3b
Patrick T. Davies and Morgan J. Thompson
In their excellent review of the environmental and genetic underpinnings of personality disorders, Turner, Prud’homme, and Legg provide compelling evidence that environmental parameters account for a substantial portion of individual differences in personality psychopathology. Moreover, early experiences with forms of family adversity (e.g., maltreatment, parenting difficulties, parental separation) were identified as risk factors for offspring personality difficulties. However, at this early stage of research, little is known about how and why these family characteristics increase the risk for various personality disorders. Towards addressing this gap, family process frameworks in developmental psychopathology aim to delineate the diversity of mechanisms and pathways underlying associations between family adversity in childhood and the subsequent emergence and course of patterns of maladaptation (e.g., Jouriles, McDonald, & Kouros, 2016; Repetti, Robles, & Reynolds, 2011). Thus, the aim of our commentary is to selectively illustrate how the synthesis of family process models with the personality disorder literature may serve as a heuristic for addressing these scientific barriers.
Delineating the mechanisms underlying family risk factors may be particularly valuable as a guide in reformulating approaches to characterizing mental health and illness. We believe that future progress will be facilitated by shifting from prevailing diagnostic (e.g., DSM-5, ICD) and syndrome (e.g., distinctions between internalizing and externalizing symptoms) approaches to dimensional frameworks of personality like the Five Factor Model (FFM; Bagby & Widiger, 2018; De Fruyt & De Clercq, 2014; Widiger, De Clercq, & De Fruyt, 2009). Although a detailed discussion is beyond the scope of this commentary, FFM distinguishes between different facets and gradations of adaptation and maladaptation in personality attributes across the Big Five personality traits. FFM enjoys stronger empirical support than prevailing frameworks (see Turner et al., this volume) and provides a more integrative characterization of both typical and atypical functioning. Moreover, from a family process perspective, FFM may be superior in its ability to carve nature at its joints in ways that elucidate distinctive precursors, pathways, and mechanisms underlying psychopathology (e.g., Krueger, Tackett, & MacDonald, 2016). Therefore, although part of our commentary will describe the larger body of research using prevailing taxonomies, we also address how dimensional frameworks like FFM may offer greater leverage in advancing an understanding of family processes.
Defensive Mechanisms as Mediators of Early Family Adversity
In elaborating on the premise that safety and security are central mechanisms underlying the etiology and course of personality pathologies, Turner and colleagues provide a thoughtful analysis of how distinctive patterns of attachment insecurity may mediate associations between exposure to specific forms of family difficulties and DSM-5 personality pathology. However, attachment is not the only defensive behavioral system that is designed to protect against harm (Bowlby, 1969). As a goal of the attachment system, maximizing accessibility to and support from caregivers is often not possible in garnering protection from harm because attachment figures are frequently physically unavailable (e.g., in the context of some sibling or peer conflicts) or are, themselves, the sources of the threat (e.g., in the context of parent–child or interparental conflict). Therefore, according to emotional security theory, the social defense system (SDS) is another distinct defensive module that organizes biobehavioral responses to threat in many types of family and interpersonal contexts (Davies & Martin, 2013). In contrast to the attachment system goal of maximizing caregiver protection, the SDS is designed to defuse threat in social contexts through several action tendencies that include heightened perceptual sensitivity to danger cues, fear, vigilance, freezing, fight and flight, camouflaging, and social de-escalation behaviors.
Just as there are different strategies for attempting to regulate accessibility to the caregiver in the attachment system, children adopt distinct ways of defusing interpersonal danger in the SDS. These distinctive profiles of responding to threatening family events are proposed to develop from specific histories of exposure to family adversity and, in turn, have unique implications for children’s psychological adjustment. For example, whereas the dominant pattern of responding is designed to directly defeat the source of threat (e.g., parents) in stressful family contexts (e.g., in parent–child or interparental conflict) through coercive and controlling behaviors, the mobilizing pattern serves to actively manage threat and opportunities for accessing social resources through dramatic displays of distress, submissive and appeasing behaviors, and solicitation of sympathy and alliances. Mobilizing responses are proposed to develop from recurrent exposure to family negativity and enmeshment, and parental psychological control and conditional warmth. In contrast, the dominant strategy is posited to be an adaptive solution to contending with parental vulnerability (e.g., depression), disengagement, and collapses in parental power as authority figures (Davies, Martin, & Sturge-Apple, 2016).
Consistent with theory emphasizing their unique developmental implications, a mobilizing profile has been shown to predict subsequent increases in children’s extraversion, internalizing symptoms, externalizing difficulties, and self-regulation problems. In comparison, children with more dominant responses to family conflict specifically evidenced greater externalizing problems and extraversion over time (Davies, Martin, Sturge-Apple, Ripple, & Cicchetti, 2016). Although this research provides some support for specificity in the mental health outcomes of the two different response patterns, prevailing diagnostic frameworks are limited in their ability to distinguish between the hypothesized sequelae of the different ways of defusing threat in the family. For example, although greater extraversion is an outcome shared by mobilizing and dominant patterns of responding, these response patterns are proposed to result in distinct forms of extraversion that can be more precisely parsed in FFM. More specifically, agentic extraversion characterized by confidence, ambition, and sensation-seeking is proposed to develop from dominant responses to threat, whereas affiliative extraversion reflected in warmth, sociability, and intimacy is theorized to be rooted in mobilizing response patterns (e.g., DeYoung, Weisberg, Quilty, & Peterson, 2013). Likewise, personality traits of impulsivity and emotion instability are proposed to undergird higher levels of externalizing sequelae of mobilizing responses, whereas higher externalizing symptoms associated with dominant response patterns may be more specifically reflected in aggressive, combative, and manipulative FFM personality attributes (Davies, Martin, Sturge-Apple et al., 2016; Widiger et al., 2009).
