Construct validity of the relationship profile test: a self-report measure of dependency-detachment

Intrapersonal dynamics of closeness versus distance: Qualities of the self-concept distinguish destructive overdependence, dysfunctional detachment, and healthy dependency

INTRODUCTION

People vary in the degree to which they affiliate with others; exaggerated efforts maintain interpersonal closeness versus distance are codified in longstanding categorical models of personality pathology, and in contemporary dimensional frameworks as well.

OBJECTIVE

To examine associations between destructive overdependence (DO), dysfuntional detachment (DD), and healthy dependency (HD) and qualities of the self-concept.

METHOD

A mixed-sex sample of 229 adults completed the Relationship Profile Test to assess DO, DD, and HD, and the Object Relations Inventory (ORI) to assess qualities of the self-concept.

RESULTS AND CONCLUSION

Analyses indicated that (1) the ORI Strong dimension was uniquely predictive of DO (inversely related); (2) ORI Warm and Nurturing were unique predictors of DD (both inversely related); and (3) ORI Nurturing and Successful were unique predictors of HD. This study illuminates key intrapersonal features of these three personality styles.

Dependency, Detachment, and Health-Related Behavior in Adult Primary Care Patients

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.

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.

Intergenerational Trauma, Dependency, and Detachment

ABSTRACT

The literature on intergenerational transmission of trauma is predominantly focused on the mental health functioning of children and grandchildren of trauma survivors. Research shows that having a traumatized parent is related to increased psychopathology and dysfunctional attachment patterns in the next generation, but little is known about the effects of parental trauma on other aspects of interpersonal relating. The current study addresses this gap. Participants were young adult students from an urban college; individual and parental trauma histories, and indices of unhealthy dependency, dysfunctional detachment, and healthy dependency, were obtained. Results indicated that a wide range of parental traumas were positively correlated with dysfunctional detachment, but not related to destructive overdependence or healthy dependency. These results suggest that a wide range of parental traumas have a negative impact on the next generation's interpersonal dependency by fostering a tendency to distance themselves from close relationships.

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.

Intergenerational Transmission of Violence Among Substance-Abusing Chinese Parents: Roles of Detachment and Social Support

Despite a large population of registered people with drug addiction, child protection in substance-abusing families is a neglected issue in China. The present study aims to investigate the association between parents' childhood abuse history and the risk of abusing their own children in substance-abusing Chinese families and also to examine the mediating role of detachment and moderating role of social support during the intergenerational transmission of abuse. A total of 173 men and 116 women were selected using cluster sampling from two compulsory drug rehabilitation centers in Jiangsu Province. Results indicated that one's childhood abuse history was positively associated with the current perpetration of child abuse for both fathers and mothers. Detachment mediated the linkage between a history of childhood maltreatment and perpetration of child abuse in all types of abuse for both men and women except for women's sexual abuse. Social support from family members buffered the intergenerational transmission of child abuse for fathers but not for mothers. Child maltreatment in substance-abusing families is an urgent issue that needs measures to prevent the intergenerational transmission of violence in China. Intervention programs could involve helping parents cope with their childhood abuse history through rebuilding secure attachment and facilitating social support for their parenting practices, especially for fathers.

Vocabulary knowledge and reading comprehension account for SES-differences in how school-aged children infer word meanings from sentences

Socioeconomic status (SES)-related language gaps are known to widen throughout the course of the school years; however, not all children from lower SES homes perform worse than their higher SES peers on measures of language. The current study uses mediation and moderated mediation to examine how cognitive and language abilities (vocabulary, reading, phonological processing, working memory) account for individual differences in a children's ability to infer a novel word's meaning, a key component in word learning, in school-aged children from varying SES backgrounds. Vocabulary and reading comprehension mediated the relationship between SES and accuracy when inferring word meanings. The relationship between SES, vocabulary, and inferring word meaning was moderated by age, such that the influence of vocabulary on task performance was strongest in young children. The reading pathway did not interact with age effects, indicating reading is an important contributor to SES-related differences in how children infer a word's meaning throughout grade school. These findings highlight different paths by which children's trajectories for inferring word meanings may be impacted.

