Personality and Individual Differences

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1 Personality and Individual Differences 47 (2009) Contents lists available at ScienceDirect Personality and Individual Differences journal homepage: Emotional reactivity and self-regulation in relation to personality disorders Laurence Claes a, *, Stefaan Vertommen a,b, Dirk Smits a,c, Patricia Bijttebier a a K.U. Leuven, Department of Psychology, Leuven, Belgium b Universitair Psychiatrisch Centrum St.-Jozef, Kortenberg, Belgium c HUB, Campus Nieuwland, Brussel, Belgium article info abstract Article history: Received 4 May 2009 Received in revised form 22 July 2009 Accepted 28 July 2009 Available online 22 August 2009 Keywords: Behavioural inhibition Behavioural activation Effortful control Personality disorders Associations of both reactive and regulative temperamental features with personality disorders (PDs) are investigated in a sample of 162 normal controls and 89 psychiatric inpatients. Reactive and regulative temperamental features were assessed by means of the BIS/BAS Scales and the Attentional Control Scale. Dimensional PD scores were obtained by using the ADP-IV. All PDs were characterized by low levels of effortful control, cluster C PDs by high BIS and cluster B PDs by high BAS. For several PDs, BIS and effortful control interacted: BIS was only related to severe PD pathology if effortful control was low. Clinical implications of these findings are discussed. Ó 2009 Elsevier Ltd. All rights reserved. 1. Introduction * Corresponding author. Address: Catholic University of Leuven, Department of Psychology, Tiensestraat 102, 3000 Leuven, Belgium. Tel.: +32 (0) ; fax: +32 (0) address: Laurence.claes@psy.kuleuven.be (L. Claes). Several authors have highlighted associations with temperament as promising avenues for understanding psychopathology (Muris & Ollendick, 2005; Nigg, 2006). Until recently, most research attention has been devoted to reactive aspects of temperament (i.e. affective-motivational reactivity). Several studies have shown that extreme (diminished as well as elevated) levels of temperamental reactivity are associated with psychopathology: high levels of behavioural inhibition system (BIS) reactivity with anxiety, depression, alcoholism and eating disorders; low levels of BIS with psychopathy; high levels of behavioural activation system (BAS) reactivity with substance abuse, manic episodes, conduct problems; low levels of BAS with depression (Bijttebier, Beck, Claes, & Vandereycken, 2009). The contribution of temperament to vulnerability for psychopathology should, however, not be viewed as merely guided by emotional reactivity. Current theories of vulnerability for psychopathology also emphasize the influence of effortful processes that enable persons to modulate their emotional reactions (Nigg, 2006). As such, the risk associated with temperamental reactivity can be decreased, making effortful control a protective factor. Given that individual differences in reactive and regulative temperament are supposed to underlie enduring personality dimensions, reactive and regulative temperament can be expected to have relevance for DSM-IV Axis I clinical disorders, and certainly for DSM-IV Axis II personality disorders (PDs). Nonetheless, in contrast to the relevance of both aspects of temperament in recent theories of vulnerability to pathology, only few studies explored their combined influence to PD symptoms, which is the aim of the present study. In Gray s (1987) Reinforcement Sensitivity Theory (RST), reactivity to immediate incentive contexts is conceptualized in terms of motivation systems of avoidance (BIS) and approach (BAS). The BIS is sensitive to stimuli that signal conditioned aversive events (punishment), non-reward, and novelty. It inhibits behaviour that may lead to negative or painful outcomes (Fowles, 1980). In terms of individual differences in personality, higher BIS sensitivity is reflected in higher proneness to anxiety (Carver & White, 1994) and is related to the personality trait of Neuroticism (Nigg, 2006). The BAS (Fowles, 1980) is sensitive to signals