Convergent and divergent validity of the ... - Wiley Online Library

Convergent and Divergent Validity of the Relationship Profile Test: Investigating the Relationship With Attachment, Interpersonal Distress, and Psychological Health m

Greg Haggerty Nassau University Medical Center m

Margaret Blake Bellevue Hospital Center m

Caleb J. Siefert Massachusetts General Hospital/Harvard Medical School The present study looked to illustrate the convergent and divergent validity of the Relationship Profile Test (RPT), which is a 30-item selfreport measuring destructive overdependence, dysfunctional detachment, and healthy dependence. The RPT items are written to draw upon Bornstein’s (1992, 1993) 4-component model as well as other essential components of the dimension in question (Bornstein et al., 2003). The results reveal that the subscales of the RPT are related in predictable ways to scores on measures of adult attachment, interpersonal distress, and psychological health and well-being. The clinical implications of the results and the assessment of dependency in the clinical setting are discussed. & 2010 Wiley Periodicals, Inc. J Clin Psychol 66: 339–354, 2010. Keywords: dependence; detachment; adult attachment; attachment avoidance; attachment anxiety; psychological well-being

The authors would like to thank Robert Bornstein and Joel Weinberger for their thoughtful review of this manuscript. Correspondence concerning this article should be addressed to: Greg Haggerty, 18 Sexton Road, Syosset, NY 11791; e-mail: [email protected]

JOURNAL OF CLINICAL PSYCHOLOGY, Vol. 66(4), 339--354 (2010) & 2010 Wiley Periodicals, Inc. Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/jclp.20654

340

Journal of Clinical Psychology, April 2010

Almost every theory of personality, no matter the theoretical orientation, tries to shed light on the precursors and outcomes of individual differences in relatedness. These differences in relatedness are not just important to theories of personality but also have implications for theories of attachment, psychopathology, social development and cognition, and illness and psychotherapy (Baumeister & Leary, 1995). Bornstein et al. (2004) note that it is unclear whether humans have a fundamental ‘‘need to relate’’ to others but research is clear that people demonstrate a range of strategies to attain a comfortable sense of closeness and dependence with others (Ainsworth, 1969, 1989; Birtchnell, 1987, 1996; Gurtman, 1992; Millon, 1996). People often view dependence as a problem exhibited by those who are either immature or suffering from psychopathology. This may be particularly true in Western societies, where there is a strong emphasis on independence and individuality (Bornstein & Huprich, 2006; Neki, 1976; Tait, 1997). Problematic dependency has been researched and discussed for many years (Fenichel, 1945; Kraepelin, 1913; Schneider, 1923; Sullivan, 1947) and criteria for assessing pathological dependency have been present since the inception of the Diagnostic and Statistical Manual of Mental Disorders (1st ed [DSM-I]; American Psychiatric Association, 1952). Numerous structures have investigated the underpinnings of the relationship between dependency and detachment. Leary’s (1957) two-dimensional (i.e., love-hate and dominance-submission) grid for personality classification situates dependency in the love-submission quadrant. Within Leary’s framework, dependent individuals were viewed as looking for closeness with others through a persistent pattern of submissiveness. Leary’s understanding imparted a strong influence on Benjamin’s (1974) structural analysis of social behavior model, which is made up of three circular orders of social behavior (i.e., focus on the other, focus on the self, and introjection) instead of Leary’s one. The five-factor model (Costa & Widiger, 1994; McCrae & Costa, 1990) classifies personality traits in five categories (i.e., neuroticism, extraversion, openness, agreeableness, conscientiousness). Research (Bornstein & Cecero, 2000) suggests that high levels of neuroticism and low levels of openness are related to dependency. Pincus and Gurtman (1995), using factor and cluster analytic techniques, identified three different subtypes of dependency that occupied distinctive positions on their circumplex models (i.e., submissive dependency, exploitable dependency, love dependency). Pincus and Wilson (2001a,b) found submissive dependence was related with higher scores on maladaptive constructs (i.e., pathological attachment, fearful attachment, and loneliness) and related to higher scores of maternal control and lower scores of parental affiliation. Love dependence was related to lower maladaptive construct scores and higher scores on parental affiliation and secure attachment. Millon’s (1990, 1996) evolutionary framework utilized a biopsychosocial model that viewed personality traits as involving a combination of biological predispositions, underlying psychological processes, and social-cultural effects (Bornstein, 2005). Despite much research investigating the relationship between dependency and detachment, most theoretical frameworks have not overtly considered the relationship between dependency, detachment, and healthy dependency. However, Bornstein’s (1992, 1993) four-component (i.e., cognitive, emotional, motivational, and behavioral) model is an exception to this and provides a theoretical framework for understanding this relationship. As Table 1 illustrates, healthy dependency (HD), destructive overdependence (DO), and dysfunctional detachment (DD) all reflect particular beliefs regarding the self and others, pervasive emotional responses to Journal of Clinical Psychology

DOI: 10.1002/jclp

341

Convergent and Divergent Validity of RPT

Table 1 Components of DO, DD, HD Component Cognitive

Emotional

Motivational

Behavioral

DD Perception of self as weak and ineffectual

Fear of negative Desire to maintain Clinginess; evaluation; close ties to reassurance-seeking; abandonment caregivers/authority helpless selfconcerns figures presentation DD Perception of Fear of being Desire to maintain Social avoidance; others as hurtful hurt/overwhelmed distance from rigidly autonomous or untrustworthy others; need self-presentation for control Autonomous functioning HD Perception of Security in intimacy; Desire for closeness self as competent; confidence in in context of coupled with situation-appropriate others as trustworthy autonomy autonomy and self-reliance help seeking Note: DO 5 destructive overdependence; DD 5 dysfunctional detachment; HD 5 healthy dependency. From Bornstein et al. (2003).