Context-Driven Variability in Personality and Interpersonal Behavior: Evidence-Based Assessment Strategies

How can assessors capture context-driven variability in personality and interpersonal behavior in ways that are both empirically sound and clinically useful? Scott et al. (2021) offer one potential solution as they discuss the Relational Self-Schema Measure, designed to assess variations in the self-schema across different relationship domains (e.g., self-with-parents, self-with-friends). This Comment outlines an evidence-based framework for assessing variability in personality and interpersonal behavior, describing three strategies that may be used by practitioners in the clinic and beyond. These are: 1) complementing decontextualized personality test results with domain-specific self-report and performance-based test data; 2) employing ambulatory assessment techniques to capture contextual variations in responding in vivo; and 3) using nomothetic test results as a springboard for patient narrative, with patient and therapist working together to explore relationship-specific variations in personality and interpersonal behavior.

Anaclitic-sociotropic and introjective-autonomic personality dimensions and depressive symptoms: a systematic review

Sociotropy (anaclitic) and autonomy (introjective) are conceptualised as two personality dimensions that confer vulnerability to depression. According to Blatt and Beck's theories, sociotropic individuals exhibit distinctive patterns of symptoms such as prominent anxiety, depressed mood, helplessness, crying and somatic concerns, while self-critical ones seem to exhibit a pattern of symptoms including prominent guilt, hopelessness, feelings of failure and worthlessness and other cognitive symptoms.This systematic review was performed with the aim of investigating whether and to what extent psychological dimensions of anaclitic-sociotropic and introjective-autonomy are related to a specific core of depressive symptoms. The search was conducted in three databases (PubMed, PsycINFO and Scopus) and 27 articles were selected.Results showed a weak association between somatic symptoms and dependent personality traits, while the relationship between self-criticism and cognitive symptomatology was significantly higher. These findings are discussed in the context of future research, necessary to corroborate the existence of a form of depression characterised by somatic features usually ignored by diagnostic criteria, essential to direct psychological treatments to these depressive personality differences.

Assessing Self-Definition and Relatedness in Level of Personality Functioning

The two polarities model (TPM) of personality organizes psychological assessment and psychotherapy and connects to personality disorder diagnosis using the DSM-5 Alternative Model for Personality Disorders (AMPD). The authors developed scales assessing the TPM from an existing self-report measure for level of personality functioning (LPF), a core component of the AMPD. Iterative content analyses of the LPF measure yielded scales for Autonomy and Communion corresponding to dimensions of the TPM. The scales were refined via internal consistency analyses using a measure of psychological attachment and studied in development and validation samples. Associations with relevant external criteria were explored in a series of multiple regressions. The new content-based LPF scales were illustrated with a case vignette. Although the new Autonomy/Communion scales await further validation prior to clinical use, initial evidence suggests that they may bridge the nomological nets of the TPM and AMPD and potentially offer clinical utility in assessment and treatment planning.

Jealousy, Violence, and Sexual Ambivalence in Adolescent Students According to Emotional Dependency in the Couple Relationship

BACKGROUND

Emotional dependency in couples involves excessive and dysfunctional emotional bonding.

AIMS

This work aimed to determine the relationship between violence, jealousy, and ambivalent sexism according to emotional dependence in adolescent student couples.

METHODS

A cross-sectional study. A total of 234 Spanish adolescents (69.7% female, M_age = 16.77, SD = 1.11) participated in the study. Participants completed an ad hoc interview and several validated tests (Partner's Emotional Dependency Scale, the Ambivalent Sexism Inventory, the Jealousy subscale of the Love Addiction Scale, the Conflict in Adolescent Dating Relationship Inventory).

RESULTS

Of the sample, 40.6% indicated high emotional dependence and 14.5% extreme emotional dependence. Differences were observed according to gender (t = 3.92, p < 0.001), with adolescent boys scoring higher than adolescent girls. Extremely emotionally dependent participants showed differences in both violence (sexual, relational, verbal, and physical) and ambivalent sexism (hostile, benevolent) and jealousy scores. Generating a predictive model of emotional dependence, with the variable jealousy and ambivalent sexism as predictor variables, it was found that jealousy has the greatest predictive and major explanatory capacity (R² = 0.297); with an R² = 0.334. However, the contribution of the ASI-Hostile subscale was not significant when the ASI-Benevolent subscale was introduced into the model. Further, in a second model where the scores on jealousy and the couple conflict inventory's subscales were considered as predictors, are again jealousy makes the greatest predictive contribution and shows the greatest explanatory capacity (R² = 0.296). It was found that the contribution is significant only for the predictive capacity of Sexual Violence and Relational Violence. In this sense, the educational context is one of the propitious places to detect and correct behaviors that may be indicative of potentially unbalanced and unbalancing relationships for adolescents.

