Personality traits of the alternative DSM-5 model and the attachment dimensions in Portuguese adults
Introduction
As the limitations of a categorical approach to personality and its disorders have been well-documented (see Krueger et al., 2014; Skodol et al., 2011; Widiger et al., 2009; Widiger and Trull, 2007, for a review), psychopathology has come to be acknowledged as laying on a dimensional continuum with normal personality traits (Markon et al., 2005). Thus, Section III of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5; American Psychiatric Association [APA], 2013) provided a dimensional-categorical model for the conceptualization of personality and its disorders that includes the assessment of impairments in personality functioning (Criterion A) and maladaptive personality traits (Criterion B) (Krueger et al., 2014).
The Personality Trait Model underlying Criterion B includes 25 specific pathological personality facets, chosen for their clinical relevance, which are hierarchically organized into five broad personality domains considered maladaptive variants of the Five-Factor Model (Gore and Widiger, 2013; Krueger and Markon, 2014): Negative Affectivity (vs. Emotional Stability), Detachment (vs. Extraversion), Antagonism (vs. Agreeableness), Disinhibition (vs. Conscientiousness), and Psychoticism (vs. Lucidity). These domains refer, respectively, to tendencies (a) to experience diverse negative emotions versus being emotionally stable; (b) to withdraw from social contact versus being socially engaged; (c) to behave adversely towards others versus being more agreeable; (d) to show uninhibited expression of impulses versus being more conscientious; and (e) to present cognitive dysregulation and problems with reality testing versus lucidity in thoughts (Krueger et al., 2014).
The Alternative DSM-5 Model for Personality Disorders sets out to adopt a more empirically-based trait approach in order to address several shortcomings of the current model in Section II – for example, lack of empirically validated cut-offs, extensive comorbidity and temporal instability (Krueger et al., 2012; Krueger and Markon, 2014). Like most dimensional universal personality trait models, it seeks to describe and understand traits and psychopathology in a continuum from normal to abnormal features (Krueger et al., 2012).
The attachment theory (Bowlby, 1969, Bowlby, 1973, Bowlby, 1980, Bowlby, 1988) has been hailed a theoretically and clinically useful framework for understanding intrapsychic and interpersonal characteristics of personality and personality disorders (Levy et al., 2015). The attachment theory postulates a complex and innate psychobiological system that starts to develop from birth and motivates people to seek safety, comfort and protection in a trustworthy caregiver in threatening or stressful situations (Bowlby, 1969; Moreira et al., 2006). One of its major contributions is its attempt to understand how affective bonding between individuals and their significant figures influences personality and psychopathology development (Ainsworth and Bowlby, 1991).
Although this attachment system has a more prominent expression in infancy, it remains active throughout the whole life cycle, affecting how people think, feel and behave “from the cradle to the grave” (Bowlby, 1979, p. 129). From a developmental perspective, consistent data suggests that one's personality in adulthood is related to the attachment experiences to a caregiver from childhood (e.g., Young et al., 2017). Hence, the adult attachment theory (Hazan and Shaver, 1987; Mikulincer and Shaver, 2003; Noftle and Shaver, 2006) enlightens individual cognitive, emotional and behavioural differences in close adult relationships, which are influenced by prior relational experiences. This system entails the activation of mental representations of the self and others, known as internal working models, whether consciously or unconsciously (Bretherton and Munholland, 2008; Mikulincer and Shaver, 2007).
Several measures of individual differences in adult attachment have been advanced over the years (e.g., Bartholomew, 1990; Bartholomew and Horowitz, 1991; Brennan et al., 1998; Hazan and Shaver, 1987). Some of them are based on Ainsworth et al.'s (1978) three-category typology of infants' attachment to their parents – secure, anxious/ambivalent, and avoidant – and have attempted to explain attachment development in the context of adult romantic relationships (e.g., Hazan and Shaver, 1987).