interpersonal contacts, affiliative/isolative motives, and a spectrum of behaviors used to attain an optimal level of interpersonal relatedness (Bornstein et al., 2004). Researchers have outlined the fundamental structure of interpersonal dependency and investigated the relationship between dependency and several other traits (Bornstein, 1993; Pincus & Gurtman, 1995). Because of this research, many have concluded that DD is the opposite of dependency and more closely relates to a schizoid personality style. Current definitions of detachment focus on an individual’s inability to cultivate relationships and illustrate circumstance-appropriate affiliative behaviors (Birtchnell, 1987, 1996). Detachment is related to problems in a broad spectrum of interpersonal areas and can be an outcome of such things as early experiences emphasizing independence at the expense of relatedness (Clark & Ladd, 2000; Colgen, 1987), intrapsychic conflict with closeness and intimacy (Birtchnell, 1987; Bornstein, 1998), and innate tempermental differences that elicit parental responses promoting detachment (Coolidge, Thedy, & Jang, 2001). DD is exhibited as a failure to develop and engage in healthy social connections with others (Kantor, 1993; Millon, 1996). Research has illustrated that healthy dependency (HD) is the flexible ability to delay short-term goals to cultivate long-term caring relationships (Bornstein, 1998; Hetherington, 1999). HD is a result of instilling a sense of confidence and self-directedness through a history of appropriately authoritative parenting (Cross & Madison, 1997; Lee & Robbins, 1995). These individuals’ parents and authority figures, by their actions, communicate that it is okay to ask for support when needed (Clark & Ladd, 2000; LangTakac & Osterweil, 1992). In much the same way, attachment literature indicates that securely attached individuals, who exhibit HD, tend to have a positive model of self (seeing themselves as worthy of support) and a positive model of others (seeing that others are adequate resources of support and comfort). Because of this, one expects that these individuals would report a high level of psychological health and well-being. Research has also shown that DD may be a result from an early parenting history that overemphasized independence and self-sufficiency. The cost of this overdetermined detachment is a lack of appropriate social skills and connections (Clark & Ladd, 2000; Colgen, 1987). These people may also exhibit innate temperaments Journal of Clinical Psychology

DOI: 10.1002/jclp

342


that elicit detachment-promoting reactions from parents and other authority figures (Coolidge, Thede, & Jang, 2001). Much like in the attachment literature on avoidantly attached individuals, people exhibiting DD have a positive model of self as being self-reliant and a negative model of others, viewing them as either incapable or unwilling to provide appropriate support and comfort. As a coping strategy, they deactivate their attachment system (i.e., are focused on keeping their attachment needs to a minimum) and exhibit an overdetermined sense of competency, emotionally detaching from others and striving for independence. Because of this, one would expect that these individuals would report a low level of psychological health and well-being. In contrast, DO is a result of overprotection and/or authoritative parenting (Head, Baker, & Williamson, 1991). Findings also point to the possibility that innate temperamental styles such as low soothability may also elicit these parenting approaches (Bornstein, 1993). These people implicitly learn they are incapable of helping themselves and require the help of others at all times. Much like the attachment literature on anxiously attached individuals, people exhibiting DO have negative models of self as incompetent and unable to provide care for oneself and positive model of other seeing them as more competent. As a coping strategy, they hyperactivate their attachment system, staying hypervigilant to real or imaginary threats including abandonment. Much like the individuals exhibiting DD, we would expect that these individuals would report a low level of psychological health and well-being. Attachment and dependency appear to have considerable conceptual overlap. Specifically, the concept of HD is similar to secure attachment but differs with respect to underlying processes. Secure attachment is the result of consistent and positive expectations regarding self-other interactions (Main, Kaplan, & Cassidy, 1985). HD is based on a set of motives and emotional responses that ‘‘enable a person to seek help from others without feeling helpless, moderate affiliative urges through internal means, and delay of short-term gratification to strengthen longterm supportive relationships’’ (Bornstein et al., 2002, p. 374). Secure attachment is also linked to increased behavioral consistency resulting in comparable interpersonal patterns illustrated in varying contexts (e.g., romantic relationships, friendships). HD is expressed in more varying ways than secure attachment in response to differing situational cues and external demands (Bornstein & Languirand, 2003). Klohnen and John (1998) also found that secure attachment and HD are empirically as well as conceptually different. Scores of secure attachment are only moderately associated with healthy-dependency scores, evidencing correlations ranging from .30 to .40 (Bornstein et al., 2001, 2002, 2003; Pincus & Wilson, 2001a,b). Even in a recent construct validity study (Bornstein et al., 2002) comparing attachment and Relationship Profile Test (RPT; Bornstein & Languirand, 2003) dependency scores, the correlations ranged from .07 to .60, illustrating that although there is considerable overlap, they are distinct constructs. In the present study, we look to further investigate the convergent and divergent validity of the RPT, a 30-item self-report, measuring DO, DD, and HD. We looked to investigate its relationship to measures of interpersonal distress, attachment, and psychological well-being. Past construct validity studies (Bornstein & Huprich, 2006) of the RPT found that DO and DD scores were positively correlated with most of the Inventory of Interpersonal Problems-64 (IIP-64) subscales and total score, while HD was negatively related to the IIP-64 subscales and total score. Additionally, the RPT subscales were also found to be related in predictable ways to the attachment Journal of Clinical Psychology