Associations between social contagion, group conformity characteristics, and non-suicidal self-injury

The current study aimed to better understand the relationship between exposure to non-suicidal self-injury (NSSI) through peers, group conformity characteristics (i.e., over-dependency, need-to-belong), and personal NSSI engagement. Methods: One hundred thirty-eight undergraduate students (n = 40 with history of NSSI) completed an online survey about NSSI history and exposure as well as their interpersonal dependency and need-to-belong in a group. Results: Results indicated that NSSI participants (NSSI+) were more likely to be exposed to NSSI in-person (IP+). NSSI+/IP + participants were more likely to think about NSSI post-media exposure and reported higher over-dependency and need-to-belong than NSSI-/IP-. Conclusions: Findings suggest that being exposed to NSSI in-person and having higher over-dependency and need-to-belong are associated with personal NSSI engagement.

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.

Associations between interpersonal dependency and severity of prolonged grief disorder symptoms in bereaved surviving family members

BACKGROUND

Several studies have shown that interpersonal dependency is a risk factor for prolonged grief disorder (PGD), a disorder that has been recently approved by the American Psychiatric Association Assembly for inclusion in the Diagnostic and Statistical Manual of Mental Disorders-5-Text Revision (DSM-5-TR). Nevertheless, it remains unclear whether this relationship is independent of depression, which may also be related to both loss and interpersonal dependency. Furthermore, anaclitic dependency (maladaptive and immature) compared to relatedness (more adaptive and mature) dependency, and the relationships between these types of dependency and PGD, have not been examined. The aim of the present study was to determine how anaclitic and relatedness dependency are associated with PGD symptom severity, controlling for depressive symptom severity, over and above potential sociodemographic and loss-related confounder variables.

METHODS

Participants (N = 241) bereaved after the death of a family member from 0.5 to 8 years before the survey (M = 3.36, SD = 2.02) completed the Depressive Experiences Questionnaire, the Patient Health Questionnaire-9, and the Prolonged Grief Disorder-13 scale (PG-13).

RESULTS

A hierarchical regression analysis confirmed that anaclitic dependency is positively associated with PGD symptom severity, even when controlling for depression severity and other potential confounder variables. There was no significant association between relatedness dependency and PGD.

CONCLUSIONS

To assess the risk of PGD in individuals bereaved after the death of a family member, it is important to assess anaclitic dependency.

Prolonged grief and posttraumatic stress disorder following the loss of a significant other: An investigation of cognitive and behavioural differences

BACKGROUND

Cognitive behavioural correlates to bereavement-related mental health problems such a Prolonged Grief Disorder (PGD) and Posttraumatic Stress Disorder (PTSD) are of theoretical and clinical importance.

METHODS

Individuals bereaved at least six months (N = 647) completed measures of loss-related cognitions and behaviours (i.e., loss-related memory characteristics, negative appraisals, coping strategies, grief resilience, and perceived social disconnection) and measures of PGD and PTSD symptoms. Individuals were assigned to one of four groups depending on probable clinical diagnoses (No-PGD/PTSD, PTSD, PGD, PGD+PTSD).

RESULTS

Results indicated that higher loss-related memory characteristics and lower grief resilience increased the likelihood of a clinical problem. The PGD and PGD+PTSD groups reported significantly higher loss-related memory characteristics and appraisals compared to the PTSD group. Social disconnection increased the likelihood of comorbid PGD+PTSD in comparison to any other group.

CONCLUSIONS

Results indicate cognitive differences between loss-related cognitions, memory characteristics and coping strategies between PGD and PTSD, and points to distinct cognitive correlates to psychopathology following loss.

