Stability and Change in Relations Between Personality Traits and the Interpersonal Problems Circumplex During Cognitive Therapy for Recurrent Depression

Abstract

Both personality impairment and maladaptive-range traits are necessary for diagnosis in the alternative model of personality disorder. We clarified personality impairment-trait connections using measures of the interpersonal problems circumplex and personality traits among adult outpatients (N = 351) with major depressive disorder receiving cognitive therapy (CT). The trait scales’ circumplex projections were summarized by elevation (correlations with general interpersonal problems), amplitude (specific relations to the circumplex dimensions of dominance and affiliation), and angle (predominant orientation in the two-dimensional circumplex). Most trait scales showed hypothesized circumplex relations, including substantive elevation (e.g., negative temperament, mistrust), amplitude (e.g., aggression, detachment), and expected angles (e.g., positive temperament and manipulativeness oriented toward overly nurturant/intrusive or domineering/vindictive problems, respectively), that were stable across time during CT. These results revealed meaningful and consistent impairment-trait connections, even during CT when mean depressive affect decreased substantially.

Keywords

personality interpersonal problems depression cognitive therapy stability

Get full access to this article

View all access options for this article.

References

Alden

L. E.

Wiggins

J. S.

Pincus

A. L.

(1990). Construction of circumplex scales for the Inventory of Interpersonal Problems. Journal of Personality Assessment, 55(3-4), 521-536. https://doi.org/10.1080/00223891.1990.9674088

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Author.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Author. https://doi.org/10.1176/appi.books.9780890425596

Beck

A. T.

Rush

A. J.

Shaw

B. F.

Emery

(1979). Cognitive therapy of depression. Guilford Press.

Bastiaansen

Hopwood

C. J.

Van den Broeck

Rossi

Schotte

De Fruyt

(2016). The twofold diagnosis of personality disorder: How do personality dysfunction and pathological traits increment each other at successive levels of the trait hierarchy? Personality Disorders, 7(3), 280-292. https://doi.org/10.1037/per0000149

Beck

A. T.

Ward

C. H.

Mendelson

Mock

Erbaugh

(1961). An inventory for measuring depression. Archives of General Psychiatry, 4(6), 561-571. https://doi.org/10.1001/archpsyc.1961.01710120031004

Berghuis

Kamphuis

J. H.

Verheul

(2012). Core features of personality disorder: Differentiating general personality dysfunctioning from personality traits. Journal of Personality Disorders, 26(5), 704-716. https://doi.org/10.1521/pedi.2012.26.5.704

Berghuis

Kamphuis

J. H.

Verheul

(2014). Specific personality traits and general personality dysfunction as predictors of the presence and severity of personality disorders in a clinical sample. Journal of Personality Assessment, 96(4), 410-416. https://doi.org/10.1080/00223891.2013.834825

Calabrese

W. R.

Simms

L. J.

(2014). Prediction of daily ratings of psychosocial functioning: Can ratings of personality disorder traits and functioning be distinguished? Personality Disorders: Theory, Research, and Treatment, 5(3), 314-322. https://doi.org/10.1037/per0000071

10.

Canty

Ripley

(2019). boot: Bootstrap R (S-Plus) functions (R package version 1.3-22) [Computer software]. https://cran.r-project.org/web/packages/boot/index.html

11.

Clark

L. A.

Simms

L. J.

K. D.

Casillas

(2014). Schedule for nonadaptive and adaptive personality: Manual for administration, scoring, and interpretation (2nd ed.). https://doi.org/10.1037/t07079-000

12.

Clark

L. A.

(2014). Three-pronged assessment and diagnosis of personality disorder and its consequences: Personality functioning, pathological traits, and psychosocial disability. Personality Disorders, 5(1), 55-69. https://doi.org/10.1037/per0000063

13.

Clark

L. A.

Vittengl

J. R.

Kraft

Jarrett

R. B.

(2003). Separate personality traits from states to predict future depression. Journal of Personality Disorders, 17(2), 152-172. https://doi.org/10.1521/pedi.17.2.152.23990

14.