DOI: 10.1002/jclp


343

(Bornstein et al., 2002). Past research (Bornstein & Huprich, 2006) on the construct validity of the RPT also found that DO and DD were negatively correlated with the Satisfaction With Life scale (SWL; Diener, Emmons, Larsen, & Griffin, 1985) and HD was positively correlated with it. The present study looks to replicate and extend these results by including more current measures of psychological health and attachment. This is important given the fact that the underlying structures of theoretically important constructs are always being updated. We used the Experiences in Close Relationships scale (ECR; Brennan, Clark, & Shaver, 1998), because there is now growing consensus in the field of adult attachment that attachment is best conceptualized along two dimensions, attachment anxiety and attachment avoidance. The ECR is also used more readily in current adult attachment research and has a more sound empirical foundation than the Adult Attachment scale (AAS; Collins & Read, 1990) used in a previous RPT construct validity study (Bornstein et al., 2002). In fact, the ECR was created by pooling all attachment self-report items that were known at the time including the AAS items. We also looked to replicate and extend the research investigating the relationship between the RPT and interpersonal distress. We chose to use the Inventory of Interpersonal Problems-32 (IIP-32) because it is half the length of the IIP-64, which we feel lends itself better to research and treatment studies. Additionally, we looked to replicate and extend the association between the RPT subscales and psychological well-being by using the Schwartz Outcome scale-10 (SOS-10; Blais et al., 1999). Recent research (Dragomirecka et al., 2006; RivasVazquez et al., 2001; Young et al., 2003) on the SOS-10 (Blais et al.) has shown that the measure is well-suited for tapping quality of life and psychological well-being as a treatment outcome in a number of different settings and with a diverse patient population. The SOS-10 also appears to be a valid measure of general life satisfaction, well-being, and psychological health. Beyond its utility as a clinical treatment measure, the SOS-10 has strong psychometric properties and is easy to use and score adding to its clinical utility. We generated some hypotheses derived from the research on overdependence, detachment, and healthy dependence (Baltes, 1996; Birtchnell, 1987; Bornstein, 1993, 2002, 2003, 2004, 2006; Colgen, 1987; Cross et al., 2000; Kantor, 1993; Pincus & Wilson, 2001a,b; Rude & Burnham, 1995). All statistically significant RPTcomparison measure correlations were expected to be moderate in magnitude (i.e., in the .25–.50 range). We expect HD scores to be negatively related to both dimensions of attachment, interpersonal distress, and positively correlated to psychological well-being. DO is expected to be positively related to attachment anxiety and negatively related to interpersonal distress and psychological well-being. Additionally, DD is expected to be positively related to attachment avoidance and negatively related to interpersonal distress and psychological well-being Methods Participants Participants comprised 225 undergraduate and master’s students from a northeastern university and were currently enrolled in a psychology course. Thirty-three of the participants were master’s students and 192 were undergraduate students with an average age of 20.9 years of age (SD 5 4.33; range 17–48). Of the participants, 183 were female and 42 were male. This sample comprised 162 (71.4%) Caucasian, 19 (8.4%) Latino or Mexican-American, 17 (7.5%) African American, 10 (4.4%) Asian Journal of Clinical Psychology

DOI: 10.1002/jclp

344


American, and 17 (7.5%) participants listed themselves as other. The participants received extra credit in their psychology course for their participation in the study. Materials and Procedure The participants were informed that they were participating in a study about relationships. Participants were asked to fill out a packet of self-reports about relationships and complete the measures in the lab in small groups of three to six. All participants received the ECR, SOS-10, RPT, and IIP-32 in the same sequence. They were guaranteed anonymity of their responses and confidentiality of their data. RPT. The RPT is a 30-item Likert-style self-report that measures dependencydetachment and yields three subscales: (a) DO, (b) DD, and (c) HD. The questions ask participants to respond to a series of self-statements, with each rated on a 7-point scale, ranging from 1 (not at all true of me) to 7 (very true of me). The items are derived from the theoretical and empirical literature on healthy dependence, detachment, and dependency. The statement items are written to draw upon the four parts of each personality style (i.e., motivational, behavioral, cognitive, and emotional) as well as other essential components of the dimension in question (Bornstein et al., 2003). Representative items from the three subscales include: ‘‘Being responsible for things makes me nervous’’ (DO), ‘‘Other people want too much from me’’ (DD), and ‘‘it is easy for me to trust people’’ (HD). In the current study, internal reliability (coefficient alpha) of .86 was obtained for DO, .71 for DD, .65 for HD. SOS-10. The SOS-10 is a 10-item psychological well-being and distress. Each yielding possible total scores from 0–60. representative of better psychological health internal reliability (coefficient alpha) of .88

Likert-style self-report measuring item is scored on a scale from 0–6, Higher scores on the SOS-10 are and well-being. In the current study,

ECR. The ECR is a 36-item self-report that measures a participant’s attachment by rating them on two orthogonal dimensions, attachment-related avoidance and attachment-related anxiety. The participants are asked to rate the extent to which each item was indicative of their feelings in close relationships on a 7-point scale, ranging from 1 (not at all) to 7 (very much). Eighteen items tap into attachmentrelated anxiety (e.g., ‘‘I worry about being abandoned,’’ ‘‘I worry a lot about my relationships’’), the other eighteen items tap into attachment-related avoidance (e.g., ‘‘I prefer not to show a partner how I feel deep down,’’ ‘‘I get uncomfortable when a romantic partner wants to be very close’’). Brennan et al. reported internal reliability (coefficient alpha) of .91 and .94 for the anxiety and avoidance subscales, respectively. In the current study, internal reliability (coefficient alpha) of .91 and .92 was obtained for the anxiety and avoidance subscales, respectively. IIP-32. The IIP-32 (Horowitz, Alden, Wiggins, & Pincus, 2000; Soldz, Budman, Demby, & Merry, 1995) is a 32-item inventory of distressing interpersonal behaviors that the respondent identifies as ‘‘hard to do’’ (i.e., behavioral inhibitions) or ‘‘does too much’’ (i.e., behavioral excesses) on a Likert-type scale, ranging from 0 (not at all) to 4 (extremely). Items were derived from verbatim transcripts of patients’ psychotherapy intake interviews. Subsequent analyses identified the current version, which conforms to the interpersonal circumplex, through the covariation among the eight IIP-32 octant scales. These eight scales can be represented pictorially as a circle Journal of Clinical Psychology

DOI: 10.1002/jclp

345


such that attributes adjacent to one another have more similarity and those across from one another have opposite qualities. Counterclockwise from the top of the circle, these subscales are as follows: (a) domineering/controlling (PA), i.e., being too controlling or manipulative in interpersonal interactions; (b) vindictive/self-centered (BC), i.e., being frequently egocentric and hostile in dealing with others; (c) cold/ distant (DE); i.e., having minimal feelings of affection for, and little connection with, other people; (d) socially inhibited/avoidant (FG), i.e., being socially avoidant and anxious and having difficulty approaching others; (e) nonassertive (HI), i.e., having difficulty expressing one’s needs to others; (f) overly accommodating/exploitable (JK), i.e., being gullible and easily taken advantage of by people; (g) self-sacrificing/ overly nurturant (LM), i.e., being excessively selfless, generous, trusting, caring, and permissive in dealing with others; and (h) intrusive/needy (NO), i.e., imposing one’s needs and having difficulty respecting the personal boundaries of other people. The IIP-32 has well-documented reliability and validity (Horowitz et al., 2000) with subscale alpha coefficients ranging from .76 to .88 and test-retest reliabilities that range from .58 to .84 (total r 5 .79). Whereas the IIP-64 has eight items in each octant, the IIP-32 has 4 of the IIP-64’s eight items in each octant. Validity evidence for the IIP-32 was illustrated by the positive association of the IIP-32 with the indices of negative mood such as anxiety and depression (Wei, Heppner, & Mallinckrodt, 2003). The internal reliability for the subscales for the IIP-32 in the present study ranged from .87 to .73.

