Journal of Personality Disorders, 28(6), 824-840, 2014 © 2014 The Guilford Press Williams et al. Aversive Interpersonal Behaviors

THE AVERSIVE INTERPERSONAL BEHAVIORS ASSOCIATED WITH PATHOLOGICAL PERSONALITY TRAITS Trevor F. Williams, BS, Katherine M. Thomas, MS, M. Brent Donnellan, PhD, and Christopher J. Hopwood, PhD

Although interpersonal dysfunction is a defining feature of personality disorders (PDs), relatively little is known about how features of PD are perceived by others. In the current study, students (n = 225) reported on the traits and aversive interpersonal behaviors of individuals with pathological personality features. Aversive behaviors were measured using the Interpersonal Sensitivity Circumplex, and pathological personality features were assessed using the DSM-5 Section 3 traits. The structural summary method for circumplex data was used to evaluate how pathological traits related to both general and specific aversive behaviors. Most traits associated with PDs were related to general aversive behaviors. Specific associations suggested that young adults are most irritated when individuals with personality pathology try to form or sustain attachments, as opposed to control, withdraw, or submit to them. These results are consistent with the assumption that personality pathology is broadly characterized by aversive behaviors and imply that individuals are most bothered by maladaptive attempts by others to become or stay connected.

Interpersonal dysfunction is a defining aspect of personality pathology (e.g., Clifton, Pilkonis, & McCarty, 2007; Hopwood, Wright, Ansell, & Pincus, 2013; Pincus & Wiggins, 1990; Wilson & Durbin, 2012), and it is established that individuals with personality pathology tend to generate negative reactions in others. For instance, clinicians have more negative reactions to patients with personality disorders (PDs) relative to other diagnoses (Purves & Sands, 2009). However, there is also variability in the degree (Rossberg, Karterud, Pederson, & Friis, 2007) and nature of these reactions across different PDs (Betan, Heim, Conklin, & Westen, 2005; Brody & Farber, 1996; Schwartz, Smith, & Chopko, 2007). Specificity regarding how different PDs irritate others has not been achieved by previous research. In this study we clarify the associations between personality pathology and aversive behaviors by soliciting informant reports of individuals with pathological personThis article was accepted under the editorship of Robert F. Krueger and John Livesley. From Department of Psychology, Michigan State University in East Lansing. Address correspondence to Christopher J. Hopwood, PhD, Assistant Professor of Clinical Psychology and Clinical Director, MSU Psychological Clinic, Psychology Building, 316 Physics-Room 107A, East Lansing, MI 48824; E-mail: [email protected]

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Aversive Interpersonal Behaviors 825

ality attributes using measures of pathological traits and aversive interpersonal behavior. INFORMANT REPORTS

Informant reports of personality pathology tend to increment self-report data for predicting important outcomes (Klein, 2003; Miller, Pilkonis, & Clifton, 2005) and, in some cases, have superior predictive validity (Fiedler, Oltmanns, & Turkheimer, 2004). One explanation for the findings is that self-reports of personality may be impacted by ego-protection motives, thereby limiting their value for the assessment of more evaluative traits (Vazire, 2010). Informant reports seem especially applicable to investigating aversive interpersonal behaviors related to personality pathology (e.g., Clifton, Turkheimer, & Oltmanns, 2005; Werner & Crick, 1999), as informant reports reflect the perspective of those who experience the aversion directly. In this study we focus on how informants experience the behavior of individuals with personality pathology using dimensional systems of individual differences in PD and interpersonal behavior. PATHOLOGICAL TRAITS

