Attachment, affective temperament, and personality disorders: a study of their relationships in psychiatric outpatients.
BACKGROUND
As the result of extensive translational and cross-disciplinary research, attachment theory is now a construct with significant neuropsychiatric traction. The correlation of attachment with other influential conceptual models (i.e. temperament and personality) is therefore of interest. Consequently, we explored how two attachment dimensions (attachment anxiety and attachment avoidance) correlated with measures of temperament and personality in 357 psychiatric outpatients.


METHODS
We performed a retrospective review of four questionnaires (the Experiences in Close Relationship scale (ECR-R), Temperament and Character inventory (TCI), Temperament Evaluation of the Memphis, Pisa, Paris and San Diego questionnaire (TEMPS-A), and Personality Self-Portrait Questionnaire (PSQ)). Frequency measures and correlations were examined, as was the predictive value of attachment security for a personality disorder (PD).


RESULTS
Significant, robust correlations were found between attachment anxiety and (1) several negative affective temperaments (dysthymic and cyclothymic); (2) several indices of personality pathology (low self-directedness (TCI), DSM-IV paranoid, borderline, histrionic, avoidant and dependent personality traits). Attachment avoidance had fewer large correlations. In an exploratory model, the negative predictive value of attachment security for a PD was 86%.


CONCLUSIONS
Subjects were a relatively homogeneous subset of ambulatory psychiatric outpatients. PD diagnoses were via self-report.


CONCLUSIONS
Clinically, these findings highlight the significant overlap between attachment, affective temperament, and personality and support the value of attachment as a screen for PDs. More broadly, given our growing understanding of the neurobiology of attachment (i.e. links with the oxytocin system), these results raise interesting questions about underlying biological systems and psychiatric treatment.
University of California Medical Center, Department of Psychiatry, USA. Electronic address: kai@kaimacdonald.com.
Kai
K
MacDonald
Rustin
R
Berlow
Michael L
ML
Thomas
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000523:psychology*; D009769:Object Attachment; D010045:Outpatients; D010551:Personality; D010554:Personality Disorders / Q000523:psychology*; D010555:Personality Inventory / Q000706:statistics & numerical data; D011581:Psychological Tests; D011594:Psychometrics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D057566:Self Report; D011795:Surveys and Questionnaires; D013694:Temperament
Attachment; Mood disorders; Personality; Psychometrics; Questionnaires; Temperament