در مورد رابطه بین نظریه سه جانبه نوع عصبی و ویژگی های اختلال شخصیتی کارن هورنای

Abstract Horney, 1945 and Horney, 1950 interpersonal theory [Horney, K. (1945). Our inner conflicts. New York, NY: W. W. Norton & Co., Inc.; Horney, K. (1950). Neurosis and human growth. New York, NY: W. W. Norton & Co., Inc.] postulated that individuals could move toward, move against, and move away from others as manifestations of their character development. In the present studies, it was hypothesized that Horney's tripartite theory might be useful in the elucidation of Diagnostic and Statistical Manual of Mental Disorders personality disorder features. In the first study, college students (n=198) completed the Coolidge Axis II Inventory [CATI; Coolidge, F. L. (1999), Coolidge Assessment Battery Manual. Port Huron, MI: Sigma Assessment Systems and Coolidge, F. L., & Merwin, M. M. (1992). Reliability and viability of the Coolidge Axis II Inventory: a new inventory for the assessment of personality disorders. Journal of Personality Assessment, 59, 223–238] and Cohen's 1967 35-item test [Cohen, J. B. (1967). An interpersonal orientation to the study of consumer behaviour. Journal of Marketing Research, 4, 270–278] of Horney's three types: Compliant, Aggressive, and Detached. In the second study, another group of college students (n=881) completed the CATI and Coolidge's 57-item test of Horney's three types. Results showed that both scales were reliable, generally similar, and numerous predicted correlational relationships were found. The usefulness of Horney's constructs in the understanding of personality disorders was discussed.

Introduction Horney, 1945 and Horney, 1950 proposed a tripartite interpersonal theory couched in the language of her own clinical experience. She postulated a basic anxiety rooted in a child's feelings of isolation and helplessness in a threatening and hostile world. She thought that this anxiety could be enhanced by a number of environmental factors, but that it was often due to problems in the parent–child relationship. These problems could include, for example, parents who were dominating, indifferent, or erratic; who failed to respect a child's needs or to provide guidance; who demonstrated demeaning attitudes and either a lack of or excessive admiration; or parents who displayed a lack of warmth and failed to keep promises. As a reaction to bad parenting, Horney, 1945 and Horney, 1950) theorized that a child could develop a sense that the parents were hypocritical by contrasting their inadequate parenting with their professed love, generosity, and Christian charity. As a function of these influences, the child would strive for ways to cope. Horney believed that these coping mechanisms were not simply ad hoc defenses, but that they might become lasting character trends that she called “neurotic trends”. According to Horney, three main defenses would crystallize: A child can move toward people, against people, or away from people. Horney further hypothesized that a healthy individual was free to vacillate between any of these three interpersonal orientations, and these orientations might help to foster self-realization. She also theorized that all three neurotic types might not encompass the entire healthy personality. A brief review of Horney's three predominant neurotic types follows. 1.1. Moving toward people Known as the Compliant type, these individuals accept their own helplessness and try to gain reassurance and protection against the basic anxiety by attempting to win the affection of others and sometimes attaching themselves to a person or group that they perceive as powerful. Horney thought that Compliant types might thus gain a feeling of support and belonging which minimizes their feelings of weakness and isolation. According to Horney, Compliant types appease others at any interpersonal cost including self-subordination and the dropping of any claims to individuality. They also evaluate themselves by what others think and become overly dependent on other people for love and safety. 1.2. Moving against people Known as the Aggressive type, these people accept the hypocrisy and underlying hostility in their environment, and they fight, either consciously or unconsciously, to protect themselves and to seek revenge. They automatically distrust other people's feelings and intentions, and they rebel in whatever way they can. 1.3. Moving away from people Known as the Detached type, these people do not have feelings of belonging or the desire to fight. They not only distance themselves from others, but they are also estranged from themselves. They become numb to their own emotional experiences and feelings, and they are uncertain as to their own identity needs and desires. They consciously and unconsciously avoid emotional involvement with others and have a strong need for self-sufficiency. Despite calls for more