Most previous research on the aversiveness of PD has focused on the categorical and polythetic DSM-IV-TR model of PDs (American Psychiatric Association, 2000). This conceptualization allows for considerable variability in the way individuals express a PD, making it unclear which aspects of a PD are aversive to others (Johansen, Karterud, Pederson, Gude, & Falkum, 2004). Dimensional trait models use specific dimensions to characterize PDs, thereby helping to parse this variability into more homogenous units, and they may thus be useful for investigating how different manifestations of personality pathology relate to aversive behaviors. One such dimensional trait system is offered in Section III of the DSM-5 (American Psychiatric Association, 2013). When originally proposed by the DSM-5 Personality and Personality Disorder Work Group, this system consisted of six hypothesized trait domains and 37 facets (Skodol, Bender et al., 2011a); however, further analyses reduced these 37 facets to 25, blending several of the original facets (Krueger, Derringer, Markon, Watson, & Skodol, 2012). These final 25 facets load onto five higher-order domains (negative affectivity, detachment, antagonism, disinhibition, and psychoticism; Krueger et al., 2012) that resemble the domains of the five-factor model (e.g., Gore & Widiger, 2013). In an initial validity study of the DSM-5 system, Wright and colleagues (2012) examined the relationship between self-reported DSM-5 traits and self-reported interpersonal problems, finding that all trait domains relate to general interpersonal problems (i.e., interpersonal distress). Wright and colleagues also identified specific relations; negative affectivity was related to warm-submissive problems (e.g., being exploitable), disinhibition and antagonism were related to cold-dominant problems (e.g., hostility), and detachment was related to cold-submissive problems (e.g., acting avoidant). These

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findings indicate common ways that individuals with personality pathology experience and create difficulties in their relationships. However, this study did not provide the complementary perspective concerning the connections between informant reports of pathological traits and their experience of aversive interpersonal behaviors. CHARACTERIZING AVERSIVE BEHAVIORS USING THE INTERPERSONAL CIRCUMPLEX

A number of interpersonal constructs, including traits, behaviors, problems, and strengths, have been effectively conceptualized using the Interpersonal Circumplex (IPC; e.g., Locke, 2011; Moskowitz, 1994). The IPC is a circular model defined by two broad orthogonal axes, agency (dominance vs. submissiveness) and communion (affiliation vs. hostility; Wiggins, 1991), such that each point within the IPC is a combination of agency and communion (Kiesler, 1983; Leary, 1957). The correlates of valenced IPC measures (e.g., problems, strengths) can be decomposed in terms of variance attributable to the general valence as well as associations that are specific to particular regions of the circle (Wright, Pincus, Conroy, & Hilsenroth, 2009). For instance, Wright and colleagues (2012) found callousness is generally related to interpersonal problems across the circle, but also specifically related to interpersonal problems involving high agency and low communion. An IPC approach to aversive behavior thus allows pathological traits to be characterized in terms of how negative the behavior is as well as the specific way in which it is aversive using the framework of agency and communion. The Interpersonal Sensitivity Circumplex (ISC), which assesses individual differences in sensitivity to others’ interpersonal behavior (Hopwood et al., 2011), was used in this study to characterize what individuals find aversive about people with pathological personality traits. PRESENT STUDY

Our purpose was to evaluate the associations between informant-rated pathological personality traits and aversive interpersonal behavior as assessed by the ISC. Three design features provide important advances relative to previous research. First, by using informants we are able to study aversive behaviors from the perspective of the person who experiences them. Second, using pathological traits allows us to parse personality pathology variance more effectively than studies focusing on polythetic diagnoses. Third, using the ISC allowed us to take advantage of the IPC framework to distinguish how aversive a trait is in general from the specific way in which it is aversive in terms of agency and communion. Our primary focus was on how pathological traits relate to the interpersonal reactions of others. We expected all pathological traits to irritate others in general, but also expected some traits to relate to specific aversions. Research examining traits and IPC measures of individual differences within the same person has consistently found that antagonism is related

Aversive Interpersonal Behaviors 827

to cold-dominant interpersonal constructs and detachment relates to coldsubmissive interpersonal constructs (e.g., McCrae & Costa, 1989). Thus, we predicted that the cold-submissive remoteness of detachment would be aversive, whereas the cold-dominant hostility of antagonism would be aversive. Findings that relate other traits to IPC measures (e.g., Wright et al., 2012) led us to further predict that the cold dominance associated with disinhibition and the warm submission associated with negative affectivity would be found most irritating. METHOD Participants