Neediness and connectedness and the five‐factor model of personality

This study examined maladaptive and relatively more adaptive forms of dependency, as measured by the neediness and connectedness factors of the Depressive Experiences Questionnaire (DEQ; Blatt, D'Afflitti, & Quinlan, 1976), within a comprehensive scheme of personality provided by the revised NEO Personality Inventory (NEO‐PI‐R; Costa & McCrae, 1992). University students (n = 475) completed the DEQ, NEO‐PI‐R, and a measure of depressive symptoms. Results indicated that neediness reflected anxiety, self‐consciousness, vulnerability, unassertiveness, and inactivity, whereas connectedness reflected anxiety, warmth, agreeableness, and valuing of relationships. Neediness demonstrated stronger relations than connectedness with depressive symptoms. These results support the validity of DEQ neediness and connectedness as measures of maladaptive and relatively more adaptive forms of dependency. Copyright © 2006 John Wiley & Sons, Ltd.

Entitled Due to Deprivation vs. Superiority: Evidence That Unidimensional Entitlement Scales Blend Distinct Entitlement Rationales across Psychological Dimensions

We aimed to corroborate the notion that the Psychological Entitlement Scale (PES), a popular unidimensional index of psychological entitlement, resembles a blend of vulnerable- and grandiose-based entitlement rationales across various psychological dimensions. College participants (N = 523) were randomly assigned to complete either the PES or a recently validated, multidimensional adaptation of the PES that purports to assess entitlement due to deprivation (vulnerable-based entitlement; "PES-V") and superiority (grandiose-based entitlement; "PES-G") claims. Participants then completed a battery of psychological dimensions including: narcissism constructs, interpersonal vulnerability and mood pathology, psychological health, normal personality and personality-disorder traits, motivation systems, a deprived identity, and status aspiration. Profile-similarity indices indicated that PES was more similar to PES-G than PES-V across psychological dimensions. Likewise, additional analyses revealed that indicators of "narcissistic entitlement" exhibited stronger profile similarity to PES-G than PES-V across psychological dimensions. In conclusion, profiles of the PES and narcissistic entitlement appear to blend grandiose- and vulnerable-based entitlement, but grandiose-based (vs. vulnerable-based) entitlement seems more prominent in the blend. As a result, unidimensional measures can create a somewhat misleading portrait of the psychologically entitled.

Cognitive predictors of grief trajectories in the first months of loss: A latent growth mixture model

Objective: The identification of modifiable cognitive antecedents of trajectories of grief is of clinical and theoretical interest. Method: The study gathered 3-wave data on 275 bereaved adults in the first 12–18 months postloss (T1 = 0–6 months, T2 = 6–12 months, T3 = 12–18 months). Participants completed measures of grief severity, cognitive factors (loss-related memory characteristics, negative appraisals, unhelpful coping strategies, and grief resilience), as well as measures of interpersonal individual differences (attachment and dependency). Latent growth mixture modeling was used to identify classes of grief trajectories. Predictors of class membership were identified using multinomial logistic regression and multigroup structural equation modeling. Results: Four latent classes were identified: 3 high grief classes (Stable, Low Adaptation, and High Adaptation) and a low grief class (Low Grief). When considered separately, variance in all four cognitive factors predicted membership of the high grief classes. When considered together, membership of the high grief classes was predicted by higher mean scores on memory characteristics. More negative appraisals predicted low or no adaptation from high grief severity. Losing a child also predicted membership to the stable class. Fast adaptation of high grief was predicted by a pattern of high memory characteristics but low engagement with unhelpful coping strategies. Conclusions: The findings have implications for clinical practice and point to early cognitive predictors of adaptation patterns in grief. Findings are consistent with cognitive models highlighting the importance of characteristics of memory, negative appraisals, and unhelpful coping strategies in the adaptation to highly negative life events.

The study identifies a number of modifiable cognitive predictors that are linked to grief severity and maintenance in the first months of loss. Targeting these cognitive predictors in the first 6 months of loss may prove helpful in facilitating grief adaptation.

Trait interpersonal vulnerability attenuates beneficial effects of constructive criticism on failure responses

