سبک های شخصیت در یک نمونه غیر بالینی: نقش اختلال در تنظیم هیجان و تکانشگری

Theories of personality and personality disorders are increasingly considering the centrality of emotion regulation and its dimensions. Impulsivity as well is recognized as a personality trait underlying diverse symptom presentations. Although research in this field has mainly regarded borderline personality disorder, recent studies supported the association of both emotion dysregulation and impulsivity with personality styles across all clusters. In the present study, we sought to extend extant research by investigating the joint contribution of selected difficulties in emotion regulation and impulsivity to traits of four personality styles in a community sample (N = 399, mean age = 37.91, 56.6% males). In particular, we focused on depressive, masochistic, passive-aggressive and sadistic personality styles. Multiple regression analyses showed the unique association of several domains of emotion dysregulation with all personality styles examined. Nonacceptance of emotional response was significantly and positively related with scores of all personality styles. Lack of emotional awareness was also characteristic of different styles. Beyond these similarities, distinct patterns were able to distinguish between externalizing (sadistic and passive-aggressive), and internalizing (depressive and masochistic) traits. Beyond the role of emotion dysregulation, trait impulsivity was also related to masochistic, passive-aggressive, and sadistic traits, independently explaining a significant amount of additional variance.

Difficulties in emotion regulation and impulse control are considered relevant components of maladaptive personality functioning and personality disorders (PD), yet research on emotion dysregulation and impulsivity has mainly regarded their influence on borderline PD and antisocial PD (Scott, Stepp, & Pilkonis, 2014). Although not recognized as official diagnoses but only listed as PD Not Otherwise Specified (NOS), a handful of other PD styles have historically been considered for their relevance in the study of personality functioning, as well as for their contribution to other PDs, namely: depressive PD, masochistic PD, passive-aggressive PD, and sadistic PD (Kernberg, 1992 and Millon, 2006). Even though they are not included in the official diagnostic systems, the prevalence of PD NOS among all PDs has been reported as ranging from 21% to 49% (Verheul & Widiger, 2004). Other authors suggested that “the majority of patients with personality pathology significant enough to warrant clinical psychotherapeutic attention are currently undiagnosable on axis II” (Westen & Arkowitz-Westen, 1998, p. 1769). Among these, depressive, masochistic, passive-aggressive, and sadistic PD have been the most discussed, even though only sparsely investigated by researchers (Kernberg, 1992 and Millon et al., 2004). For instance, Johnson et al. (1999) found in an adolescent sample that PD diagnoses included in the appendix to DSM-IV (i.e., depressive and passive-aggressive PD) were more predictive of subsequent development of major mental disorders than either cluster A, B or C PDs. Of note, different measures largely used for personality assessment still include these personality styles (e.g., Millon, 2006), yet results concerning them are rarely presented. To our knowledge, little is known about whether emotion dysregulation and impulsivity could also characterize these personality styles. Thus, in the present study we first reviewed the extant literature, and then empirically tested the associations between emotion dysregulation, impulsivity and traits of each of these PD styles in a large community sample.

Table 2 shows means, standard deviations, skewness, kurtosis and reliability coefficients for each dimension. Table 2. Mean, standard deviation (S.D.), skewness, kurtosis and Cronbach’s alpha of all study variables (N = 399). Mean S.D. Skewness Kurtosis Cronbach’s α DERS Nonacceptance 13.51 5.67 0.74 −0.20 .87 DERS Goals 13.58 4.77 0.42 −0.36 .85 DERS Impulse 12.05 4.92 0.93 0.98 .84 DERS Awareness 14.06 4.32 0.52 0.24 .63 DERS Strategies 16.70 6.95 0.95 0.70 .89 DERS Clarity 10.03 3.88 0.97 0.98 .78 BIS-11 63.13 8.11 0.59 0.88 .80 Sadistic 52.49 22.51 −0.69 −0.17 .82 Passive-aggressive 53.69 24.42 −0.39 −0.90 .84 Masochistic 40.07 29.66 −0.03 −0.91 .80 Depressive 41.59 30.75 0.03 −0.93 .87 Note: DERS = Difficulties in Emotion Regulation Scale, subscale scores. BIS-11 = Barratt Impulsiveness Scale, total score. Sadistic to Depressive are all scales of the Millon Clinical Multiaxial Inventory-III. Table options Skewness and kurtosis values between −1 and 1 suggested that all study variables were reasonably normally distributed, thus parametric analyses methods could be performed. Cronbach’s alphas of the six DERS dimensions showed a good internal consistency for five of the six scale, with an almost adequate coefficient for Awareness (consistent with recent research conducted with the Italian version of the DERS; Fossati, Gratz, Maffei, & Borroni, 2013). Both the BIS-11 total score and the MCMI-III scales showed good internal consistency. All DERS dimensions and the BIS-11 total score were significantly and positively related with MCMI-III scales for sadistic, passive-aggressive, masochistic, and depressive PD styles (see Table 3). Table 3. Correlation coefficients of the six DERS subscales and BIS-11 total score with MCMI-III scales for personality disorders considered in this study (N = 399). Nonacceptance Goals Impulse Awareness Strategies Clarity BIS-11 Sadistic .34⁎⁎ .35⁎⁎ .41⁎⁎ .11⁎ .33⁎⁎ .23⁎⁎ .40⁎⁎ Passive-aggressive .41⁎⁎ .37⁎⁎ .45⁎⁎ .18⁎⁎ .43⁎⁎ .30⁎⁎ .38⁎⁎ Masochistic .47⁎⁎ .41⁎⁎ .46⁎⁎ .16⁎⁎ .51⁎⁎ .38⁎⁎ .35⁎⁎ Depressive .49⁎⁎ .38⁎⁎ .44⁎⁎ .16⁎⁎ .54⁎⁎ .33⁎⁎ .32⁎⁎ Note: Nonacceptance to Clarity are scales of the Difficulties in Emotion Regulation Scale (DERS). BIS-11 = Barratt Impulsiveness Scale total score. Sadistic to Depressive are all scales of the Millon Clinical Multiaxial Inventory-III. For ease of interpretation, medium effect sizes (i.e., ⩾.30) are bolded and large effect sizes (i.e., ⩾.50) are bolded and italicized. ⁎ p < .05. ⁎⁎ p < .01. Table options Hierarchical multiple regression analyses were carried out in order to explore the effects of emotional dysregulation and impulsivity on PDs styles. Gender was entered in Step 1 as control variable, whereas Step 2 included the six DERS dimensions and BIS-11 total score as independent variables (results are shown in Table 4). VIF values ranging between 1.31 and 3.26 suggested that least squares method could be used since multicollinearity did not bias regression findings.