Participants were college students (n = 239) who received course credit for providing reports of a person they knew well at the time of the study. Four participants’ data were excluded because they did not report knowing the rated individual sufficiently well (see next section). The remaining 235 participants were mostly between the ages of 18 and 25 (99%); 160 (68%) were women and 193 (82%) were white. The individuals that participants chose to rate tended to be similar to themselves: 225 (95%) were between the ages of 18 and 25, 144 (62%) were women, and 200 (86%) were white. Procedures

Participants chose a single individual they knew well who has problems that seem to be related to his or her personality. In essence, participants were asked to select targets on the basis of a “lay” translation of general personality pathology, as defined in Section III of DSM-5 (Bender, Morey, & Skokol, 2011; Skodol, Bender et al., 2011a). (For the full instructions given to participants, please see the Appendix to this article.) The design of this study (i.e., asking informants to choose the target) and the instructions to choose a target with some level of dysfunction increased the likelihood that targets would have pathological traits and protected against positively biased ratings of targets (Leising, Erbs, & Fritz, 2010). Participants were also asked how well they know this person on a 5-point scale ranging from “I don’t really know the person’” (1) to “Extremely well” (5). Participants not endorsing a 3 (“Fairly well”) or higher on this scale (n = 4) were not included in analyses. Measures

Pathological Traits. Participants rated targets on the 37 facets initially proposed by the DSM-5 Personality and Personality Disorders Workgroup (see Krueger et al., 2012); traits were rated on a 4-point scale from “very little or not at all” (1) to “extremely descriptive” (4). Brief descriptions of facets were provided (e.g., “Callousness: Lack of empathy or concern for others’ feelings or problems…”; see Skodol, Clark, et al., 2011b). Mean levels (item averages) for facets ranged from 1.36 to 2.26 (SD = 0.66–1.04). These initial 37 facets were reduced to 25 according to the results of Krueger and colleagues

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(2012). For example, scores for traits aggression and callousness were averaged to create the composite facet of callousness. The means for the final 25 facets ranged from 1.36–2.26 (SD = .63–1.04). We captured the higher-order domains using 15 of the final facets with relatively limited cross-loadings, as suggested for DSM-5 (http://www.psychiatry.org/practice/dsm/dsm5/onlineassessment-measures#Level1). Aversive Interpersonal Behaviors. The Interpersonal Sensitivity Circumplex (ISC; Hopwood et al., 2011) is a 64-item questionnaire with content that represents behaviors that would bother most people to some extent (e.g., “It bothers me when the person orders me around’”). The ISC was developed as a self-report measure; in this study, informants were asked to rate ISC items based on the interpersonal behaviors of a target individual with personality difficulties. These behaviors were rated on a 7-point Likert-type scale ranging from (1) “not at all, never bothers me” to (7) “Very much, bothers me most of the time.” Items cohere into eight 8-item scales (i.e., octant scales) that each represent an interpersonal sensitivity (e.g., sensitivity to control) with reference to their angular location in the IPC. Scale means (item averages) ranged from 2.38 to 3.80 (SD = 0.99–1.67), with adequate internal consistency (Mdn = .89, Range = .72–.92). Analyses