Results Table 2 outlines the gender differences in the RPT subscale scores. Our results revealed that that women’s mean score for the RPT subscales were higher than the men’s, but only DO yielded a significant difference. The results also revealed that women in our sample scored significantly higher on attachment anxiety than men. Other significant gender differences were also discovered on the IIP-32. Specifically, men scored significantly higher on the subscales vindictive/self-centered and cold/ distant. Women scored significantly higher on the subscale self-sacrificing. The effect sizes for the gender comparisons were in the small to medium range. There were no significant gender differences found on the SOS-10. Table 3 outlines the gender differences for the comparison measures. Table 2 Gender Differences in Relationship Profile Test Subscale Scores Score Women Relationship Profile Test subscales DO DD HD

Gender differences effect sizes

Men

M

SD

M

SD

t

d

27.97 32.46 34.84

7.70 5.55 6.76

25.26 31.40 33.88

7.88 6.56 6.04

2.05 1.07 .83

.27 .14 .11

Note: DO 5 destructive overdependence; DD 5 dysfunctional detachment; HD 5 healthy dependency. N 5 183 women and 42 men. Two-tailed t tests were used to assess gender differences. po.05. Journal of Clinical Psychology

DOI: 10.1002/jclp

346


Table 3 Gender Differences in the Comparison Measures’ Subscale Scores Score Women Subscales ECR Anx Avoid IIP-32 PA BC DE FG HI JK LM NO Total SOS-10

Gender difference effect sizes

Men

M

SD

M

SD

T

d

3.72 2.66

1.13 1.07

3.33 2.85

1.15 1.06

2.03 1.03

.27 .14

3.40 2.29 3.25 23.21 6.40 7.23 7.98 5.20 40.34 4.40

3.32 3.06 3.36 3.03 3.85 3.88 4.05 3.54 17.34 .90

3.59 4.24 5.29 23.40 6.57 6.77 6.50 4.62 40.58 4.60

3.17 4.13 4.44 3.09 4.12 3.72 3.30 3.08 19.99 .86

.33 3.44 3.30 .37 .26 .68 2.20 .99 .08 1.27

.04 .47 .44 .05 .03 .09 .30 .13 .01 .17

Note: DO 5 destructive overdependence; DD 5 dysfunctional detachment; HD 5 healthy dependency; ECR 5 Experiences in Close Relationships; Anx 5 Attachment Anxiety dimension of the ECR; Avoid 5 Attachment Avoidance dimension of the ECR; IIP-32 5 Inventory of Interpersonal Problems-32; PA 5 Dominant/Controlling; BC 5 Vindictive/Self-Centered; DE 5 Cold/Distant; FG 5 Social Inhibition; HI 5 Non-Assertive; JK 5 Overly Accommodating; LM 5 Self-Sacrificing; NO 5 Intrusive/Needy; Total 5 IIP-32 Total score; SOS-10 Schwartz Outcome Scale-10. N 5 183 women and 42 men. Two-tailed t tests were used to assess gender differences. po.05; po.01.

Table 4 Differences Between Caucasians and All Other Ethnicities on the RPT Score Caucasians Relationship Profile Test subscales DO DD HD

Ethnicity differences effect sizes

All other ethnicities

M

SD

M

SD

t

d

27.41 31.85 35.19

7.93 5.76 7.01

27.22 33.39 33.51

7.69 5.73 5.46

.15 1.61 1.49

.02 .22 .21

Note: DO 5 destructive overdependence; DD 5 dysfunctional detachment; HD 5 healthy dependency. N 5 162 Caucasians and 63 of all other ethnicities. Two-tailed t tests were used to assess ethnicity differences. po.05.

Tables 4 and 5 outline the differences between Caucasian participants and participants of all other ethnicities. All the ethnicities other than Caucasian were pooled together because over 71.4% were Caucasian in this sample. Caucasian participants scored significantly lower on the ECR’s attachment avoidance Journal of Clinical Psychology

DOI: 10.1002/jclp

347


Table 5 Differences Between Caucasians and All Other Ethnicities on Comparison Measures Score Caucasians Subscales ECR Anx Avoid IIP-32 PA BC DE FG HI JK LM NO Total SOS-10

Ethnicity differences effect sizes

All other

M

SD

M

SD

t

d

3.63 2.54

1.19 .96

3.69 3.19

1.04 1.23

.33 3.85

.05 .54

3.39 2.45 3.09 22.84 6.25 7.02 7.50 5.19 38.93 4.45

3.32 3.18 3.45 3.07 3.90 3.94 3.88 3.65 17.71 0.93

3.67 3.66 5.26 24.33 6.67 6.88 7.31 4.53 42.50 4.49

3.25 3.87 3.99 2.65 3.77 3.53 3.97 2.64 16.54 0.79

.49 2.13 3.61 2.97 .64 .20 .27 1.12 1.15 .28

.07 .30 .50 .42 .09 .03 .04 .16 .17 .04

Note: DO 5 destructive overdependence; DD 5 dysfunctional detachment; HD 5 healthy dependency; ECR 5 Experiences in Close Relationships; Anx 5 Attachment Anxiety dimension of the ECR; Avoid 5 Attachment Avoidance dimension of the ECR; IIP-32 5 Inventory of Interpersonal Problems-32; PA 5 dominant/controlling; BC 5 vindictive/self-centered; DE 5 cold/distant; FG 5 social inhibition; HI 5 nonassertive; JK 5 overly accommodating; LM 5 self-sacrificing; NO 5 intrusive/needy; Total 5 IIP-32 Total score; SOS-10 Schwartz Outcome Scale-10. N 5 162 Caucasians and 63 of all other ethnicities. Two-tailed t tests were used to assess ethnicity differences. po.05; po.01.