Craighead

W. E.

Johnson

B. N.

Carey

Dunlop

B. W.

(2015). Psychosocial treatments for major depressive disorder. In Nathan

P. E.

Gorman

J. M.

(Eds.), A guide to treatments that work (4th ed., pp. 381-408). Oxford University Press. https://doi.org/10.1093/med:psych/9780199342211.003.0013

15.

T. V.

Yardley

A. E.

Thomas

K. M.

(2020). Mapping Big Five Personality Traits within and across domains of interpersonal functioning. Assessment. Advance online publication. https://doi.org/10.1177/1073191120913952

16.

First

M. B.

Spitzer

R. L.

Gibbon

Williams

J. B.

(1996). Structured Clinical Interview for DSM-IV Axis I Disorders—Patient edition (SCID-I/P, version 2.0). New York State Psychiatric Institute, Biometrics Research Department. https://doi.org/10.1037/t07827-000

17.

Griens

A. M. G. F.

Jonker

Spinhoven

Blom

M. B. J.

(2002). The influence of depressive state features on trait measurement. Journal of Affective Disorders, 70(1), 95-99. https://doi.org/10.1016/S0165-0327(00)00371-2

18.

Gurtman

M. B.

(2009). Exploring personality with the interpersonal circumplex. Social and Personality Psychology Compass, 3(4), 601-619. https://doi.org/10.1111/j.1751-9004.2009.00172.x

19.

Gurtman

M. B.

Balakrishnan

J. D.

(1998). Circular measurement redux: The analysis and interpretation of interpersonal circle profiles. Clinical Psychology: Science and Practice, 5(3), 344-360. https://doi.org/10.1111/j.1468-2850.1998.tb00154.x

20.

Hamilton

(1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry, 23(1), 56-61. https://doi.org/10.1136/jnnp.23.1.56

21.

Hopwood

C. J.

Koonce

E. A.

Morey

L. C.

(2009). An exploratory study of integrative personality pathology systems and the interpersonal circumplex. Journal of Psychopathology and Behavioral Assessment, 31(4), 331-339. https://doi.org/10.1007/s10862-008-9124-y

22.

Hopwood

C. J.

Koonce

E. A.

Morey

L. C.

(2013). Erratum to: An exploratory study of integrative personality pathology systems and the interpersonal circumplex. Journal of Psychopathology and Behavioral Assessment, 35(3), 404-406. https://doi.org/10.1007/s10862-012-9337-y

23.

Horowitz

L. M.

Alden

L. E.

Wiggins

J. S.

Pincus

A. L.

(2000). Inventory of interpersonal problems manual. Psychological Corporation.

24.

Horowitz

L. M.

Rosenberg

S. E.

Baer

B. A.

Ureño

Villaseñor

V. S.

(1988). Inventory of interpersonal problems: Psychometric properties and clinical applications. Journal of Consulting and Clinical Psychology, 56(6), 885-892. https://doi.org/10.1037/0022-006X.56.6.885

25.

Jarrett

R. B.

Thase

M. E.

(2010). Comparative efficacy and durability of continuation phase cognitive therapy for preventing recurrent depression: Design of a double-blinded fluoxetine- and pill placebo-controlled randomized trial with 2-year follow-up. Contemporary Clinical Trials, 31(4), 355-377. https://doi.org/10.1016/j.Cct.2010.04.004

26.

Klein

D. N.

Bufferd

S. J.

Clark

L. A.

(2014). Depression and comorbidity: Personality disorder. In Richards

C. S.

O’Hara

M. W.

(Eds.), The Oxford handbook of depression and comorbidity (pp. 200-217). Oxford University Press. https://doi.org/10.1093/oxfordhb/9780199797004.013.025

27.

Krueger

R. F.

Hopwood

C. J.

Wright

A. G. C.

Markon

K. E.

(2014). DSM-5 and the path toward empirically based and clinically useful conceptualization of personality and psychopathology. Clinical Psychology: Science and Practice, 21(3), 245-261. https://doi.org/10.1111/cpsp.12073

28.