of unconditioned reward, non-punishment and escape from punishment. In terms of individual differences in personality, elevated BAS sensitivity is reflected in elevated proneness to engage in goaldirected efforts and to experience positive feelings (Carver & White, 1994) and is related to the personality trait of Extraversion (Nigg, 2006). Over the years, RST developed to include a third major system: the fight flight system (FFS: Gray, 1987). Whereas the BIS responds to conditioned aversive stimuli, the FFS responds to unconditioned aversive stimuli. In 2000, Gray and McNaughton presented a major revision of RST (Corr, 2008). The BAS is now assumed to be responsive to (un)conditioned positively valenced stimuli. The Fight/Flight/Freeze System (FFFS) adopts /$ - see front matter Ó 2009 Elsevier Ltd. All rights reserved. doi: /j.paid

2 L. Claes et al. / Personality and Individual Differences 47 (2009) the punishment system role that was originally ascribed to the BIS. Finally, the BIS is now believed to be responsible for the resolution of goal conflict in general (reactive control), i.e. to regulate situations in which both the BAS and the FFFS have been activated (Bijttebier et al., 2009). Only a handful of studies have investigated patterns of reactivity associated with Axis II PDs. High levels of BIS have been related to all cluster C PDs (Caseras, Torrubia, & Farré, 2001; Farmer & Nelson-Gray, 1995; Fullana et al., 2004; Pastor et al., 2007), cluster A paranoid and schizotypal PDs (Gilbert, Boxall, Cheung, & Irons, 2005; Pastor et al., 2007) as well as cluster B borderline PD; whereas low levels of BIS have been related to cluster B antisocial and narcissistic PDs (Fowles, 1980; Pastor et al., 2007). High levels of BAS have been related to all cluster B PDs (Carver & White, 1994; Farmer & Nelson-Gray, 1995; Harmon-Jones, 2003; Pastor et al., 2007; Quay, 1993) as well as the cluster A paranoid and schizotypal PDs (Pastor et al., 2007), which reflects according to Fowles (1992) the tendency toward positive schizophrenia symptoms in these PDs. Finally, low levels of BAS have been described in cluster A schizoid and cluster C-avoidant PDs, which are both characterized by low levels of extraversion (Pastor et al., 2007). Current theories of psychopathology (Nigg, 2006) not only emphasize the role of temperamental reactivity, but also the influence of effortful processes that enable persons to regulate their emotional reactivity and as such decrease the risks associated with reactivity (Bijttebier et al., 2009). The notion of effortful control (EC; Rothbart, 1989) includes both behavioural forms of self-control as well as attentional processes (e.g., the ability to voluntarily focus or shift attention) and is related to the personality trait Conscientiousness (Nigg, 2006). As far as we know, few studies have focussed on the association between (lack of) EC and PDs. Hoermann, Clarkin, Hull, and Levy (2005) compared three subgroups of borderline patients with different levels of EC with respect to symptoms, interpersonal relations and personality organization. Subgroup 1 (high EC), exhibited the fewest problems in symptoms, interpersonal functioning and personality organization, whereas subgroup 3 (low EC) was characterized by the most problems in these areas. Subgroup 2, high in some aspects of EC and low in others, was situated between groups 1 and 3. Both reactive and effortful dimensions of temperament have been related separately to PDs. However, integration of both dimensions in one study is needed to investigate their joint influence on PDs and test current theorizing about temperament and psychopathology. The work of Depue and Lenzenweger (2005) offers a clear theoretical framework to understand the influence of both reactive and regulative features on personality disturbance. The reactive dimensions (BIS and BAS) of temperament provide the qualitative emotional content of contemporaneous behaviour, and the regulative dimension (EC) of temperament modulates the probability of elicitation of all the reactive systems. For example, the antisocial PD is characterized by a high ratio of