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Bornstein RF, Porcerelli JH, Jones JR. Dependency, Detachment, and Health-Related Behavior in Adult Primary Care Patients. J Clin Psychol Med Settings 2023; 30:699-707. [PMID: 36781518 DOI: 10.1007/s10880-023-09943-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2023] [Indexed: 02/15/2023]
Abstract
This investigation examined links between three related personality styles as assessed with the Relationship Profile Test-destructive overdependence, dysfunctional detachment, and healthy dependency-and indices of health and health-related behavior in a mixed-sex (74% female) sample of 100 primary care patients with a mean age of 38.62 (SD = 12.99). Fourteen primary care physicians also participated. As hypothesized, destructive overdependence and dysfunctional detachment scores were positively correlated with number of contacts with the emergency department; healthy dependency scores were inversely related to emergency department contacts and number of overnight hospitalizations. Healthy dependency scores were associated with an array of positive health behaviors; destructive overdependence scores were negatively associated with positive health behaviors. In addition, healthy dependency scores were inversely related to physician ratings of a difficult doctor-patient relationship. These results demonstrate that destructive overdependence, dysfunctional detachment and healthy dependency scores are associated in expected ways with indices of health and health-related behavior, and help illuminate the underlying factors that contribute to comparatively poor health and variations in health service use among overdependent and detached medical patients.
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Affiliation(s)
| | - John H Porcerelli
- Department of Psychology, University of Detroit Mercy, Detroit, MI, 48221-3038, USA.
- Doctoral Program in Clinical Psychology, University of Detroit Mercy, 4004 W. McNichols Road, 142 Reno Hall, Detroit, MI, 48221-3038, USA.
| | - John R Jones
- United States Air Force, Wilford Hall Ambulatory Surgical Center, San Antonio, TX, USA
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Gritti ES, Bornstein RF, Costantini G, Harris ET, Barbot B. Italian Version of the Relationship Profile Test (RPT-I): Temporal Stability, Construct Validity, and Cross-Cultural Comparison. J Pers Assess 2021; 104:335-346. [PMID: 34282977 DOI: 10.1080/00223891.2021.1947309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
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.
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Affiliation(s)
| | | | - Giulio Costantini
- Psychology Department, Università degli Studi di Milano-Bicocca, Milano, Italy
| | | | - Baptiste Barbot
- Psychological Sciences Research Institute, Universite catholique de Louvain, Louvain-la-Neuve, Belgium
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Personality Pathology in Primary Care: Ongoing Needs for Detection and Intervention. J Clin Psychol Med Settings 2018; 25:43-54. [DOI: 10.1007/s10880-017-9525-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Denckla CA, Consedine NS, Bornstein RF. Self-compassion mediates the link between dependency and depressive symptomatology in college students. SELF AND IDENTITY 2016; 16:373-383. [PMID: 30140175 DOI: 10.1080/15298868.2016.1264464] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
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.
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Affiliation(s)
- Christy A Denckla
- T. H. Chan School of Public Health, Harvard University, Cambridge, MA, USA.,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard University, Cambridge, MA, USA
| | - Nathan S Consedine
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Robert F Bornstein
- Gordon F. Derner Institute of Advanced Psychological Studies, Adelphi University, Garden City, NY, USA
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Haggerty G, Siefert CJ, Bornstein RF, Sinclair SJ, Blais MA, Zodan J, Rao N. Correlates of interpersonal dependency and detachment in an adolescent inpatient sample. Bull Menninger Clin 2015; 79:281-304. [PMID: 26682828 DOI: 10.1521/bumc.2015.79.4.281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Interpersonal dependency has been linked to psychological distress, depression, help seeking, treatment compliance, and sensitivity to interpersonal cues in adult samples. However, there is a dearth of research focusing on dependency in child and adolescent samples. The current study examined the construct validity of a measure of interpersonal dependency. The authors investigated how interpersonal dependency and detachment relate to behavioral problems, subjective well-being, interpersonal problems, and global symptom severity in adolescent inpatients. Destructive overdependence (DO) and dysfunctional detachment (DD) were positively related to interpersonal distress, behavioral problems, and symptom severity and negatively related to psychological health and well-being. Healthy dependency (HD) was associated with fewer behavioral problems and less symptom severity and positively related to subjective well-being. The clinical implications of these findings are discussed.
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Affiliation(s)
- Greg Haggerty
- Van Tauber Institute for Global Psychiatry, Nassau University Medical Center, East Meadow, New York
| | | | - Robert F Bornstein
- Derner Institute of Advance Psychological Studies, Adelphi University, Garden City, New York
| | | | - Mark A Blais
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jennifer Zodan
- Van Tauber Institute for Global Psychiatry, Nassau University Medical Center, East Meadow, New York
| | - Nyapati Rao
- Van Tauber Institute for Global Psychiatry, Nassau University Medical Center, East Meadow, New York
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Haggerty G, Bornstein RF, Khalid M, Sharma V, Riaz U, Blanchard M, Siefert CJ, Sinclair SJ. Construct Validity of the Relationship Profile Test: Links With Measures of Psychopathology and Adult Attachment. J Pers Assess 2015; 98:82-7. [PMID: 26620463 PMCID: PMC4703550 DOI: 10.1080/00223891.2015.1110824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study assessed the construct validity of the Relationship Profile Test (RPT; Bornstein & Languirand, 2003 ) with a substance abuse sample. One hundred-eight substance abuse patients completed the RPT, Experiences in Close Relationships Scale-Short Form (Wei, Russell, Mallinckrodt, & Vogel, 2007 ), Personality Assessment Inventory (Morey, 1991 ), and Symptom Checklist-90-Revised (Derogatis, 1983 ). Results suggest that the RPT has good construct validity when compared against theoretically related broadband measures of personality, psychopathology, and adult attachment. Overall, health dependency was negatively related to measures of psychopathology and insecure attachment, and overdependence was positively related to measures of psychopathology and attachment anxiety. Many of the predictions regarding RPT detachment and the criterion measures were not supported. Implications of these findings are discussed.