Our first set of analyses was designed to evaluate the psychometric characteristics of the measures used in the study. Research on informant-based trait measures leads us to predict that the higher-order structure of our instrument will map onto the DSM-5 model relatively well (Mullins-Sweatt, Jamerson, Samuel, Olson, & Widiger, 2006; Samuel, Mullins-Sweatt, & Widiger, 2013; Markon, Quilty, Bagby, & Krueger, 2013). Accordingly, the 15 facets used to calculate domain indicators for the DSM-5 domains were subjected to a principle axis factor analysis (PAFA) with a Promax rotation to confirm that the structure identified in previous research was approximated in this sample. As an IPC measure, the ISC is expected to adhere to a circular structure and have scales that are equally spaced around the IPC (Guttman, 1954). Given the structural validity of the self-report version of the ISC (Hopwood et al., 2011) and research supporting the use of informant versions of the IIP-C (e.g., Clifton, Turkheimer, & Oltmanns, 2005), we expected that the informant version of the ISC would also show circumplex structure. These predictions were tested using the program RANDALL (Tracey, 1997), which provides a randomized test of hypothesized order relations among octant scales. There are 288 possible predictions about the relative magnitude of correlations among octants on an IPC measure (correlations assumed to be equal are not compared). A correspondence index (CI; i.e., proportion of order of predictions confirmed minus the proportion violated; Hubert & Arabie, 1987) and statistical test are provided by RANDALL. Our subsequent analyses were designed to test study hypotheses. As an initial step, correlations between all ISC scales and DSM-5 traits were com-

Aversive Interpersonal Behaviors 829

FIGURE 1. Circumplex structural summary method parameters.

puted. However, to clearly distinguish between the general and specific aversive behaviors, the circumplex structural summary method was used (see Figure 1; Gurtman & Pincus, 2003; Wright, Pincus, Conroy, & Hilsenroth, 2009). This method represents the pattern of correlations between ISC octant scales and an external indicator as a cosine curve, decomposing validity correlations into three interpretable parameters: elevation, amplitude, and angular displacement. Elevation is the mean correlation of the external indicator across scales. In the case of the ISC, elevation indicates the level of non-specific interpersonal aversion associated with that indicator (Hopwood et al., 2011). Following previous research (e.g., Wright et al., 2012), elevations > .15 were considered meaningful in this study. Amplitude represents the degree to which correlations differ across octants, and thus the interpersonal specificity of the variable. In Figure 1, amplitude is displayed as the difference between the peak and elevation (i.e., the mean level) of the curve, representing the degree to which the peak sensitivity is stronger than the average sensitivity of a given trait. Since elevation and amplitude reflect separate influences on correlation coefficients between ISC scales and the index trait, these parameters cannot sum to a number greater than one (Gurtman, 1992). We used two criteria to evaluate whether traits were aversive in a specific way or not: amplitude > .15 and/or amplitude > elevation. The first value is based on previously used conventions (e.g., Wright et al., 2012), and the second indicates that the specific relation to that octant is more substantial than the general association of the trait across octants. Angular displacement is the angle at which the curve peaks (see Figure 1), indicating the location of a trait’s predominant interpersonal theme. This parameter is

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Williams et al. TABLE 1. Pattern Coefficients for Selected DSM-5 Facets

Facets

NA

DET

Emotional Lability

.40

.04

Anxiousness

.70

.11

Separation Insecurity

.67

.00

Withdrawal

.03

.60

Intimacy Avoidance

.01

.62

Anhedonia

.09

.67

Manipulativeness

.19

–.23

Grandiosity

–.10

.06

ANT

DIS

PSY

.24

.06

.00

–.07

–.04

.02

.03

–.03

–.02

-.11

–.04

.15

.15

.03

–.16

–.03

–.08

.02

.48

.02

.21

.72

–.15

.07

Deceitfulness

.03

.09

.56

.19

–.15

Impulsivity

–.04

–.17

–.04

.82

.06

Distractability

.13

.14

–.21

.34

.12

Irresponsibility

–.03

.10

.14

.56

–.12

Eccentricity

–.02

.08

–.01

.13

.61

Unusual Beliefs and Experiences

–.14

.23

.14

.07

.60

Perceptual Dysregulation

.07

–.13

.02

–.10

.72

Note. Loadings > .30 are bolded. Factors were extracted with Principal Axes Factor Analysis and subjected to a Promax rotation. NA = Negative Affectivity, DET = Detachment, ANT = Antagonism, DIS = Disinhibition, and PSY = Psychoticism. Means, variances, and correlation matrix for the full instrument are available upon request.