investigations of Horney's theories (i.e. van den Daele, 1987), there has been a dearth of empirical research. The purpose of the present studies was to address this lacuna. Horney's tripartite theory is important to study, because it is a clinically based theory which can potentially aid case conceptualization and psychotherapeutic intervention. Furthermore, her theory easily generates testable clinical hypotheses regarding developmental issues and the formation of anxiety-reduction mechanisms. Her theory also bridges the gap between normal personality development and personality psychopathology, and therefore, it seems important to understand specifically how Horney's types relate to modern personality disorders. The present studies investigated two different operationalizations of Horney's theory in the context of personality disorders. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; APA, 1994), personality traits are enduring patterns of interpreting and responding to one's environment, and these traits constitute disorders when they cause significant impairment or distress. Because Horney's tripartite interpersonal theory also views neurotic styles as enduring reactions to the environment, it was hypothesized that Horney's theory would be useful in the explication of modern personality disorders. In Experiment 1, Cohen's (1967) operationalization of Horney's three neurotic types was used as a measure of compliance, aggression, and detachment. The Coolidge Axis II Inventory (CATI; Coolidge, 1993; 1999) was used to assess personality disorders. Specifically, it was hypothesized that Horney's Compliant type would be positively correlated with the dependent and histrionic personality disorders and negatively correlated with antisocial, obsessive-compulsive, paranoid, passive-aggressive, schizoid, and schizotypal personality disorders. It was hypothesized that the Aggressive type would be positively correlated with the antisocial, borderline, narcissistic, paranoid, and passive-aggressive personality disorders and negatively correlated with the dependent and the schizoid personality disorders. It was hypothesized that the Detached type would be positively correlated with the antisocial, avoidant, paranoid, passive-aggressive, schizoid, and schizotypal personality disorders and negatively correlated with the histrionic personality disorder.

6. Results 6.1. HCTI scale psychometrics 6.1.1. HCTI scale means and standard deviations The means (n=881) for the three scales were as follows: Compliance=51.1 (SD=7.0); Aggression=44.5 (SD=7.7); and Detachment=37.5 (SD=7.1). The means for the males (n=315) were: Compliance=50.2 (SD=7.0); Aggression=46.9 (SD=7.7); and Detachment=38.3 (SD=7.5). The means for the females (n=566) were: Compliance=51.7 (SD=6.9); Aggression=43.2 (SD=7.4); and Detachment=37.0 (SD=6.9). 6.1.2. HCTI scale reliabilities The scale reliabilities were as follows: Compliance (0.78), Aggression (0.83), and Detachment (0.82). The scale reliabilities were established on 875 of the original 881 participants, because six participants had at least one missing value on the HCTI. 6.1.3. HCTI test–retest reliabilities One week test–retest reliabilities on a random sample consisting of 67 of the original participants were as follows: Compliance (0.92); Aggression (0.92); and Detachment (0.91). 6.1.4. HCTI scale factor analyses A principal components factor analysis with varimax rotation revealed that the Compliance scale had a five factor solution (eigenvalues greater than 1.00) with 9, 8, 8, 6, and 6% of the variance accounted for by its factors, respectively. The first factor was interpreted as a need for relationships. The second factor appeared to be a measure of altruism. The third factor appeared to measure self-abasement in relationships. The fourth factor appeared to be a measure of affection and sympathy for others. The fifth factor appeared to measure the need to be liked and concern for what other people think about them. The Aggression scale had a five factor solution with 10, 9, 8, 6, and 5% of the variance accounted for by its factors, respectively. The first factor appeared to measure a malevolent view of other people's behavior. The second factor appeared to measure the need to be in command and to be powerful. The third factor appeared to measure attitudes valuing strength and toughness. The fourth factor appeared to measure a malevolent view of the world. The fifth factor appeared to measure the values of testing one's strength and bravery. The Detachment scale had a five factor solution with 14, 9, 9, 5, and 5% of the variance accounted for by its factors, respectively. The first factor appeared to measure the need to be alone. The second factor appeared to measure interpersonal avoidance and resistance. The third factor appeared to measure avoidance of social interactions. The fourth factor appeared to measure lack of loneliness. The fifth factor appeared to be a measure of self-sufficiency. 