BAS/BIS reactivity and a low level of EC. Our aim is to investigate the joint interactive or additive influence of reactive and effortful dimensions of temperament on PDs. In the first case (interactive), EC acts as a moderator on the association between temperamental reactivity and PDs, so they may not be studied separately. In the second case (additive), reactivity and EC each play a unique role and have additive effects on personality psychopathology. Based on the literature, we expect that high levels of BIS are related to cluster A, B (e.g., borderline, histrionic) and C PDs; and low levels of BIS to cluster B antisocial and narcissistic PDs. High levels of BAS are considered to be related to all cluster B PDs. Fewer hypotheses can be formulated concerning the joined (additive or interactive) influence of both reactive and regulative features on PDs. Based on the literature on anxiety problems (Muris & Ollendick, 2005), we may expect that cluster C PDs are not only determined by the main effects of BIS and EC, but also by their interaction (BIS EC), meaning that high BIS only determines problematic cluster C PDs if EC is low. In the same line of reasoning and referring to research on conduct disorders (Uzieblo, Verschuere, & Crombez, 2007), the cluster B antisocial PD is not only determined by the main effects of BAS and EC, but also by their interaction (BAS EC), meaning that high BAS only determines the antisocial PD if EC is low. These studies, suggest in both cases an interactive effect instead of solely an additive effect of BIS/ BAS and EC on PDs. 2. Method 2.1. Participants and procedure The total sample consisted of 251 participants (55.4% females). One hundred and sixty two (56.2% females) participants were recruited in the Flemish-speaking Belgian population and 89 (53.9% females) participants were recruited in a general admission unit of an inpatient psychiatric clinic. All participants were provided with an envelope holding informed consent documents and questionnaires. Participants willing to participate provided written informed consent, completed the questionnaires and returned the documents to the researcher in a sealed envelope. There were no significant gender differences in the patient and the normal control group [{ 2 (1) = 0.11, n.s.]. The mean age of the total sample was years (SD = 16.16) and there were no significant age differences between patients and normal controls [F(1, 247) = 0.15, n.s.]. Overall, 4.4% participants received only elementary education, 42% secondary education, 34.4% higher education and 19.2% university education. Patients more often received only elementary education compared to normal controls, and normal controls followed more often secondary, and certainly more higher and university education than patients [{ 2 (3) = 11.99, p < 0.01]. Finally, with respect to marital status, 49.1% of the participants were married, 10.8% divorced, 0.4% widowed, and 39.2% not married. Patients were more often divorced than normal controls, and normal controls were more often married than patients [{ 2 (3) = 21.39, n.s.]. We preferred to include both normal controls and psychiatric patients in one sample to enlarge the variability in the level of personality psychopathology. The prevalence of the different categorical PD diagnoses were as follows for normal controls/patients: paranoid (1.2%; 14.6%), schizoid (0%; 10.1%), schizotypal (1.2%; 9%), antisocial (0.6%; 6.7%), borderline (1.9%; 37.1%), histrionic (0%; 11.2%), narcissistic (0%; 0%), avoidant (0.6%; 28.1%), dependent (0.6%; 14.6%), and obsessive compulsive (3.1%; 27%) PDs Instruments Temperamental reactivity was assessed by means of the Behavioural Inhibition System and Behavioural Activation System Scales (BIS/BAS Scales; Carver & White, 1994). The BIS/BAS scales consist of seven items related to BIS (seven items; a = 0.82 in the present study) and 13 items related to BAS (n = 13; a = 0.77). All items were judged on a four-point scale from 1 (I strongly agree) to 4 (I strongly disagree). Effortful control was measured by means of the Attentional Control Scale (ACS; Derryberry & Reed, 2002). The ACS comprises 20 items, tapping individual differences in attentional control. Items are summed to yield a total score. The total measure of attentional control is internally consistent (a = 0.86). It is positively related to indices of positive emotionality such as extraversion (r = 0.40) and