dimension, the IIP-32’s cold/distant subscale, and they scored significantly higher than all the other ethnicities on the IIP-32’s subscale of intrusive/needy. The effect sizes for the ethnicity comparisons were in the small to medium range. Table 6 summarizes all of the relationships among RPT subscales and scores on the ECR, IIP-32, and SOS-10 respectively. We will outline these relationships below. As predicted, DO was positively correlated with attachment anxiety but was also positively correlated to attachment avoidance as well. Results also revealed that DO was positively correlated with all IIP-32 subscales except PA. It was also positively correlated with the IIP-32 total score. DO was also negatively correlated with the SOS-10. DD was positively correlated with both attachment avoidance and attachment anxiety. DD was also positively correlated with the IIP-32 subscales of DE, FG, HI, JK, LM, and the IIP-32 total score. DD was also negatively correlated with the SOS-10. HD was negatively correlated with attachment anxiety and attachment avoidance. HD was also negatively correlated with every IIP-32 subscale with the exemption of the subscale intrusive/needy, which did not reach statistical significance. HD was negatively correlated with the IIP-32 total score as well. HD was also positively correlated with the SOS-10. Discussion The present findings support the discriminant validity of the RPT as a measure of dependency-detachment. Scores on the three RPT subscales were related to measures Journal of Clinical Psychology

DOI: 10.1002/jclp

348


Table 6 Convergent and Discriminant Validity of the RPT Subscales Comparison measure-subscale correlations RPT-DO Predict ECR Anx Avoid IIP-32 PA BC DE FG HI JK LM NO Total SOS-10

1

o o o 1 1 1 1 1 1

RPT-DD

Obtain .46 .17 .05 .23 .25 .43 .67 .62 .38 .26 .65 .44

Predict

1 o 1 1 1 1 o o o 1

RPT-HD

Obtain

Predict

Obtain

.21 .44

.33 .48

.02 .13 .28 .19 .23 .27 .19 .02 .30 .21

.15 .15 .31 .35 .37 .35 .25 .04 .42 .54

1

Note: RPT 5 Relationship Profile Test; DO 5 destructive overdependence; DD 5 dysfunctional detachment; HD 5 healthy dependence; Predict 5 predicted RPT-comparison measure relationship; Obtain 5 obtained RPT-comparison measure relationship; ECR 5 experiences in close relationships; Anx 5 Attachment Anxiety dimension of the ECR; Avoid 5 Attachment Avoidance dimension of the ECR; IIP-32 5 Inventory of Interpersonal Problems-32; PA 5 dominant/controlling; BC 5 vindictive/self-centered; DE 5 cold/distant; FG 5 social inhibition; HI 5 nonassertive; JK 5 overly accommodating; LM 5 selfsacrificing; NO 5 intrusive/needy; Total 5 IIP-32 Total score; Schwartz Outcome Scale-10; Predicted relationships are as follows: 1 5 positive correlated predicted, 5 negative correlation predicted, o 5 scores expected to be uncorrelated. N 5 225 (183 women and 42 of men). po.05; po.01.

of adult attachment, interpersonal distress, and psychological health in a theoretically predictable way. Our data illustrates that a person exhibiting HD reports experiencing less interpersonal distress than those exhibiting DO or DD. Individuals scoring high on HD tended to rate themselves as more secure and to report a better quality of life and psychological health in general. These results further replicate and extend past research investigating the construct validity of the HD scale of the RPT (Bornstein, Geiselman, Eisenhart, & Languirand, 2002; Bornstein & Huprich, 2006; Bornstein et al., 2003, 2004). When these research findings are taken as a whole, a picture of a person exhibiting healthy dependence becomes one who is confidently well-related to others in their life. They look to please others but this is not motivated by worries about abandonment or relationship distress (Bornstein et al., 2002). Our results also reveal that people exhibiting destructive overdependence endorsed items for being nonassertive, overly accommodating, self-sacrificing, intrusive, and needy. People who scored high on DO also scored high on attachment anxiety. Research (for review Mikulincer & Shaver, 2007; Schachner, Shaver, & Mikulincer, 2005) reveals that people who score high on attachment anxiety are fearful of losing those on which they depend and engage in efforts to keep these people close. Individuals scoring high on DO also reported feeling less psychologically healthy and experienced a lessened sense of well-being than people exhibiting healthy Journal of Clinical Psychology