The extant literature on interpersonal criticism suggests that relative to destructive criticism, constructive criticism significantly minimizes the injurious psychological aftermath people experience after failure. However, we propose the possibility that for some people, these psychological benefits of constructive criticism are less apparent. Specifically, we hypothesized that for people high in trait interpersonal vulnerability, a construct marked by maladaptive cognitive-emotional responses in interpersonal contexts and/or by dysfunctional relational concerns, effects of constructive (vs. destructive) criticism on reduced maladaptive appraisals will diminish, and this diminution of reduced maladaptive appraisals will predict downstream effects on worsened post-failure mood. An experiment had a college sample (N = 349) complete four instruments represented under an interpersonal vulnerability construct (IVC). Next, participants imagined failing in various domains and receiving subsequent feedback from emotionally important others. Feedback type was manipulated to typify either destructive criticism or constructive criticism. Finally, participants provided ratings of maladaptive appraisals and post-failure mood. Latent variable path modelling supported hypotheses. Effects of constructive (vs. destructive) criticism on reduced maladaptive appraisals (namely, shame proneness) diminished as IVC increased, which predicted worsened post-failure mood. Findings have implications for multidisciplinary theoretical perspectives relevant to interpersonal vulnerability and offer practical considerations for clinicians working with vulnerable clients.

Malignant Self-Regard in clinical outpatient samples

While the malignant self-regard construct and a corresponding questionnaire, the Malignant Self-Regard Questionnaire (MSRQ; Huprich, 2011) have been empirically evaluated in several non-clinical samples, it has yet to be evaluated in a clinical population. In this study, 139 outpatients in the Departments of Psychiatry and Behavioral Sciences (n = 83) and Internal Medicine (n = 57) were administered the MSRQ and a number other measures to assess its construct and incremental validity. The MSRQ was internally consistent in both samples, and was positively correlated with four dimensions of levels of personality functioning, DSM-5 personality trait domains, overdependence, detachment, insecure attachment, and general perceptions of physical and mental well-being. Furthermore, the MSRQ incrementally predicated variance in levels of personality functioning, interpersonal dependency, and general perceptions of physical and mental well-being above and beyond DSM-5 traits and (where appropriate) levels of personality functioning. These findings converge with studies of the MSRQ in nonclinical samples and support the clinical utility and validity of the MSRQ for further use.

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.

Interpersonal dependency and online gaming addiction

Background and aims The present study explores the relationship between social motivations and addiction to online gaming and if that possible connection can be explained by the personality traits responsible for social functioning. Methods We employ Bernstein's concept of interpersonal dependency to distinguish healthy dependency, dysfunctional detachment, and destructive overdependence, and Charlton and Danforth's conceptualisation of online gaming addiction and high engagement. An online questionnaire was administered to a self-nominated sample of 4,074 online gamers. Two regression models were constructed to separately explain gaming addiction and high engagement using social motivations to play, while controlling for age, gender, and time spent online. Results High scores on subscales measuring dysfunctional detachment and destructive overdependence were positively associated with online gaming addiction, while healthy dependency was negatively correlated with addiction scores. In contrast, the overall role of social motivation was negligible. Discussion People with healthy relationship profiles are less likely to develop problematic patterns of online gaming. High in-game engagement, although sharing some factors with addiction, was only poorly explained by the study variables, suggesting the mutual exclusiveness of addiction and engagement.

Correlates of interpersonal dependency and detachment in an adolescent inpatient sample

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.

Beyond Description in Interpersonal Construct Validation: Methodological Advances in the Circumplex Structural Summary Approach

The interpersonal circumplex is a well-established structural model that organizes interpersonal functioning within the two-dimensional space marked by dominance and affiliation. The structural summary method (SSM) was developed to evaluate the interpersonal nature of other constructs and measures outside the interpersonal circumplex. To date, this method has been primarily descriptive, providing no way to draw inferences when comparing SSM parameters across constructs or groups. We describe a newly developed resampling-based method for deriving confidence intervals, which allows for SSM parameter comparisons. In a series of five studies, we evaluated the accuracy of the approach across a wide range of possible sample sizes and parameter values, and demonstrated its utility for posing theoretical questions on the interpersonal nature of relevant constructs (e.g., personality disorders) using real-world data. As a result, the SSM is strengthened for its intended purpose of construct evaluation and theory building.

Construct Validity of the Relationship Profile Test: Links With Measures of Psychopathology and Adult Attachment

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.

Predictors of Prolonged Grief, Resilience, and Recovery Among Bereaved Spouses

OBJECTIVE

Most reactions to loss can be characterized by three prototypical trajectories of resilience, gradual recovery, and chronic distress (Bonanno, ). However, research on the factors that uniquely predict these trajectories of response has been limited. We examined theoretically relevant predictors of each of the trajectory patterns.

METHOD

We assessed 115 bereaved spouses at 1.5 to 3 years postloss and 74 married controls. To identify grief trajectory, we provided bereaved participants with a graphical depiction of the trajectories and asked them to select the one that best described their experience.