More recent improvements are based on the assumption that dimensional measures are more accurate and valid than categorical measures (Noftle and Shaver, 2006). Bartholomew's (1990; Bartholomew and Horowitz, 1991) scheme is believed to be the most influential dimensional model. It posits that the four adult attachment styles – secure, anxious-ambivalent, fearful-avoidant, and dismissive-avoidant – are defined by two orthogonal dimensions equivalent to the internal working models of the self and others. Brennan et al. (1998) also found two independent dimensions of adult attachment: attachment-related anxiety and avoidance. Such findings are in line with Bartholomew's (1990; Bartholomew and Horowitz, 1991) model, and both dimensions are able to represent all the attachment style measures with consistent precision (Noftle and Shaver, 2006). Hence, Attachment Anxiety is related to the fear of rejection, abandonment and unlovability, while Attachment Avoidance is related to the avoidance of intimacy and dependency on others (Brennan et al., 1998). Research has repeatedly supported this two dimensional representation of adult attachment (e.g., Fraley and Shaver, 2000; Moreira et al., 2006; Noftle and Shaver, 2006). In comparison with anxious or avoidant individuals, who present high scores in these attachment dimensions, secure people tend to score low in both (Shaver and Mikulincer, 2005).
In general, a secure attachment is related to the ability to mentalize (Fonagy et al., 2002), to emotionally self-regulate (Sroufe, 1997) and to regulate proximity vs. avoidance in interpersonal relationships (Mikulincer and Shaver, 2007). In this sense, secure people tend to display lower levels of Neuroticism and higher levels of Extraversion, Agreeableness and Conscientiousness (Shaver and Brennan, 1992). On the other hand, individuals with anxious-attachment are described as worrisome and obsessive, and those with avoidant-attachment as distrustful and indifferent (Bartholomew and Horowitz, 1991). Previous research suggests that avoidant-attachment is related to poorer psychological functioning, showing less empathy (Mikulincer et al., 2001) and leading to antisocial behaviour (Fagot and Kavanagh, 1990), whereas anxious-attachment is more associated with distress (Collins and Read, 1990) and negative affect (Sheinbaum et al., 2015).
Despite somewhat inconsistent and controversial findings, Del Giudice (2011) reported on a meta-analysis that males tend to show significantly higher avoidance and lower anxiety than females (see also Barry et al., 2015; for opposite findings, see Schmitt et al., 2003). Nonetheless, even though gender differences are critical to theory and clinical practice, many studies do not analyse data accounting for gender differences in attachment (Barry et al., 2015). Hence, further research in this field appears to be necessary.
Personality traits also seemingly develop differently in males and females as a result of social environment experiences (Srivastava et al., 2003) and biological differences (Shaffer, 2009). Gender differences in personality traits have been documented in many studies (e.g., Costa Jr. et al., 2001; Ellis, 2011; Feingold, 1994; Lippa, 2010; Lynn and Martin, 1997; Schmitt et al., 2017; Vecchione et al., 2012; Weisberg et al., 2011). Females often report higher Neuroticism, Extraversion, Agreeableness and Openness to Feelings than males (Costa Jr. et al., 2001; Weisberg et al., 2011). More specifically, males tend to score higher in some Extraversion facets (e.g., Assertiveness, Excitement Seeking), whereas females score higher in many Neuroticism (e.g., Anxiety, Depression) and Agreeableness (e.g., Trust, Modesty) facets (Costa Jr. et al., 2001). In a broad study across 37 countries, a tendency for females to display higher Neuroticism values was also found, while a greater likelihood of males scoring higher in Psychoticism was observed (Lynn and Martin, 1997).
Empirical evidence suggests that attachment disorders are a risk factor for the development of pathological personality traits (Fossati et al., 2015; Levy et al., 2015) and, conversely, that personality/temperament influences attachment development (Goldsmith and Alansky, 1987). Hence, one might expect associations between the attachment dimensions and the DSM-5 personality traits. Although previous studies have examined the relationship between attachment styles/dimensions and personality traits (e.g., Fossati et al., 2015; Noftle and Shaver, 2006), to our knowledge there are no published studies on the associations examined herein. Moreover, the APA (2013) encourages further research to assess the validity and clinical usefulness of the Alternative DSM-5 Model for Personality Disorders.