DOI: 10.1002/jclp


349

dependence. When our results are looked at in combination with past research on the RPT (Bornstein, Geiselman, Eisenhart, & Languirand, 2002; Bornstein & Huprich, 2006; Bornstein et al., 2003, 2004), we begin to see the person exhibiting overdependence as focused on keeping people close at all costs. They may be hypervigilant to signs and signals of impending abandonment (Bornstein et al., 2002). The present findings also show that people exhibiting dysfunctional detachment also endorsed items for being vindictive, self-centered, cold, distant, and socially inhibited. Those scoring high on DD also scored high on attachment avoidance. Research (for review Mikulincer & Shaver, 2007; Schachner et al., 2005) reveals that people scoring high on attachment avoidance are reluctant to trust others’ benevolence and, therefore, strive for more independence and emotional detachment. People scoring high on DD also reported experiencing lower psychological health and well-being. When these results are looked at in combination with past research on the RPT (Bornstein, Geiselman, Eisenhart, & Languirand, 2002; Bornstein & Huprich, 2006; Bornstein et al., 2003, 2004), we begin to see a person exhibiting dysfunctional detachment as focused on asserting independence from others and illustrating a overdetermined sense of self-reliance. These people view interpersonal relationships as conflictual or at the very least ungratifying (Bornstein et al., 2002). There were also results that were not predicted in our hypotheses. We found that people who scored high on RPT DO also scored high on the IIP-32 subscale of vindictive/self-centered. Research (Bornstein, 2006; Mongrain, Vettese, Shuster, & Kendel, 1998; Ojha & Singh, 1985) reveals that overly dependent people are specifically afraid of abandonment and, as a result, show increased self-centered behavior such as jealousy and possessiveness with romantic partners (Bornstein, 2006; Bringle & Buunk, 1985; Bush, Bush, & Jennings, 1988). Our results also showed that DO was positively related to the IIP-32 subscale of cold/distant. One way of understanding this result is to take into consideration that overdependent people may use many different strategies to keep people close to them such as what Bornstein (1995) refers to as active dependency. They may become cold and distant as a way of signaling their displeasure in the other’s autonomous actions. It can be used manipulatively to instill guilt in the other when that person strives for some independence from the overdependent person. We also found a positive relationship between RPT DD and the IIP-32 subscales of overly accommodating and self-sacrificing. Past research (Bornstein et al., 2002, 2003) results shows that detached people are more cold and withdrawn from others and exhibit an over-determined self-reliance. Perhaps these results hint to the fact that dysfunctional detachment is more complex than originally theorized. Research by Ekselius, Lindstrom, von Knorring, Bodlund, and Kullgren (1994) even found a positive relationship between dependency and detachment related PD scores in clinical and nonclinical samples. Their findings revealed a significant correlation (i.e., r 5 .24) between the number of criteria fulfilled for both schizoid PD and dependent PD. In fact, their results revealed significant correlations among almost all of the PDs. Ekselius et al. (1994) state that this could be because several or perhaps all PDs are correlated to the same basic personality traits. Our results also showed that attachment avoidance and attachment anxiety were both positively correlated with DO and DD. When we look closer at our findings among attachment DO, and DD, we also find that the effect sizes of the predicted relationships were more than twice as large as the effect size of the unpredicted relationships. One explanation is that high scores on the attachment dimensions relate Journal of Clinical Psychology

DOI: 10.1002/jclp

350


to attachment insecurity and to problems in relationships with those upon which they are dependent upon (for review see Mikulincer & Shaver, 2007). Perhaps insecure attachment, DO, and DD tap unique aspects of a larger construct of problems of relatedness. These results need to be taken in light of some of the studies limitations. The present study utilized a predominantly Caucasian college population and it is unclear if our results will generalize to other populations. These results were also based solely on selfreport data. As Bornstein and Huprich (2006) noted, many participants may have answered questions in a socially desirable ways, whether they were actually aware of it or not. Also, it is likely that their insights into these issues could vary. Another limitation is that the sample has more females than males, but this is in line with the student body at the northeastern university from which this sample was taken. The present results, however, are in line with results of past construct validity studies on RPT, of which samples were more evenly distributed among the genders. With regard to ethnicity, it is difficult to know if our sample is similar to past research using the RPT because ethnicity data are not reported in these studies. Future research should investigate ethnic differences on the RPT as some cultures value independence while others dependence (Bornstein & Huprich, 2006; Neki, 1976; Tait, 1997). Because ethnic groups other than Caucasian were underrepresented in our sample, it was difficult to adequately identify differences in responding. Echoing Bornstein et al. (2002, 2003), the RPT, aside from its obvious research utility, may provide clinicians with a useful assessment tool for the assessment of dependency-detachment dynamics, which are important to treatment. In addition, higher levels of dependency are associated with increased service use during inpatient and outpatient treatment (O’Neill & Bornstein, 2001), have a greater number of unscheduled contacts with emergency services than do less dependent patients (Bornstein, Porcerelli, Huprich, & Markova, 2009), and request between-session contact with therapists more frequently than nondependent patients (Emery & Lesher, 1982; Overholser, 1996). Future research needs to investigate the RPT by using a clinical population, and the RPT could highlight changes in DO, DD, and HD during psychotherapy treatment. Bornstein et al. (2003) hypothesized that perhaps DO, DD, and HD might shift during successful versus unsuccessful treatment and in response to therapy that utilizes different theoretical orientations (insight-oriented vs. behavioral). Psychotherapy researchers might also use baseline DO, DD, and HD to predict therapy outcome. Bornstein et al. (2003) found, in preliminary findings, that people with elevated DO receive more benefit from insight-oriented therapy than people with elevated DD. Also, HD has never been studied in relation to therapeutic outcome but research has shown that qualities associated with HD (i.e., relationship maturity and stability of self-concept) predicts successful outcome in insight-oriented treatment (Hogland & Piper, 1997; Hogland et al., 2000; Piper et al., 2000; Summers, 1999).

References Ainsworth, M.D.S. (1969). Object relations, dependency, and attachment: A theoretical review of the infant-mother relationship. Child Development, 40, 969–1025. Ainsworth, M.D.S. (1989). Attachments beyond infancy. American Psychologist, 44, 709–716. American Psychiatric Association. (1952). Diagnostic and statistical manual of mental disorders. Washington, DC: Author. Journal of Clinical Psychology