only interpretable for traits that meet the above amplitude criteria and have a prototypical pattern of associations with ISC scales. Prototypicality is assessed using an R2 value, which reflects the squared correlation between the actual pattern of correlations and a perfect cosine curve. It is problematic to interpret displacement parameters for variables with non-protoyptical correlation profiles because the pattern of such profiles does not conform to the assumptions of a circumplex. In this study, we define adequate R2 values as > .70. In summary, elevation values > .15 can be interpreted as indicating that a trait is interpersonally aversive in general; amplitude values > elevation or > .15 can be interpreted as indicating that the trait is aversive in a specific way; and displacement can be interpreted as indicating the nature of that specific aversion when amplitude is meaningful. RESULTS Measure Properties

PAFA with a Promax rotation revealed a structure similar to previous studies (see Table 1) in that all five domains were represented, with the three highest loadings on each factor matching the intended facets. These results suggest that the overall structure of the DSM-5 traits held up to this novel assessment approach, giving us confidence in interpreting the domain scores. The means of these domains ranged from 1.49–2.11 (SD = .54–.77). The informant version of the ISC was tested for circumplex structure using RANDALL (Tracey, 1997). Of 288 predictions, 252 were confirmed,

Aversive Interpersonal Behaviors 831

yielding a CI of .75 (p < .001). While this indicates significant and adequate fit to circumplex structure, it is worth noting that we observed a higher correlation between cold-dominant aversive behaviors and submissive aversive behaviors than would be expected (r = .53, p < .001). Other ISC correlations were less anomalous relative to circumplex predictions. Interpersonal Aversions and Pathological Traits

Correlations between DSM-5 traits and ISC octant scales are reported in Table 2. This table shows that substantial variance in interpersonal sensitivities can be explained by perceptions of pathological personality traits. The strongest correlation for each trait across ISC scales ranged from .21 to .53. These correlations also show the value in depicting circumplex correlations using the structural summary method. For instance, consider the pattern of correlations between ISC scales and antagonism. This trait has a very strong correlation with Sensitivity to Attention-Seeking (NO), somewhat strong correlations to adjacent scales, and weak correlations with scales on the opposite side of the circle (i.e., the correlation with Sensitivity to Timidity is .08). This is the kind of pattern that would be anticipated when a trait has specific interpersonal content. In the structural summary, the fact that all correlations are positive would be reflected in a meaningful elevation parameter, whereas systematic correlations would be indicated by a significant amplitude, and the displacement value would be likely to indicate aversions related specifically to the NO octant. Contrast this with the trait disinihibition, which has relatively limited variability in ISC octant correlations. This trait would be expected to have a substantial elevation given that all correlations were positive, but it would not have a meaningful amplitude value because the correlations with ISC scales are fairly similar. The circumplex structural summary method was used to evaluate these kinds of patterns for all domains and facets. Across domains and facets, R2 values ranged from .39 to .97 (Mdn = .82), with 22 meeting our cutoff for prototypicality. All domains and facets had positive elevations (Mdn = .16; Range = .10–.24), with all domains and 18 facets being above the .15 cutoff used to indicate a meaningful relation to general aversive behavior. Only eight traits (facets and domains) met amplitude and R2 criteria for specificity. Among these, antagonism (59°; intrusive and exhibitionistic behaviors) was the only interpersonally specific domain, and grandiosity was the most specific facet. Most facets related to aversive behaviors on the warm side of the IPC. Distractibility was the only trait primarily perceived by raters to be specifically associated with cold-aversive behaviors (angular displacement = 234°), although this trait had a relatively modest amplitude. DISCUSSION

The aim of this study was to evaluate how impressions of pathological personality attributes relate to aversive interpersonal behaviors. This research expands upon previous investigations by using an informant perspective, a