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Affiliation(s)
- Greg Haggerty
- a Von Tauber Institute for Global Psychiatry, Nassau University Medical Center
| | - Robert F Bornstein
- b Derner Institute of Advanced Psychological Studies, Adelphi University
| | - Mohammad Khalid
- a Von Tauber Institute for Global Psychiatry, Nassau University Medical Center
| | - Vishal Sharma
- a Von Tauber Institute for Global Psychiatry, Nassau University Medical Center
| | - Usman Riaz
- a Von Tauber Institute for Global Psychiatry, Nassau University Medical Center
| | - Mark Blanchard
- b Derner Institute of Advanced Psychological Studies, Adelphi University
| | - Caleb J Siefert
- c Department of Behavioral Sciences , University of Michigan-Dearborn
| | - Samuel J Sinclair
- d Psychological Evaluation and Research Laboratory (PEaRL), Massachusetts General Hospital/Harvard Medical School
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Denckla CA, Bornstein RF, Mancini AD, Bonanno GA. Extending the construct validity of dependency among conjugally bereaved adults. Assessment 2014; 22:385-93. [PMID: 25038214 DOI: 10.1177/1073191114542597] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Relationship Profile Test is a widely used measure of dependency, detachment, and healthy dependency that has been examined in both clinical and nonclinical settings, though researchers have yet to validate this measure among conjugally bereaved adults. The present study examines the construct validity of a three-facet model of dependency-detachment by comparing relationships among self-report, semistructured interview-rated, and knowledgeable informant-rated functioning among conjugally bereaved adults. Participants (N = 112) included bereaved adults (M = 51.1 years; SD = 9.7) who had experienced the loss of a spouse 1.5 to 3 years prior to taking part in this study. Findings indicate adequate psychometric properties and theoretically expected associations with various measures of wellness and health including satisfaction with life, coping flexibility, somatic complaints, and ego resiliency. Results draw attention to adaptive correlates of dependency, suggesting potentially beneficial mental health interventions.
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Huprich S, Rosen A, Kiss A. Manifestations of interpersonal dependency and depressive subtypes in outpatient psychotherapy patients. Personal Ment Health 2013; 7:223-32. [PMID: 24343965 DOI: 10.1002/pmh.1222] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 11/20/2012] [Accepted: 11/28/2012] [Indexed: 11/08/2022]
Abstract
The present study investigated the relationship between normative and pathological dependency and anaclitic and introjective depressive experiences among 71 patients participating in outpatient psychotherapy at a university-based psychology clinic. We examined the interrelationships among the Relationship Profile Test subscales, the Depressive Experiences Questionnaire subscales and the Outcome Questionnaire-45.2. Results indicated that destructive overdependence was positively correlated with anaclitic and introjective depression and negatively correlated with overall perceptions of mental health. Dysfunctional detachment was positively correlated with introjective depression and negatively correlated with generalized perceptions of one's own mental health. Healthy dependency was negatively correlated with introjective depression and positively correlated with mental health. These results not only support the construct validity of the Relationship Profile Test but also shed light on a link between depression, dependence and self-criticism.
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Healthy and Maladaptive Dependency and Its Relationship to Pain Management and Perceptions in Physical Therapy Patients. J Clin Psychol Med Settings 2013; 20:508-14. [DOI: 10.1007/s10880-013-9372-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Contrary to clinical lore, a dependent personality style is associated with active as well as passive behavior and may be adaptive in certain contexts (e.g., in fostering compliance with medical and psychotherapeutic treatment regimens). The cognitive/interactionist model conceptualizes dependency-related responding in terms of four components: (a) motivational (a marked need for guidance, support, and approval from others); (b) cognitive (a perception of oneself as powerless and ineffectual); (c) affective (a tendency to become anxious when required to function autonomously); and (d) behavioral (use of diverse self-presentation strategies to strengthen ties to potential caregivers). Clinicians' understanding of the etiology and dynamics of dependency has improved substantially in recent years; current challenges include delineating useful subtypes of dependency, developing valid symptom criteria for Dependent Personality Disorder in DSM-5 and beyond, and working effectively with dependent patients in the age of managed care.
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Affiliation(s)
- Robert F Bornstein
- Derner Institute of Advanced Psychological Studies, Adelphi University, Garden City, New York 11530
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Denckla CA, Mancini AD, Bornstein RF, Bonanno GA. Adaptive and Maladaptive Dependency in Bereavement: Distinguishing Prolonged and Resolved Grief Trajectories. PERSONALITY AND INDIVIDUAL DIFFERENCES 2011; 51:1012-1017. [PMID: 21984858 DOI: 10.1016/j.paid.2011.08.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
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.
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Affiliation(s)
- Christy A Denckla
- Gordon F. Derner Institute of Advanced Psychological Studies, Adelphi University
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