Approach Mechanisms as Mediators of Early Family Adversity
Family process models have also underscored how children’s early experiences of adversity may alter patterns of behavioral reactivity to environmental resources in ways that have significant consequences for their personality. For example, life history theory proposes that children’s implicit processing of harsh and unpredictable family contexts calibrates fast life history strategies that prepare individuals for the likelihood of facing threatening, uncertain, and impoverished environmental conditions in future developmental periods (Belsky, Schlomer, & Ellis, 2012). Fast life history strategies are specifically characterized by immediate, opportunistic, live-for-today, responses that prioritize quick acquisition of rewards and a short-term temporal perspective that focuses on the here and now rather than the long term. Thus, these responses are posited to have an adaptive function of increasing accessibility to social and material resources in unreliable and harsh environments.
Although research has documented early family unpredictability and harshness as predictors of some markers of fast life history strategies (e.g., Belsky et al., 2012), little is known about the implications of this unfolding cascade for personality development. Dimensional personality approaches may address this gap by providing more nuanced characterizations of the developmental tradeoffs of these strategies. On the benign side of the personality continuum, the bold nature of fast life history strategies may coalesce into FFM tendencies to be more assertive, self-assured, strong, and tough. However, developmental costs for personality characteristics may be reflected in impairments in approach-oriented behavioral systems that regulate exploration and affiliation (Davies, Martin, & Sturge-Apple, 2016). For example, the underlying goal of the exploratory system is to acquire basic survival materials through familiarity and mastery of the physical world. Impairments in this system resulting from fast life history strategies may be manifested in personality dispositions of carelessness, aimlessness, closed-mindedness, and disinterest. By comparison, the goal of the affiliative system is to gain access to survival materials through acquisition of social skills and, ultimately, the formation and maintenance of cooperative alliances. Thus, fast life history disruptions to the affiliative system may be reflected in manipulative, exploitative, combative, and callous personality attributes.
Sources of Heterogeneity in Family Risk
Turner and colleagues also provide compelling evidence that a large part of the variability in personality disorders is attributable to non-shared environmental influences. Within family process models, a central task is to understand why children in the same family respond so differently to similar family risk by identifying genetic, physiological, and phenotypical attributes of children that moderate the pathways between family characteristics and personality adjustment and psychopathology (e.g., Plomin, 2011; Rutter, Moffitt, & Caspi, 2006). For example, at the physiological level of analysis, an emerging corpus of research points to the promise of examining parasympathetic nervous system (e.g., respiratory sinus arrhythmia), sympathetic nervous system (e.g., pre-ejection period), and hypothalamic-pituitary-adrenal axis (e.g., cortisol) functioning as possible moderators of associations between forms of family adversity and children’s psychopathology (e.g., Beauchaine, 2012; Hinnant, Erath, Tu, & El-Sheikh, 2016; Obradovic, 2012). Likewise, although genes that organize a wide array of different physiological systems may serve to alter the impact of family experiences on children’s adjustment, research has been particularly focused on documenting the moderating role of dopaminergic and serotonergic genes in contexts of family risk (Belsky & Beaver, 2011; Cicchetti & Rogosch, 2012). Finally, defined as temporally stable styles of behavior with constitutional roots, children’s temperamental attributes (e.g., negative emotionality, effortful control) may also serve as moderators by altering their sensitivity to family risk factors (Hentges, Davies, & Cicchetti, 2015; Liu, Zhou, Wang, Liang, & Shi, 2018).
As Turner and colleagues note, personality disorder research has predominantly interpreted the moderating role of child attributes in diathesis-stress frameworks. However, differential susceptibility theory (DST) has recently proposed that many temperamental, physiological, and genetic factors that have, in the past, been identified as diatheses may be “plasticity” or “susceptibility” factors (Belsky & Pluess, 2016). Consistent with diathesis-stress models, DST predicts that children with susceptibility attributes will exhibit greater psychological problems when exposure to family stress is high. However, because “susceptibility” is defined as greater plasticity in a “for better or for worse” fashion, DST maintains that children with “susceptibility” attributes profit more from supportive parenting contexts. Given the complementary focus of DST on how children with susceptibility attributes may thrive in supportive rearing contexts, fair tests of the relative viability of the two models will require: (a) simultaneous assessments of both cohesive and adverse family parameters; and (b) use of personality approaches like the FFM that capture both benign (e.g., cooperative) and impairing (e.g., docile, meek) dimensions of personality traits (e.g., agreeableness). In addition, more precisely identifying the forms of moderating effects of child attributes in models of family risk is just one part of a larger scientific process that will require creative syntheses of moderation and mediation to advance knowledge on the family processes involved in personality adjustment and maladjustment. For example, mediated moderation models will be useful in understanding how and why associations between family characteristics and personality dimensions are stronger or weaker for children with specific genetic, physiological, or temperamental attributes (e.g., Brody et al., 2012; Hentges et al., 2015).
Conclusion
Family process and personality psychopathology approaches have developed in relative isolation from each other. Therefore, the goal of this commentary was to illustrate how the synthesis of these two areas of inquiry may advance an understanding of the origins and course of typical and atypical personality characteristics in mutually informative ways. Progress in integrating these approaches will be facilitated by the delineation of mediational pathways involving specific family risk factors, children’s responses to threats, challenges and opportunities, and assessments of both typical and maladaptive personality traits. Complex blends of mediator and moderator models will further facilitate the identification of the multiplicity of processes and pathways linking family adversity with personality sequelae.
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