IDI-6-ED), and the other three items loading on a functional dependency factor (IDI-6-FD). This factor solution was validated by confirmatory factor analysis in Study 2 ( N = 916). The IDI-6-ED and IDI-6-FD demonstrated good convergent and divergent validity in Study 3 ( N = 100). In Study 4 ( N = 22-43), the IDI-6-ED and IDI-6-FD were generally stable over 4-week and 8-week intervals and were found to be responsive to the effects of psychological treatment. These results have implications for dependency conceptualizations and support the IDI-6 as a brief, psychometrically sound instrument.

Disambiguating Dependency and Attachment Among Conjugally Bereaved Adults

This study aims to investigate the effects of dependency and attachment in adjusting to the loss of a loved one by directly comparing the relative contribution of each to bereavement outcomes among midlife adults. Comparisons among attachment and dependency are made using models that control for attachment among three groups of bereaved adults (N=102): prolonged grievers (n=25), resolved grievers (n=41), and a married comparison group (n=36). Prolonged grievers displayed higher marginal means of dysfunctional detachment dependency and lower marginal means of healthy dependency compared to resolved grievers and married adults, even when controlling for attachment style. Findings suggest that attachment and dependency predict unique domains of grief outcome.

Absolute and relative short-term stability of interpersonal dependency in suicide attempters

Previous studies have reported an association between suicide and interpersonal dependency (IPD), but no study has examined whether IPD constitutes a state-dependent phenomenon or an enduring personality trait in this association. The aims of the present study were, firstly, to evaluate both the absolute and the relative stability of IPD as well as depression in suicide attempters and, secondly, to examine whether the relative stability of IPD was related to the depressive level rated on admission and/or at follow-up. The sample consisted of 41 suicide attempters evaluated on admission and 1 month later. The subjects filled in the Interpersonal Dependency Inventory (IDI) and the Beck Depression Inventory-II (BDI-II). The absolute and the relative stability of depression and IPD were analyzed using paired t-tests and Pearson's or intraclass correlation coefficients, respectively. The relative stability of IPD, taking into account the changes of the depressive level, was tested by two regression analyses. In the first regression analysis follow-up, the IDI scores were the dependent variable and the baseline IDI scores and BDI-II scores were the predictors. In the second regression analysis, the IDI change scores were the dependent variable and the BDI-II change scores were the predictors. Absolute and relative stability were demonstrated for IPD, whereas depression presented only relative stability. The IPD scores on admission were also significant predictors of the follow-up IPD scores after controlling for depression level. The 1-month duration of follow-up may be too brief to detect any decrease in the level of IPD. In conclusion, in contrast with the depression scores, the IPD scores presented short-term absolute and relative stability, and these results support the view that IPD is a stable personality trait in suicide attempters. The stability of IPD in suicide attempters suggests the interest of specific therapeutic approaches of this personality trait.

Adaptive and Maladaptive Dependency in Bereavement: Distinguishing Prolonged and Resolved Grief Trajectories

Interpersonal dependency is typically viewed as a risk factor for prolonged grief among conjugally bereaved adults. However, emerging empirical evidence and theoretical advances suggest that one manifestation of interpersonal dependency--adaptive dependency--may serve as a protective factor in coping with loss. This study compared adaptive and maladaptive dependency across three matched groups: prolonged grievers, asymptomatically bereaved adults, and a married comparison group. Results suggest a link between adaptive dependency and asymptomatic bereavement, and between maladaptive dependency and prolonged grief.

[Affective dependency and psychiatry: a discord]

INTRODUCTION

The term "loving dependence" is increasingly used by professionals of the relation of help and the patients themselves. It joins in the wider spectre of the interpersonal dependency. More and more patients suffering from this disorder are coming for psychiatric consultation. However, this notion remains vague and absent in the vocabulary of the psychiatrists. Globally, this term describes the functioning of certain patients who present a fear of not being loved and a dependency on another person. The fear of not being loved provokes a fear of abandonment or incites development of strategies to be loved (seduce, help). Dependency on another person is a consequence of the lack of confidence in the capabilities of the individual. The other person reassures them because this person does what the patient is afraid of doing, because he/she does not feel capable. The lack of confidence in own's capabilities can also incite the individual to become a perfectionist and successful. The fear of not being loved and of not being competent is determined partly in the person's childhood. These impressions are real and/or the individuals are hypersensitive.

AIM OF THE PAPER

The article describes the emotional, cognitive and behavioural levels, the various types of interpersonal dependency: dependences of type "umbilical cord", "rescuer", "stereotype" and "against dependence". The objective is to specify the concept better on clinical level, with the aim of defining criteria and pathological limits. This is the first stage before beginning rigorous scientific research. The stakes are high. There are relationships with anxiety, depressive disorders, alcoholism, food behaviour disorders, suicide and somatic pathologies.

DISCUSSION

Dependency seems to be the consequence of a pathological expression of the normal dimensions of the personality: the need to be loved and valued (admired). The onset of dependency occurs in stages, when the person is weakened by events of life or by depression. The impression not to have been loved and/or valued in childhood is vulnerability. We detail the common points and the differences between the types of described dependences and the diagnostic categories of the DSM. The category-specific classification of the DSM is not adapted to making a diagnosis in these patients. To diagnose a pathological personality, the patient has to be constantly in a functioning of pathological intensity, which is not still the case. This is a real problem, because these clinical situations are very frequent. We defend a dimensional approach of the personality disorders. A meeting between the psychiatry and the relationally dependent person is possible, on one hand in a dimensional classification of personality disorders and, on the other, by working on self-esteem. The relational dependency and self-esteem share the same appearances and the same causes. There are two different names from the same identity.

The complex relationship between dependency and domestic violence: Converging psychological factors and social forces

Research indicates that economic dependency in women and emotional dependency in men independently contribute to domestic-partner abuse risk and that high levels of emotional dependency in an abused partner may reduce the likelihood that the victimized person will terminate the relationship. An analysis of psychological factors and social forces that contribute to domestic violence suggests that multimodal intervention strategies are needed to combat this complex problem.