832

Williams et al. TABLE 2. Correlations Between ISC Domains and Facets PA

BC

DE

FG

HI

JK

LM

NO

Domains Negative Affectivity

.23

.19

.06

.17

.21

.31

.22

.23

Detachment

.21

.13

.10

.19

.10

.21

.29

.25

Antagonism

.43

.27

.05

.08

.05

.17

.27

.53

Psychoticism

.14

.09

.11

.17

.19

.29

.34

.17

Disinhibition

.17

.22

.18

.27

.24

.25

.12

.16

.35

.28

.08

.14

.10

.24

.25

.34

Facets Emotional Lability Anxiousness

.07

.09

.01

.09

.17

.24

.12

.07

Submissiveness

–.02

–.02

.00

.15

.30

.25

.12

.00

Separation Insecurity

.09

.05

.03

.15

.23

.25

.15

.12

Hostility

.38

.29

.09

.17

.00

.09

.17

.36

Perseveration

.17

.15

.19

.19

.13

.14

.15

.16

Restricted Affectivity

.15

.10

.12

.11

.00

.01

.11

.18

Withdrawal

.12

.07

.07

.20

.12

.24

.24

.14

Intimacy Avoidance

.22

.14

.08

.11

.03

.13

.20

.27

Anhedonia

.13

.08

.08

.13

.09

.13

.23

.16

Depressivity

.08

.13

.08

.15

.19

.25

.18

.12

Suspiciousness

.19

.16

.09

.13

.08

.14

.19

.17

Callousness

.41

.31

.09

.13

-.07

.02

.19

.42 .33

Manipulativeness

.33

.22

.09

.08

.10

.17

.25

Grandiosity

.37

.19

.00

.05

-.03

.14

.20

.50

Attention Seeking

.39

.21

.09

.16

.17

.27

.23

.41

Deceitfulness

.28

.21

.04

.08

.05

.08

.15

.38

Impulsivity

.14

.17

.20

.22

.20

.23

.15

.14

Distractibility

.04

.11

.11

.21

.21

.15

–.01

–.02

Risk Taking

.17

.17

.14

.27

.27

.31

.26

.18

Irresponsibility

.22

.19

.09

.18

.13

.16

.12

.24

Rigid Perfectionism

.24

.10

.04

.09

.03

.22

.22

.28

Eccentricity

.18

.11

.08

.12

.12

.21

.27

.20

Unusual Beliefs and Experiences

.14

.10

.09

.15

.14

.21

.25

.18

Perceptual Dysregulation

.02

.01

.08

.16

.22

.27

.30

.03

Note . PA = 90°, Sensitivity to Control; BC = 135°, Sensitivity to Antagonism; DE = 180°, Sensitivity to Remoteness; FG = 225°, Sensitivity to Timidity; HI = 270°, Sensitivity to Passivity; JK = 315°, Sensitivity to Dependence; LM = 0/360°, Sensitivity to Affection; and NO = 45°, Sensitivity to Attention-Seeking. Bolded values represent the largest correlation across the row.

dimensional trait approach to PDs, and a model of aversive interpersonal behavior that parses overall severity from the specific nature of aversiveness. Specifically, informants rated targets with pathological personality characteristics on a measure of traits from Section 3 of the DSM-5 (e.g., Krueger et al., 2012) and a circumplex measure of interpersonal sensitivities (Hopwood et al., 2011).

Aversive Interpersonal Behaviors 833

FIGURE 2. ISC Profiles of DSM-5 traits: x-axes represent ISC scales: 90° = Control, 135° = Antagonism, 180° = Remoteness, 225° = Timidity, 270° = Passivity, 315° = Dependent, 360° = Affection, 45° = Attention Seeking; y-axes represent the correlation between the DSM5 trait domain and ISC octant scale.