3 950 L. Claes et al. / Personality and Individual Differences 47 (2009) inversely related to aspects of negative emotionality such as trait anxiety (r = 0.55; Derryberry & Reed, 2002). Both categorical and dimensional PD scores were obtained by using the Assessment DSM-IV Personality Disorders (ADP-IV; Schotte, De Doncker, Vankerckhoven, Vertommen, & Cosyns, 1998). The ADP-IV consists of 94 items, which represent the 80 criteria of the 10 DSM-IV PDs. Each item was evaluated on a seven-point scale ranging from 1 (totally disagree) to 7 (totally agree) (trait score). If the trait score was equally or higher than 5 (rather agree), one also has to indicate on a three-point scale how much distress the feature causes the patient or his/her environment (1 = not at all, 3 = most certainly) (distress score). Dimensional trait scores were computed by adding the trait scores within the 10. The categorical diagnostic evaluation followed the DSM-IV PD definition by combining the trait and distress scores in scoring algorithms (e.g., Trait > 4, Distress > 1). In the present study, the internal consistency (alpha coefficients) of the ADP-IV dimensional scales ranged from 0.76 (schizoid PD) to 0.90 (borderline PD). Following Widiger and Trull (2007) we used the dimensional instead of the categorical approach of PDs. 3. Results 3.1. Gender and group differences on reactive/regulative temperamental aspects and dimensional PD scores To determine gender (male/female) and group (control/patients) differences on temperamental and PD scores, we performed MANOVA s with gender and group as independent variables and reactive/regulative temperament and PD scores as dependent variables (Table 1). With respect to the reactive temperamental aspect (BIS/BAS), female participants scored significantly higher on the BIS scale than males; on the BAS scale, no significant gender differences emerged. With respect to the regulative temperamental aspect (ACS), no significant differences between male/female participants were found. In contrast, patients scored significantly lower than normal controls on the total ACS. On all PD scales, patients scored significantly higher than normal controls. Males scored significantly higher on the antisocial and narcissistic PD scales compared to females, and females scored significantly higher than males on the dependent PD scale Correlations between reactive/regulative temperamental aspects and dimensional PD scores controlled for gender The correlations between reactive and regulative temperamental aspects and PD scores controlled for gender are given in Table Prediction of dimensional PD scores based on gender, group, reactive and regulative temperamental aspects, and their interaction Finally, we tried to find out if reactive and regulative temperamental characteristics as well as their interactions were able to predict additive or interactive the dimensional PD scores. Significant interactions between reactive and regulative temperamental characteristics mean that their effects are partly interactive, and not only additive. The results of the hierarchical regression analyses with GENDER, GROUP, BIS, BAS, ACS and their interactions as predictor variables and the dimensional PD scores as dependent variables are displayed in Table 3. GENDER and GROUP were entered in the first step, BIS, BAS and ACS in the second step, and the interactions in the third step. The BIS BAS interaction was Table 1 Means and standard deviations of male and female controls and patients on the measures of (BIS/BAS), self-regulation (ACS) and personality disorders (ADP-IV). Males vs. Females Controls Patients Total group Controls vs. Patients Males Females Total Males Females Total Males Females M (SD) M (SD) M (SD) M (SD) M (SD) M (SD) M (SD) M (SD) F(1, 247) F(1, 247) BIS 18.7 (3.3) 21.5 (3.6) 20.3 (3.7) 21.3 (4.2) 23.8 (3.6) 