RESULTS

Group comparisons revealed substantial differences between resilient and prolonged grievers, and almost no differences between resilient and married controls. Multivariate analyses indicated that prolonged grief, when compared to resilience, was uniquely associated with maladaptive dependency traits, difficulty accessing positive memories of the deceased, and higher recalled marital adjustment.

CONCLUSION

The present results extend our understanding of factors associated with distinct trajectories of adjustment after loss.

The complex role of personality in cancer treatment: impact of dependency-detachment on health status, distress, and physician-patient relationship

Personality traits have been associated with positive and negative adjustment to a cancer diagnosis. No studies have assessed trait dependency and detachment and their relationship to health, distress, and the doctor-patient relationship in patients undergoing radiation treatment for cancer. Fifty adults (32 women; mean [SD], 60.32 [12.74] years) undergoing radiation treatment for a variety of cancers completed measures of dependency and detachment, doctor-patient relationship, physical health, somatization, anxiety, and depression. Overdependence scores were positively and significantly correlated with patients' anxiety and negatively and significantly correlated with the physician-patient relationship. Detachment scores were positively and significantly correlated with pain, somatization, depression, and anxiety and marginally associated with lower health-related quality of life. These preliminary findings support the construct validity and clinical utility of trait dependency and detachment testing with oncology patients and suggest that detachment is associated with poorer quality of life and higher psychological distress, whereas dependency is associated with poorer doctor-patient relationships after a cancer diagnosis.

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.

Extending the construct validity of dependency among conjugally bereaved adults

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.

Manifestations of interpersonal dependency and depressive subtypes in outpatient psychotherapy patients

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.

Illuminating a neglected clinical issue: societal costs of interpersonal dependency and dependent personality disorder

OBJECTIVES

To determine the degree to which patients with high levels of trait dependency or dependent personality disorder (DPD) engage in behaviors that harm themselves and others (e.g., domestic violence, child abuse).

METHOD

Six domains of literature were reviewed: (a) dependency as a risk factor for physical illness; (b) health care utilization and expenditures; (c) global and domain-specific functional impairment; (d) violence toward others; (e) victimization by others; and (f) self-harm.

RESULTS

High levels of trait dependency and DPD are associated with elevated risk for physical illness, partner and child abuse, and suicidality, as well as with high levels of functional impairment and increased health care expenditure.

CONCLUSIONS

Contrary to clinical lore, trait dependency and DPD are associated with behaviors that lead to myriad negative consequences for the dependent person, those close to them, and society as a whole. These patterns have noteworthy implications for assessment and treatment of dependent patients and suggest that DPD should be included as a diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition.

From Dysfunction to Adaptation: An Interactionist Model of Dependency

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.

Construct validity of the Schwartz Outcome Scale: validation using a 28-day inpatient chemical rehabilitation patient sample

The Schwartz Outcome Scale-10 (SOS-10) is a 10-item self-report that measures quality of life and psychological well-being. It is easy to administer and score, and past research has revealed its utility, validity, and reliability with different samples (i.e., clinical and nonclinical) and in different clinical settings (i.e., inpatient, outpatient, nonpsychiatry medical settings). The present study looks to investigate the utility of the SOS-10 in measuring psychological well-being and quality of life with the 28-day inpatient chemical dependency sample. In addition, the current study looks to investigate its ability to be used as a treatment outcome measure for chemical-dependent inpatients. The results revealed that the SOS-10 was associated with aspects of interpersonal dependency and alexithymia in predicted ways. The SOS-10 was positively associated to "Healthy Dependence" and negatively related to alexithymia and "Destructive Overdependence" and "Dysfunctional Detachment." The results also showed that the SOS-10 showed healthy change from admission to discharge and that this change was paralleled by healthy change in interpersonal dependency and alexithymia.

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.