McCabe

G. A.

Widiger

T. A.

(2020). A comprehensive comparison of the ICD-11 and DSM-5 section III personality disorder models. Psychological Assessment, 32(1), 72-84. https://doi.org/10.1037/pas0000772

29.

Morey

L. C.

Good

E. W.

Hopwood

C. J.

(2020). Global personality dysfunction and the relationship of pathological and normal trait domains in the DSM-5 alternative model for personality disorders. Journal of Personality, 32(1), 72-84. https://doi.org/10.1111/jopy.12560

30.

Morey

L. C.

Hopwood

C. J.

Markowitz

J. C.

Gunderson

J. G.

Grilo

C. M.

McGlashan

T. H.

Shea

M. T.

Yen

Sanislow

C. A.

Ansell

E. B.

Skodol

A. E.

(2012). Comparison of alternative models for personality disorders, II: 6, 8- and 10-year follow-up. Psychological Medicine, 42(8), 1705-1713. https://doi.org/10.1017/S0033291711002601

31.

Morey

L. C.

Shea

M. T.

Markowitz

J. C.

Stout

R. L.

Hopwood

C. J.

Gunderson

J. G.

Grilo

C. M.

McGlashan

T. H.

Yen

Sanislow

C. A.

Skodol

A. E.

(2010). State effects of major depression on the assessment of personality and personality disorder. American Journal of Psychiatry, 167(5), 528-535. https://doi.org/10.1176/appi.ajp.2009.09071023

32.

Naragon-Gainey

Gallagher

M. W.

Brown

T. A.

(2013). Stable “trait” variance of temperament as a predictor of the temporal course of depression and social phobia. Journal of Abnormal Psychology, 122(3), 611-623. https://doi.org/10.1037/a0032997.supp

33.

Noordhof

Kamphuis

J. H.

Sellbom

Eigenhuis

Bagby

R. M.

(2018). Change in self-reported personality during major depressive disorder treatment: A reanalysis of treatment studies from a demoralization perspective. Personality Disorders, 9(1), 93-100. https://doi.org/10.1037/per0000238

34.

Nuzum

Shapiro

J. L.

Clark

L. A.

(2019). Affect, behavior, and cognition in personality and functioning: An item-content approach to clarifying empirical overlap. Psychological Assessment, 31(7), 905-912. https://doi.org/10.1037/pas0000712

35.

Pryor

L. R.

Miller

J. D.

Gaughan

E. T.

(2009). Testing two alternative pathological personality measures in the assessment of psychopathy: An examination of the SNAP and DAPP-BQ. Journal of Personality Disorders, 23(1), 85-100. https://doi.org/10.1521/pedi.2009.23.1.85

36.

R Core Team. (2019). R: A language and environment for statistical computing. R Foundation for Statistical Computing. https://www.R-project.org/

37.

Ready

R. E.

Clark

L. A.

(2002). Correspondence of psychiatric patient and informant ratings of personality traits, temperament, and interpersonal problems. Psychological Assessment, 14(1), 39-49. https://doi.org/10.1037/1040-3590.14.1.39

38.

Reed

G. M.

(2018). Progress in developing a classification of personality disorders for ICD-11. World Psychiatry, 17(2), 227-229. https://doi.org/10.1002/wps.20533

39.

Renner

Jarrett

R. B.

Vittengl

J. R.

Barrett

M. S.

Clark

L. A.

Thase

M. E.

(2012). Interpersonal problems as predictors of therapeutic alliance and symptom improvement in cognitive therapy for depression. Journal of Affective Disorders, 138(3), 458-467. https://doi.org/10.1016/j.Jad.2011.12.044

40.

Revelle

(2018). psych: Procedures for personality and psychological research (R package version 1.8.12) [Computer software]. Northwestern University.

41.

Rush

A. J.

Gullion

C. M.

Basco

M. R.

Jarrett

R. B.

Trivedi

M. H.

(1996). The Inventory of Depressive Symptomatology (IDS): Psychometric properties. Psychological Medicine, 26(3), 477-486. https://doi.org/10.1017/S0033291700035558

42.