22.6 (4.1) 19.7 (3.9) 22.3 (3.8) 24.3 *** 28.4 *** BAS 35.8 (5.3) 35.0 (5.3) 35.4 (5.3) 35.7 (6.0) 35.4 (4.8) 35.5 (5.4) 35.8 (5.6) 35.1 (5.2) Self-Regulation ACS 56.5 (13.7) 54.4 (12.8) 55.3 (13.2) 42.9 (13.2) 41.8 (13.7) 42.3 (13.4) 51.5 (15.0) 50.0 (14.4) 54.5 *** 0.8 Personality Disorders PAR 13.9 (5.5) 12.9 (4.8) 13.3 (5.2) 20.7 (9.4) 20.3 (9.1) 20.5 (9.1) 16.4 (7.8) 15.4 (7.5) 60.4 *** 0.5 SZ 15.5 (6.0) 12.1 (4.6) 13.6 (5.5) 20.5 (7.8) 21.0 (7.7) 20.7 (7.7) 17.3 (7.1) 15.1 (7.2) 69.6 *** 3.1 ST 17.1 (8.2) 16.5 (6.5) 16.8 (7.3) 28.0 (10.4) 27.3 (10.1) 27.6 (10.2) 21.1 (10.4) 20.3 (9.4) 92.5 *** 0.3 AS 12.2 (5.6) 10.3 (3.6) 11.1 (4.7) 16.8 (8.4) 15.0 (7.9) 15.9 (8.1) 13.9 (7.1) 12.0 (5.9) 33.0 *** 5.0 * BDL 19.7 (8.0) 19.7 (7.4) 19.7 (7.6) 34.3 (13.1) 38.5 (13.7) 36.6 (13.5) 25.1 (12.3) 26.2 (13.4) *** 2.4 HYS 14.9 (5.3) 14.6 (5.6) 14.8 (5.5) 23.5 (7.7) 24.8 (8.8) 24.2 (8.3) 18.0 (7.5) 18.2 (8.4) *** 0.4 NARC 16.9 (6.4) 15.2 (5.5) 15.9 (6.0) 22.9 (8.2) 19.7 (6.1) 21.1 (7.3) 19.1 (7.7) 16.7 (6.1) 37.6 *** 8.3 ** AV 14.8 (6.0) 14.6 (6.0) 14.7 (6.0) 23.5 (8.9) 27.2 (9.9) 25.5 (9.6) 18.0 (8.3) 18.9 (9.7) *** 3.0 DEP 15.2 (5.6) 15.7 (6.13) 15.5 (5.9) 24.1 (8.6) 28.2 (9.7) 26.3 (9.4) 18.5 (8.0) 20.0 (9.6) *** 5.5 * OC 20.5 (6.7) 19.3 (7.19) 19.8 (7.0) 28.7 (8.9) 29.7 (8.2) 29.2 (8.5) 23.5 (8.5) 22.9 (9.0) 85.0 *** 0.0 PAR, paranoid PD; SZ, schizoid PD; ST, schizotypal PD; AS, antisocial PD; BDL, borderline PD; HIS, histrionic PD; NARC, narcissistic PD; AV, avoidance PD; DEP, dependent PD; OC, obsessive compulsive PD; BIS, Behavioural Inhibition Scale; BAS, Behavioural Activation Scale; ACS, Attentional Control Scale. p < p < p < * ** ***

4 L. Claes et al. / Personality and Individual Differences 47 (2009) Table 2 Correlations between reactivity and self-regulation and the 10 personality disorder scores controlled for gender. Cluster A PDs Cluster B PDs Cluster C PDs Paranoid Schizoid Schizotypal Antisocial Borderline Histrionic Narcissistic Avoidant Dependent Obsessive compulsive BIS_Total 0.34 *** 0.17 ** 0.20 *** *** 0.28 *** 0.18 ** 0.49 *** 0.48 *** 0.45 *** BAS_Total ** *** 0.18 ** 0.25 *** 0.22 *** Self-regulation ACS_Total 0.43 *** 0.32 *** 0.39 *** 0.30 *** 0.50 *** 0.41 *** 0.34 *** 0.48 *** 0.53 *** 0.42 *** BIS, Behavioural Inhibition Scale; BAS, Behavioural Activation Scale; ACS, Attentional Control Scale. ** p < *** p < Table 3 Prediction of dimensional personality disorder scores based on gender, group, reactivity and self-regulation and their interaction. Cluster A PDs Cluster B PDs Cluster C PDs PAR SZ ST AS BDL HIS NARC AV DEP OC b b b D b b b b b b R 2 = 0.20 *** R 2 = 0.24 *** R 2 = 0.28 *** R 2 = 0.14 *** R 2 = 0.39 *** R 2 = 0.32 *** R 2 = 0.15 *** R 2 = 0.33 *** R 2 = 0.34 *** R 2 = 0.26 *** GENDER * * ** GROUP 0.45 *** 0.47 *** 0.52 *** 0.34 *** 0.62 *** 0.56 *** 0.36 *** 0.57 *** 0.58 *** 0.52 *** R 2 = 0.30 ***a R 2 = 0.29 ***a R 2 = 0.31 ***a R 2 = 0.27 **a R 2 = 0.50 ***a R 2 = 0.42 ***a R 2 = 0.24 ***a R 2 = 0.48 ***a R 2 = 0.52 ***a R 2 = 0.39 ***a GENDER 0.12 * 0.16 ** ** GROUP 0.28 *** 0.40 *** 0.43 *** 0.31 *** 0.47 *** 0.46 *** 0.26 *** 0.38 *** 0.38 *** 0.35 *** BIS 0.19 ** *** 0.14 ** *** 0.28 *** 0.31 *** BAS ** *** 0.16 *** 0.24 *** 0.21 *** 0.09 * * ACS 0.26 *** 0.15 ** 0.21 *** 0.25 *** 0.26 *** 0.19 *** 0.21 *** 0.21 *** 0.28 *** 0.17 ** R 2 = 0.34 ***a R 2 = 0.29 *** R 2 = 0.32 *** R 2 = 0.30 ***a R 2 = 0.54 ***a R 2 = 0.44 ***a R 2 = 0.25 *** R 2 = 0.51 ***a R 2 = 0.55 ***a R 2 = 0.40 *** GENDER 0.13 ** 0.16 ** ** ** GROUP 0.25 *** 0.41 *** 0.42 *** 0.30 *** 0.44 *** 0.44 *** 0.24 *** 0.36 *** 0.35 *** 0.33 *** BIS 0.21 *** *** 0.17 *** *** 0.31 *** 0.32 *** BAS ** *** 0.16 *** 0.22 *** 0.21 *** ACS 0.26 *** 0.15 ** 0.21 *** 0.24 *** 0.26 *** 0.18 *** 0.21 *** 0.22 *** 0.29 *** 0.17 ** BIS ACS 0.16 ** *** ** 0.16 ** 0.11 * BAS ACS * BIS BAS ACS * PAR, paranoid PD; SZ, schizoid PD; ST, schizotypal PD; AS, antisocial PD; BDL, borderline PD; HIS, histrionic PD; NARC, narcissistic PD; AV, avoidance PD; DEP, dependent PD; OC, obsessive compulsive PD; BIS, Behavioural Inhibition Scale; BAS, Behavioural Activation Scale; ACS, Attentional Control Scale. a