Noftle and Shaver (2006) found several associations between the Big Five personality traits and the two dimensions of attachment, using a dimensional attachment measure (ECR; Brennan et al., 1998) and the Big Five Model (NEO Personality Inventory Revised [NEO-PI-R], Costa and McCrae, 1992; Big Five Inventory [BFI], John et al., 1991). Considering that the domains of the DSM-5 Section III Personality Trait Model are maladaptive variants of the Five-Factor Model (Costa Jr. and Widiger, 2012), Noftle and Shaver's (2006) findings are highly relevant for our study in its attempt to further understand the association of personality as a continuum with attachment dimensions. According to their study, Attachment Anxiety and Avoidance correlated positively with Neuroticism and its Depression and Vulnerability facets. Attachment Anxiety also correlated positively with the Anxiety facet of Neuroticism, while it negatively and modestly correlated with Agreeableness and its Trust facet. Attachment Avoidance negatively correlated with Agreeableness (e.g., Trust and Altruism facets), Extraversion (e.g., Positive Emotions and Warmth facets) and Openness (e.g., Feelings facet). Attachment Anxiety and Avoidance negatively correlated with the Assertiveness facet of Extraversion. These authors also found that both attachment dimensions negatively correlated with Conscientiousness (e.g., Self-discipline facet). Hence, Extraversion, Agreeableness, Openness and Conscientiousness appear to be related to a secure attachment while Neuroticism seems to be linked to an insecure attachment. In such light, the DSM-5 personality domains should be related to the attachment dimensions.
An opposite relational pattern to that reported in Noftle and Shaver's (2006) findings was anticipated. We expected Attachment Anxiety to correlate positively with Negative Affectivity and its Anxiousness, Separation Insecurity and Submissiveness facets (Hypothesis 1); Detachment and its Depressivity facet (Hypothesis 2); Antagonism (Hypothesis 3); and Disinhibition and its Impulsivity, Irresponsibility and Distractibility facets (Hypothesis 4). Attachment Avoidance was expected to correlate positively with Negative Affectivity and its Anxiousness facet (Hypothesis 5); Detachment and its Withdrawal, Intimacy Avoidance, Depressivity, Suspiciousness and Restricted Affectivity facets (Hypothesis 6); Antagonism and its Callousness facet (Hypothesis 7); and Disinhibition and its Impulsivity, Irresponsibility and Distractibility facets (Hypothesis 8). We made no predictions for Psychoticism and its facets. Finally, we expected Attachment Anxiety to predict Negative Affectivity and Attachment Avoidance to predict Detachment for both males and females. Furthermore, given that these associations were not previously studied separately for males and females, we decided to examine gender differences.
Section snippets
Participants
The participants consisted of 106 Portuguese adults aged between 19 and 77 years (M = 35.66; SD = 14.52), who received paper-and-pencil versions of the questionnaires and were asked to complete them voluntarily and individually. Over half of the participants were female (59.4%), single (51.9%), with higher education (56.6%) and employed (53.8%).
Socio-demographic Questionnaire
A 16-item questionnaire designed to collect data on the participants (e.g., age, gender, level of schooling, employment status, marital status, degree
Study 1. Spearman's rank-order correlation analysis
Table 1 shows the group descriptive statistics for the PID-5 personality traits and the ECR attachment dimensions for males and females.
Given that there are no previous studies regarding gender differences on this subject, results of these analyses are exploratory. Such gender differences are reported in Table 2. Differences were found for several PID-5 traits, namely for Antagonism, Emotional Lability, Suspiciousness, Restricted Affectivity, Manipulativeness, Deceitfulness, Callousness,
Discussion
The current study aimed to understand the associations between the DSM-5 maladaptive personality traits and the dimensions of adult attachment in Portuguese adults. In general, several associations were found and our results are in line with those reported in previous studies on the relationship between personality traits and adult attachment dimensions/styles (e.g., Fossati et al., 2015; Noftle and Shaver, 2006).
Gender differences observed in some of the personality traits, but not in the
Acknowledgements
Funding: This research was supported by grants from Fundação para a Ciência e a Tecnologia [FCT; UID/GES/00315/2013].
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