DOI: 10.1002/jclp


351

Baltes, M.M. (1996). The many faces of dependence in old age. Cambridge, UK: Cambridge University Press. Baumeister, R.F., & Leary, M.R. (1995). The need to belong: Desire for interpersonal attachment as a fundamental human motivation. Psychological Bulletin, 117, 497–529. Benjamin, L.S. (1974). Structural analysis of social behavior. Psychological Review, 81, 392–425. Bentall, R.P., & Swarbrick, R. (2003). The best laid schemas of paranoid patients: Autonomy, sociotropy, and need for closure. Psychology and Psychotherapy, 76, 163–171. Birtchnell, J. (1987). Attachment-detachment, directiveness-receptiveness: A system for classifying interpersonal attitudes and behavior. British Journal of Medical Psychology, 60, 17–27. Birtchnell, J. (1996). Detachment. In C.G. Costello (Ed.), Personality characteristics of the personality disordered (pp. 173–205). New York: Wiley. Blais, M.A., Lenderking, W.R., Baer, L., deLorell, A., Peets, K., Leary, L., et al. (1999). Development and initial validation of a brief mental health outcome measure. Journal of Personality, 73(3), 359–373. Bornstein, R.F. (1992). The dependent personality: Developmental, social, and clinical perspectives. Psychological Bulletin, 112, 3–23. Bornstein, R.F. (1993). The dependent personality. New York: Guilford. Bornstein, R.F. (1995). Active dependency. Journal of Nervous and Mental Disease, 183, 64–77. Bornstein, R.F. (1998). Depathologizing dependency. Journal of Nervous and Mental Disease, 186, 67–73. Bornstein, R.F. (2005). The dependent patient: A practitioner’s guide. Washington, DC: APA Books. Bornstein, R.F. (2006). The complex relationship between dependency and domestic violence: Converging psychological factors and social forces. American Psychologist, 61(6), 595–606. Bornstein, R.F., & Cecero, J.J. (2000). Deconstructing dependency in a five-factor world: A meta-analytic review. Journal of Personality Assessment, 74, 324–343. Bornstein, R.F., & Huprich, S.K. (2006). Construct validity of the relationship profile test: Three-year retest reliability and links with core personality traits, object relations, and interpersonal problems. Journal of Personality Assessment, 86(2), 162–171. Bornstein, R.F., & Languirand, M.A. (2003). Healthy dependency. New York: Newmarket. Bornstein, R.F., Geiselman, K.J., Eisenhart, E.A., & Languirand, M.A. (2002). Construct validity of the relationship profile test: Links with attachment, identity, relatedness, and affect. Assessment, 9(4), 373–381. Bornstein, R.F., Geiselman, K.J., Gallagher, H.A., Ng, H.M., Hughes, E.E., & Languirand, M.A. (2004). Construct validity of the Relationship Profile Test: Impact of gender, gender role, and gender role stereotype. Journal of Personality Assessment, 82(1), 104–113. Bornstein, R.F., Languirand, M.A., Geiselman, K.J., Creighton, J.A., West, M.A., Gallagher, H.A., et al. (2003). Construct validity of the Relationship Profile Test: A Self-report measure of dependency-detachment. Journal of Personality Assessment, 80(1), 64–74. Bornstein, R.F., Languirand, M.A., West, M.A., Creighton, J.A., & Geiselman, K.J. (2001, April). Construct validity of the Relationship Profile Test. Paper presented at the 72nd meeting of the Eastern Psychological Association, Washington, DC. Bornstein, R.F., Porcerelli, J.H., Huprich, S.K., & Markova, T. (2009). Construct validity of the Relationship Profile Test: Correlates of overdependence, detachment, and healthy dependence in low income urban women seeking medical services. Journal of Personality Assessment, 91, 537–544. Brennan, K.A., Clark, C.L., & Shaver, P.R. (1998). Self-report measurement of adult attachment: An integrative overview. In J.A. Simpson & W.S. Rholes (Eds.), Attachment theory and close relationships (pp. 46–76). New York: Guilford Press. Journal of Clinical Psychology

DOI: 10.1002/jclp

352


Bringle, R.G., & Buunk, B. (1985). Jealousy and social behavior. In P. Shaver (Ed.), Review of personality and social psychology (Vol. 6, pp. 241–264). Beverly Hills, CA: Sage. Bush, C.R., Bush, J.P., & Jennings, J. (1988). Effects of jealousy threats on relationship perceptions and emotions. Journal of Social and Personal Relationships, 5, 285–303. Clark, K.E., & Ladd, G.W. (2000). Connectedness and autonomy support in parent-child relationships: Links to the children’s socioemotional orientation and peer relationships. Developmental Psychology, 36, 485–498. Colgen, P. (1987). Treatment of dependency disorders in men: Toward a balance of identity and intimacy. Journal of Chemical Dependency Treatment, 1, 205–227. Collins, N.J., & Read, S.J. (1990). Adult attachment, working models, and relationship quality in dating couples. Journal of Personality and Social Psychology, 58, 644–663. Coolidge, F.L., Thede, L.L., & Jang, K.J. (2001). Heritability of personality disorders in childhood: A preliminary investigation. Journal of Personality Disorders, 15, 33–40. Costa, P.T., & Widiger, T.A. (Eds.). (1994). Personality disorders and the five-factor model of personality. Washington, DC: American Psychological Association. Cross, S.E., & Madison, L. (1997). Models of the self: Self-construals and gender. Psychological Bulletin, 122, 5–37. Cross, S.E., Bacon, P.L., & Morris, M.L. (2000). The relational-interdependent self- construal and relationships. Journal of Personality and Social Psychology, 78, 791–808. Diener, E., Emmons, R.A., Larsen, R.J., & Griffin, S. (1985). The satisfactory with life scale. Journal of Personality Assessment, 49, 71–75. Dragomirecka, E., Lenderking, W.R., Motlova, L., Goppoldova, E., & Selepova, P. (2006). A brief mental health outcome measure: Translation and validation of the Czech version of the Schwartz Outcome Scale-10. Quality of Life Research, 15, 307–312. Ekselius, L., Lindstrom, E., von Knorring, L., Bodlund, O., & Kullgren, G. (1994). Comorbidity among the personality disorders in the DSM-III-R. Personality and Individual Differences, 17, 155–160. Emery, G., & Lasher, E. (1982). Treatment of depression in older adults: Personality considerations. Psychotherapy, 19, 500–505. Fenichel, O. (1945). The psychoanalytic theory of neurosis. New York: Norton. Gurtman, M.B. (1992). Construct validity of interpersonal personality measures: The interpersonal circumplex as a nomological net. Journal of Personality and Social Psychology, 63, 105–118. Head, S.B., Baker, J.D., & Williamson, D.A. (1991). Family environment characteristics and dependent personality disorder. Journal of Personality Disorders, 5, 256–263. Hetherington, A. (1999). The development of trust and dependency in an individual throughout the lifespan and its influence on group dynamics. Social Science International, 15, 1–10. Hoglend, P., & Piper, W.E. (1997). Treatment length and termination constructs in dynamic psychotherapy. Nordic Journal of Psychiatry, 51, 37–42. Hoglend, P., Bogwald, K.P., Amlo, S., Heyerdahl, O., Sorbye, O., Marble, A., et al. (2000). Assessment of change in dynamic psychotherapy. Journal of Psychotherapy Practice and Research, 9, 190–199. Horowitz, L., Alden, L., Wiggins, J., & Pincus, A. (2000). Inventory of interpersonal problems. TX: The Psychological Corporation. Horowitz, L.M., Rosenberg, S.E., Baer, B.A., Ureno, G., & Villasenor, V.S. (1988). Inventory of interpersonal problems: Psychometric properties and clinical Applications. Journal of Consulting and Clinical Psychology, 56, 885–892. Kantor, M. (1993). Distancing. Westport, CT: Praeger. Khohnen, E.C., & John, O.P. (1998). Working models of attachment: A theory-based prototype approach. In J.A. Simpson & W.S. Rhodes (Eds.), Attachment theory and close relationships (pp. 115–140). New York: Guilford. Journal of Clinical Psychology