A significant increase in R 2 compared to prior step. * p < ** p < *** p < Fig. 1. Mean dependent PD z-scores for participants with low/high levels of BIS low/high levels of Attention Control. not included because we were particularly interested in the interaction of both BIS/BAS and ACS. All cluster C PDs are associated with a high level of BIS, a low level of EC and their interaction. This interaction refers to the moderating function of EC on the expression of BIS. Patients with high levels of BIS and low levels of EC score higher on cluster C PDs than patients with high levels of BIS and high levels of EC (Fig. 1). The trend indicated in Fig. 1 is the same across all cluster C PDs. Within the cluster B PDs, all PDs are characterized by a high level of BAS and a low level of EC. The antisocial PD is further predicted by a low level of BIS, whereas the borderline PD is predicted by a high level of BIS. For the borderline PD, it also holds that a high level of BIS is modulated by the level of EC (BIS ACS), meaning that the higher BIS is and the lower EC is, the higher the score on the borderline PD. For the antisocial PD, it holds that a high level of BAS is modulated by the level of EC (BAS ACS), indicating that the higher BAS is and the lower EC is, the higher the score on the antisocial PD (Fig. 2). All cluster A PDs are characterized by low levels of EC. The paranoid PD is predicted by high BIS, low EC, and their interaction. The schizoid PD is predicted by low BAS and low EC.

5 952 L. Claes et al. / Personality and Individual Differences 47 (2009) Fig. 2. Mean antisocial PD z-scores for participants with low/high levels of BAS low/high levels of Attention Control. GENDER (0 = female, 1 = male) has a positive influence on the paranoid, schizoid, narcissistic and obsessive compulsive PDs, meaning that males score higher on these PDs than females. Also the variable GROUP (0 = normal controls; 1 = patients) shows a significantly positive influence on all PDs, meaning that patients score higher on the PDs scales than normal controls. 4. Discussion In this study, we investigated the separate and combined influence of reactive and regulative temperamental features on PDs. All cluster C PDs are related to high BIS (anxiety), low EC and their interaction. Comparable findings were mentioned by other authors (e.g., Fullana et al., 1994; Pastor et al., 2007) who reported high levels of BIS in cluster C PDs; however they did not investigate the influence of EC. Patients with high levels of BIS and low levels of EC scored higher on cluster C symptoms than patients with high levels of BIS and high levels of EC. It seems like a high level of EC protects high BIS reactive or anxious patients against the development of cluster C PD. All cluster B PDs were characterized by high levels of BAS and low levels of EC, results that were also mentioned by other authors (e.g., Carver & White, 1994; Harmon-Jones, 2003). However, within the cluster B PDs, the borderline PD showed similarities with the cluster C PDs: the borderline PD also scored high on BIS and the interaction between BIS and EC is significant. Also Pastor et al. (2007) mentioned high BIS in borderline patients. These findings were not surprising as the borderline PD is often described as one of the female variants of the cluster B PDs (characterized by anxiety), whereas the antisocial and the narcissistic PDs are often considered as the male variants of cluster B PDs (characterized by the absence of fear) (O Connor, 2008). In our study, only the antisocial PD was characterized by a negative correlation with BIS (absence of anxiety), whereas in the study by Pastor et al. (2007), both the antisocial and narcissistic PD were characterized by the absence of BIS. For the antisocial PD, it also holds that a high level of BAS is modulated by the level of EC (BAS ACS). Furthermore, the results of the cluster A PDs were mixed. All cluster A PDs were characterized by low levels of EC. In the regression analysis, the paranoid PD showed the highest similarity with the cluster C PDs (characterized by anxiety and low levels of EC). The schizoid PD showed