Skodol

A. E.

(2014). Manifestations, assessment, and differential diagnosis. In Oldham

J. M.

Skodol

A. E.

Bender

D. S.

(Eds.), The American psychiatric publishing textbook of personality disorders (2nd ed., pp. 131-164). American Psychiatric Association. https://doi.org/10.1176/appi.books.9781585625031.rh25

43.

Stepp

S. D.

Miller

J. D.

Hallquist

M. N.

Trull

T. J.

Pilkonis

P. A.

(2012). Integrating competing dimensional models of personality: Linking the SNAP, TCI, and NEO using item response theory. Personality Disorders, 3(2), 107-126. https://doi.org/10.1037/a0025905

44.

Vittengl

J. R.

Clark

L. A.

Jarrett

R. B.

(2003). Interpersonal problems, personality pathology, and social adjustment after cognitive therapy for depression. Psychological Assessment, 15(1), 29-40. https://doi.org/10.1037/1040-3590.15.1.29

45.

Vittengl

J. R.

Clark

L. A.

Kraft

Jarrett

R. B.

(2005). Multiple measures, methods, and moments: A factor-analytic investigation of change in depressive symptoms during acute-phase cognitive therapy. Psychological Medicine, 35(5), 693-704. https://doi.org/10.1017/S0033291704004143

46.

Vittengl

J. R.

Clark

L. A.

Thase

M. E.

Jarrett

R. B.

(2014). Replication and extension: Separate personality traits from states to predict depression. Journal of Personality Disorders, 28(2), 225-246. https://doi.org/10.1521/pedi_2013_27_117

47.

Vittengl

J. R.

Clark

L. A.

Thase

M. E.

Jarrett

R. B.

(2018). Relations of shared and unique components of personality and psychosocial functioning to depressive symptoms. Journal of Personality Disorders, 32(5), 577-602. https://doi.org/10.1521/pedi_2017_31_313

48.

Wendt

L. P.

Wright

A. G. C.

Pilkonis

P. A.

Nolte

Fonagy

Montague

P. R.

Benecke

Krieger

Zimmermann

(2019). The latent structure of interpersonal problems: Validity of dimensional, categorical, and hybrid models. Journal of Abnormal Psychology, 128(8), 823-839. https://doi.org/10.1037/abn0000460.supp

49.

Widiger

T. A.

(2010). Personality, interpersonal circumplex, and DSM-5: A commentary on five studies. Journal of Personality Assessment, 92(6), 528-532. https://doi.org/10.1080/00223891.2010.513707

50.

Wiggins

J. S.

Pincus

A. L.

(2002). Personality structure and the structure of personality disorders. In Costa

P. T.

Jr. Widiger

T. A.

(Eds.), Personality disorders and the five-factor model of personality (2nd ed., pp. 103-124). American Psychological Association. https://doi.org/10.1037/10423-007

51.

World Health Organization. (2019). International statistical classification of diseases and related health problems (11th ed.). https://icd.who.int/

52.

Wright

A. G. C.

Pincus

A. L.

Hopwood

C. J.

Thomas

K. M.

Markon

K. E.

Krueger

R. F.

(2012). An interpersonal analysis of pathological personality traits in DSM-5. Assessment, 19(3), 263-275. https://doi.org/10.1177/1073191112446657

53.

Wright

A. G.

Simms

L. J.

(2016). Stability and fluctuation of personality disorder features in daily life. Journal of Abnormal Psychology, 125(5), 641-656. https://doi.org/10.1037/abn0000169

54.

Zimmermann

Mayer

Leising

Krieger

grosse Holtforth

Pretsch

(2017). Exploring occasion specificity in the assessment of DSM-5 maladaptive personality traits: A latent state-trait analysis. European Journal of Psychological Assessment, 33(1), 47-54. https://doi.org/10.1027/1015-5759/a000271

55.

Zimmermann

Wright

A. G. C.

(2017). Beyond description in interpersonal construct validation: Methodological advances in the circumplex structural summary approach. Assessment, 24(1), 3-23. https://doi.org/10.1177/1073191115621795