DOI: 10.1002/jclp


353

Kraepelin, E. (1913). Psychiatrie: Ein lehrbuch [Psychiatry: A textbook]. Leipzig, Germany: Barth. Lang-Takac, E., & Osterweil, Z. (1992). Separateness and connectedness: Differences between the genders. Sex Roles, 27, 277–289. Leary, T. (1957). Interpersonal diagnosis of personality. New York: Ronald. Lee, R.M., & Robbins, S.B. (1995). Measuring belongingness: The Social Connectedness and Social Assurance scales. Journal of Consulting Psychology, 42, 232–241. Lysaker, P.H., Wickett, A.M., Lancaster, R.S., Campbell, K., & Davis, L.W. (2004). Heightened interpersonal dependency in schizophrenia: Associations with gaver impairment in neurocognition but not with negative or positive symptoms. Bulletin on the Menninger Clinic, 68, 164–173. Main, M., Kaplan, N., & Cassidy, J. (1985). Security in infancy, childhood, and adulthood. Monographs of the Society of Research in Child Development, 50, 66–104. Marusic, I., Kamenov, Z., & Jelic, M. (2006). Personality and attachment to romantic partners. Review of Psychology, 13(1), 9–18. McCrae, R.R., & Costa, P.T. (1990). Personality in adulthood. New York: Guilford. Mikulincer, M., & Shaver, P.R. (2007). Attachment in adulthood: Structure, dynamics, and change. New York: The Guilford Press. Millon, T. (1990). Toward a new personology: An evolutionary model. New York: Wiley. Millon, T. (1996). Disorders of personality: DSM-IV and beyond. New York: Wiley. Mongrain, M., Vettese, L.C., Shuster, B., & Kendal, N. (1998). Perceptual biases, affect, and behavior in relationships of dependents and self-critics. Journal of Personality and Social Psychology, 75, 230–241. Neki, J.S. (1976). An examination of the cultural relativism of dependence as a dynamic of social and therapeutic relationship. British Journal of Medical Psychology, 49, 1–10. Ojha, H., & Singh, R.I.P. (1985). Relationship of marriage role attitude with dependence proneness and insecurity in university students. Psychologia, 28, 249–253. O’Neill, R.M., & Bornstein, R.F. (2001). The dependent patient in a psychiatric inpatient setting: Relationship of interpersonal dependency to consultation and medication frequencies. Journal of Clinical Psychology, 57, 289–298. Overholser, J.C. (1996). The dependent personality and interpersonal problems. Journal of Nervous and Mental Disease, 184, 8–16. Pincus, A.L., & Gurtman, M.B. (1995). The three faces of interpersonal dependency: Structural analysis of self-report dependency measures. Journal of Personality and Social Psychology, 69, 744–758. Pincus, A.L., & Wilson, K.R. (2001). Interpersonal variability in dependent personality. Journal of Personality, 69, 223–251. Piper, W.E., Joyce, A.S., McCallum, M., Azim, H.F., & Ogrodniczuk, J.S. (2000). Interpretive and supportive psychotherapies: Matching therapy and patient personality. Washington, DC: American Psychological Association. Rivas-Vazquez, R.A., Rivas-Vazquez, A., Blais, M.A., Rey, G.J., Rivas-Vazqez, F., Jacobo, M., et al. (2001). Development of the Spanish version of the Schwartz Outcome Scale-10: A brief mental health outcome measure. Journal of Personality Assessment, 77(3), 436–446. Rude, S.S., & Burnham, B.L. (1995). Connectedness and neediness: Factors of the DEQ and SAS dependency scales. Cognitive Therapy and Research, 19, 323–340. Schachner, D.A., Shaver, P.R., & Mikulincer, M. (2005). Patterns of nonverbal behavior and sensitivity in the context of attachment relationships. Journal of Nonverbal Behavior, 29(3), 141–169. Schneider, K. (1923). Die psychopathishen personlichkeiten. Vienna, Austia: Deuticke. Journal of Clinical Psychology

DOI: 10.1002/jclp

354


Soldz, S., Budman, S., Demby, A., & Merry, J. (1995). A short form of the Inventory of Interpersonal Problems Circumplex Scales. Assessment, 2, 53–63. Sullivan, H.S. (1947). Conceptions of modern psychiatry. Washington, DC: William Alanson White Institute. Summers, F. (1999). Transcending the self: An object relations model of psychoanalytic therapy. Hillsdale, NJ: The Analytic Press. Tait, M. (1997). Dependence: A means or an impediment to growth? British Journal of Guidance and Counseling, 25, 17–26. Wei, M., Heppner, P.P., & Mallinckrodt, B. (2003). Perceived coping as a mediator between attachment and psychological distress: A structural equation modeling approach. Journal of Consulting Psychology, 50, 438–447. Youngm, J.L., Waehler, C.A., Laux, J.M., McDonald, P.S., & Hilsenroth, M.J. (2003). Four studies extending the utility of the Schwartz Outcome Scale (SOS-10). Journal of Personality Assessment, 80(2), 130–138.

Journal of Clinical Psychology

DOI: 10.1002/jclp