a low level of EC and BAS, a finding that confirmed Pastor et al. s (2007) description that patients with a schizoid PD are loners who prefer solitary activities and have low levels of pleasure in life. Finally, patients scored higher on all PDs scales than normal controls and males scored significantly higher on the paranoid, schizoid, narcissistic and obsessive compulsive PDs. Regression analyses without including GROUP as predictor variable resulted in similar conclusions, indicating that the differences between patients and normal controls are rather quantitative than qualitative, which argues for a dimensional approach to PDs. To summarize, all PDs are characterized by low levels of EC, cluster C PDs by high BIS and cluster B PDs by high BAS. The low score on EC confirms that participants with personality psychopathology lack a self-regulatory capacity that normally emerges throughout development and that allows persons to gain active control over reactive behavioural and emotional responses. Furthermore, several PDs are characterized by an interaction of BIS and EC which shows us that BIS only relates to severe PD pathology, if EC is low. Our results suggest that treatments designed to facilitate EC can be useful among patients suffering from PDs. In correspondence with our findings, Robinson, Pearce, Engel, and Wonderlich (2009) state that training of EC may be helpful among personality disordered individuals. Furthermore, patients with high levels of BIS and low levels of BAS are mainly motivated by avoidance of mistakes (e.g., cluster C), whereas patients with high levels of BAS tend to seek for positive experiences (e.g., cluster B). This knowledge is important in the motivational phase of treatment of PDs. According to Higgins (1997) individuals can best be motivated when the therapy strategy used, fits the focus they have. When individuals are in a promotion focus (BAS), they are oriented toward fulfilling their aspirations and success is experienced as the presence of positive outcomes. On the other hand, individuals in prevention focus (BIS), are oriented toward meeting their responsibilities and success is experienced as the absence of negative outcomes. Also Farmer and Nelson-Gray (2005) have extensively described the applicability of BIS and BAS reactivity in clinical settings. Thus, our results clearly show that it can be interesting to take into account the interaction of reactive and regulatory temperamental features to explain variance in personality psychopathology. Although this study has some strength, a couple of limitations need to be acknowledged. The cross-sectional nature of this study makes it impossible to make statements about the causal nature of reactive and temperamental features on the development of PDs but can inform and lay the groundwork for a longitudinal study. Longitudinal studies need to be performed, to determine whether temperamental vulnerabilities cause the origin of PDs. Furthermore, the study was exclusively based on self-report measures of both temperamental and PD related features. Future research should also include both interview measures of temperamental/personality related features as well as performance-based tasks to investigate for example, levels of EC (e.g., the Stroop Task, the Trail making Task: see Robinson et al., 2009) and temperamental reactivity (e.g., Avila, 2001). Finally, the number of participants in our study was rather small to perform multiple analyses, so further research with larger samples needs to confirm our findings and needs to include BIS/FFFS and BAS facets in the prediction of PDs (e.g., Corr, 2008). Despite these limitations, our study was one of the few studies that investigated the association of reactive and regulative temperamental features on PD scores in a sample of both male/female controls and patients. References Avila, C. (2001). Distinguishing BIS-mediated and BAS-mediated disinhibition mechanisms: A comparison of disinhibition models of Gray (1981, 1987) and of Patterson and Newman (1993). Journal of Personality and Social Psychology, 80,

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