6.1.5. HCTI scales and the CATI personality disorder scales It appeared that there was sufficient variation on the personality disorder scales in order to make speculations about relationships with the HCTI scales. The median percentage of the sample that was elevated by at least two standard deviations (the clinical norm, see Coolidge, 1999) across the 14 CATI personality disorder scales was 3.1 with a range of 1.6% on the borderline personality disorder scale to 5.7% on the sadistic scale. The results of the zero-order correlation analysis between the HCTI scales and the CATI personality disorder scales appear in Table 1. On the HCTI Compliance scale, seven of the eight original predictions were in the hypothesized directions, and four of these were significant. The Compliance scale was also significantly correlated with the avoidant scale, but this relationship had not been hypothesized. On the HCTI Aggression scale, all 11 personality disorder scales were significantly and positively correlated, and five of the seven personality disorder scales had been predicted correctly. On the HCTI Detachment scale, 10 of the 11 personality disorder scales had significant correlations, and all seven predicted relationships were confirmed. Comparisons between Cohen's CAD scales with the HCTI on the original 22 predicted relationships showed that Cohen's scales were in the correct direction in 19 cases with significant correlations in 18 of the 19 cases. The HCTI scales were in the correct predicted direction in 18 cases with significant correlations in 15 cases. The mean of the absolute values of the 11 personality disorder correlations on Cohen's Compliance scale was r=0.20, while on the HCTI Compliance scale, it was r=0.17. The mean of the absolute values of the 11 personality disorder correlations on Cohen's Aggression scale was r=0.32, while on the HCTI Compliance scale, it was r=0.34. The mean of the absolute values of the 11 personality disorder correlations on Cohen's Detachment scale was r=0.18, while on the HCTI Compliance scale, it was r=0.35. With respect to the five additional hypotheses on the sadistic, self-defeating, and depressive scales, all three predictions were confirmed for the sadistic scale (a negative correlation with Compliance and positive correlations with Aggression and Detachment). The predicted positive correlation between the Compliant type and the self-defeating scale was not confirmed, nor was the predicted negative correlation between the depressive scale and the Detached type. However, three significant correlations were obtained that had not been predicted: positive correlations between Aggressive and Detached types with the self-defeating scale and a positive correlation between the Aggressive type and the depressive personality disorder scale. A canonical correlation analysis revealed three significant canonical variates, although only the first two canonical correlations were substantial (r>0.50). The first canonical set included canonical loadings from the Compliance (−0.65), Aggression (0.71), and Detachment (0.85) HCTI scales with substantial canonical loadings (r ⩾0.30) from the antisocial (0.56), avoidant (0.31), histrionic (−0.36), obsessive–compulsive (0.41), paranoid (0.73), passive–aggressive (0.39), schizotypal (0.62), and schizoid (0.71) scales. The second canonical set included canonical loadings from the Compliance (0.10), Aggression (−0.56), and Detachment (0.49) HCTI scales with substantial canonical loadings (r⩾0.30) from the antisocial (−0.54), avoidant (0.64), histrionic (−0.72), narcissistic (−0.37), obsessive-compulsive (0.34), and schizoid (0.47) scales. A three-factor analysis of variance was performed upon the T scores for the three HCTI scales as well as gender and age (younger <30 years, middle ⩾30 and ⩽55 years, older >55 years). The three-factor interaction was not significant, but the scales-by-gender interaction was significant (F (2802)=14.80, p<0.001, eta squared=0.04) as well as the scales-by-age interaction (F (2802)=7.41, p<0.001, eta squared=0.03). Subsequent post hoc analyses (Tukey's test at p=0.05) revealed that, in general, Compliance scores were greater than Aggression scores which, in turn, were significantly higher than Detachment scores. Males had significantly higher Aggression and Detachment scores than females, while females had significantly greater Compliance scores than males. Compliance was significantly higher for males and females in the older age group. Aggression scores progressively got lower as a function of age for females. In contrast, Aggression scores in males were lowest in the middle age group compared to the younger and older adult groups. On the Detachment scale, male and female scores increased from young to middle age and then leveled off.