Anaclitic and Introjective psychopathology and the interpersonal function of perfectionsiam/self-criticism.

Blatt (1974, 2004) put forward that the phenomenological field of psychopathology could be subdivied into an anaclitic and an introjective cluster. Each of these clusters is underlain by a specific predisposing personality style that entails vulnerability for specific ‘triggering’ stressors. The theory of Blatt refers strongly to the classical psychoanalytic theory on the hysterical and obsessional dimensions in psychopathology, and also converges with contemporary theories, like cognitive-behavioural formulations on sociotropic and autonomous depression (Beck, 1983). Robins, Ladd, Welkowitz, Blaney, Diaz, and Kutcher (1994) reviewed theoretical writings on anaclitic and introjective psychopathology and concluded that the personality trait hypothesized to predispose for anaclitic psychopathology, namely interpersonal dependency, can be subdivided into three core characteristics: Concern about what others think, Pleasing Others, and Dependency; and that the personality trait hypothesized to predispose for introjective psychopathology, namely self-criticism/autonomy, can be subdivided into three clusters as well: Perfectionism/Self-criticism, Need for Control, and Defensive Separation. Robins et al. (1994) constructed the Personal Style Inventory-II to measure these theoretical constructs. However, inquiry into the factor structure of this questionnaire suggested that the perfectionism/self-criticism subscale was associated equally strong with both types of psychopathology (e.g. Bagby, Parker, Joffe, Shuller, & Gilchrist, 1998). These findings seem to be in conflict with the results obtained with the Depressive Experiences Questionnaire (DEQ; Blatt, D’Aflitti, & Quinlan, 1976) that suggest that self-criticism is specifically associated with introjective psychopathology. However, the self-criticism scale of the DEQ comprises a mixture of items that measure self-criticism and items that measure an excessively autonomous and aloof interpersonal stance. Thus, the observed specific associations might be due to the interpersonal content of the scale, and not to its self-critical content. In the present paper, the authors studied interviews with 31 outpatients in a mixed qualitative/quantitative way to obtain a more clinical picture of the prevalence of the different PSI-II characteristics in anaclitic and introjective psychopathology. In line with the results of the studies into the factor structure of the PSI-II, our results suggest that Concern about what Others Think, Dependency, and Pleasing Others are characteristics that underlie anaclitic psychopathology; that Defensive Separation and Need for Control underlie introjective psychopathology; and that Perfectionism/Self-criticism is associated with both types of psychopathology. Closer consideration of the perfectionistic/self-critical interview fragments revealed that perfectionism/self-criticism has a different interpersonal motivation in anaclitic than in introjective subjects. Anaclitic subjects tend to be perfectionistic/self-critical to attract other people; introjective subjects tend to be perfectionistic/self-critical to keep the other at a distance and/or to keep control over the other. Thus, we conclude that perfectionism/self-criticism was not specifically associated with introjective nor with anaclitic psychopathology, unless we took into account its interpersonal function. In the context of clinical practice, these results prompt for careful exploration of the interpersonal aspect of perfectionism/self-criticism, in order to obtain a clear view on the connection between this characteristic and the manifest psychopathology of a patient. Future research should consider the hypothesis that the self-criticism scale of the DEQ is associated with introjective psychopathology because it does not merely measure self-criticism, but also an aloof and controlling interpersonal stance