Physical health correlates of pathological and healthy dependency in urban women

This study assessed the relationship between dependency and indicators of health/illness, healthcare costs, and utilization. Dependency ratings were obtained using the Relationship Profile Test (Bornstein and Languirand, 2003), a questionnaire that assesses healthy and pathological dependency: destructive overdependence (DO), dysfunctional detachment (DD), and healthy dependency (HD). The sample consisted of primarily low-income, African-American, and female primary care patients (N = 110). DO and DD were significantly associated with indices of increased illness, with DO evidencing slightly larger effect sizes than DD. HD was significantly (negatively) associated with 1 health/illness variable. DD and DO were associated with higher total outpatient costs with DD also being associated with average costs per visit. DO and HD were associated with utilization (increased hospital days and fewer emergency room visits, respectively). Further research is recommended to inform researchers and clinicians about the dependency-illness relationship and to develop interventions that maximize HD and minimize pathological dependency.

Expanding the Construct Validity of the Relationship Profile Test: Associations With Physical Health and Anaclitic and Introjective Traits

The authors examined the construct validity of the Relationship Profile Test (RPT) with respect to measures of two related constructs—physical health and well-being (functional health status), and depression-linked personality type (anaclitic vs. introjective). In Study 1, the authors administered the RPT, Depressive Experiences Questionnaire (DEQ), and Medical Outcomes Study Short Form (MOS SF-20) to 116 undergraduate students. In Study 2, the RPT, DEQ, and MOS SF-20 were administered to 110, mostly African American female, primary care outpatients. Destructive Overdependence was positively correlated with anaclitic and introjective trait scores in both samples. Dysfunctional Detachment was positively correlated with introjective scores in both samples and with anaclitic scores in the primary care sample. Healthy Dependency was negatively correlated with introjective scores in both samples and with anaclitic scores in the primary care sample. These studies support the construct validity of the RPT in ethnically diverse nonclinical and clinical samples, and extend previous findings documenting links between RPT subscale scores and scores on measures of other theoretically related constructs.

Personality traits measured by the Swedish universities Scales of Personality: factor structure and position within the five-factor model in an Estonian sample

The study aims to test the reliability and validity of the Estonian version of the Swedish universities Scales of Personality (SSP), and to characterize the position of the SSP-measured traits within the basic personality dimensions of the five-factor model. A total of 529 participants completed the Estonian version of the SSP. A subsample of 197 persons completed the SSP together with the Revised NEO Personality Inventory (NEO-PI-R). The internal consistency of the SSP scales was satisfactory. Principal component analysis yielded three factors representing neuroticism, aggression and disinhibition. The factor solution obtained in the Estonian sample was similar to the original SSP study in the Swedish normative sample. NEO-PI-R Neuroticism had highest correlations with SSP neuroticism factor scales. Extraversion had strongest relationship with adventure seeking and low detachment. Agreeableness correlated positively with SSP social desirability and negatively to aggression-irritability scales. Conscientiousness facet Deliberation correlated with Impulsiveness. The Estonian SSP showed acceptable reliability and validity, which confirms that SSP is applicable in different social and cultural background. The SSP measures traits that correspond to the major personality models. The SSP characterizes three broad dimensions of personality, namely neuroticism, disinhibition and aggression, which are useful in assessment of personality correlates of mental disorders.

The adaptive and maladaptive faces of dependency in later life: links to physical and psychological health outcomes

OBJECTIVES

Negotiating the balance between reliance on others and desires for autonomy is a fundamental task of successful aging. The purpose of the present study was to replicate and extend a three-factor model of interpersonal dependency in a sample of older adults, and to examine the physical and psychological health correlates of this multifaceted construct.

METHODS

Data come from the third wave of a population-based study of older Americans (n = 166; mean age 80 years). We conducted an exploratory factor analysis of selected dependency items from two scales, and then conducted logistic and hierarchical linear regressions to analyze the association of dependency factors with self-reported health, use of hypertension medication, depressed affect and positive affect.

RESULTS

We found three factors closely paralleling those of Bornstein and Languirand's (Psychological Bulletin, 112(1), 3-23, 2004) measure: destructive overdependence, healthy dependency and dysfunctional detachment, as well as a fourth factor we labeled 'healthy independence'. Healthy dependency was associated with better self-reported health. Dysfunctional detachment was related to a greater likelihood and healthy independence a lesser likelihood of taking hypertension medication. Whereas both healthy independence and healthy dependency were positively related to positive affect and negatively related to depressed affect, destructive overdependence was positively related to depressed affect.

CONCLUSION

Understanding the complex nature of interpersonal dependency and autonomy in old age, as well as their implications for health and wellbeing, may enable practitioners to assist older adults in negotiating the task of balancing these needs.