Aversive Behaviors and Pathological Traits

As predicted, all DSM-5 trait domains and all but seven facets had ISC elevation parameters > .15, implying that people tend to find the behavior of individuals with personality pathology generally aversive. This finding extends previous research that has found individuals with specific PDs tend to bother others (e.g., Schwartz et al., 2007) by suggesting aversive behaviors characterize personality pathology more broadly. We went beyond the question of whether pathological personality attributes are generally aversive by testing how they are aversive to others. The only specific relationship between domains and aversive behaviors was the somewhat unexpected association between antagonism and warm-dominant aversive behaviors (“Sensitivity to Attention-Seeking”; Figure 2). Although this could have to do with our values for determining specificity, this result was surprising for several reasons. For one, we predicted that more domains would be related to specific aversive behaviors (e.g., disinhibition). It is especially surprising that detachment did not relate to specific aversive behaviors as it is often empirically and conceptually related to specific interpersonal

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behaviors involving cold-submissive withdrawal, whereas this is less true for the other domains (e.g., McCrae & Costa, 1989). Examining Figure 2 and Table 2 indicates that the profile of correlations for detachment has a primary peak (360°; “Sensitivity to Affection”) and a secondary peak (225°; “Sensitivity to Timidity”). This suggests that individuals perceived as detached are seen as aversive primarily when they attempt to be affectionate and close and when they act weak and ineffectual. It is interesting to note that if detachment’s pattern of correlations contained no secondary peak it would likely show a meaningfully specific relation to affectionate (warm) aversive behaviors. It was also surprising that antagonism related to warm-dominant aversive behaviors (“Sensitivity to Attention-Seeking”), rather than to cold-dominant aversive behaviors as might be expected (“Sensitivity to Antagonism”). These different classes of aversive behaviors both involve dominance, yet differ in respect to warmth. Cold-dominant aversive behaviors involve attempts to disconnect with others (e.g., “doesn’t respond to me”), whereas attentionseeking represent irritating bids for appreciation (e.g., “shows off”). The larger theme is that warmth involves attempting to be close to others (trying to connect) and coldness involves distance (Moskowitz, 1994; Wiggins, 1991). Our results suggest that it is not so much the coldness of antagonism that is most bothersome, but rather that antagonistic people bother others most when they try to engage them. In other words, people would generally prefer to avoid individuals they perceive as antagonistic. In fact, the overall pattern characterizing the strongest correlations between DSM-5 pathological personality traits and ISC scales suggests that people generally don’t like to be close to individuals who irritate them, regardless of how they irritate them. Of the eight traits related to specific aversive behaviors (antagonism and seven facets), all but one related to aversive behaviors on the warm side of the ISC (see Table 3). Variability among these traits in terms of dominance was more in line with our predictions. Traits associated with narcissism and antisocial proclivities such as callousness, hostility, deceitfulness, and grandiosity tended to fall between warm and dominance, whereas submissiveness was in the warm-submissive quadrant. Finally, no prediction of specificity was made regarding perceptual dysregulation (and psychoticism more broadly), however it projected to nodal warmth. Why would traits that tend to involve narcissism and antisocial behavior tend to project onto the warm half of the ISC? Consider the example of grandiosity, which was defined in this study as: “Vanity/boastfulness/exaggeration of one’s achievements and abilities; self centeredness; feeling and acting entitled, firmly holding the belief that one is better than others and deserves only the best of everything in life” (Skodol, Bender, et al., 2011a, p. 39). Comparing this definition to the aversive behaviors to which it was related (e.g., bragging, having to be right) suggests that it is primarily the self-enhancing behaviors that occur at the expense of others displayed by grandiose individuals that irritate others most. These behaviors might be especially annoying in the context of a close relationship. The only trait related to cold-aversive behaviors was distractibility, which others perceived as related to irritating remoteness. In considering this

Aversive Interpersonal Behaviors 835 TABLE 3. ISC Structural Summary Parameters for DSM-5 Traits Elevation

Amplitude

Displacement

R2

Negative Affectivity

.20

.08

356°

.63

Detachment

.18

.08

18°

.71

Antagonism

.23

.22

59°

.91

Psychoticism

.19

.11

332°

.84

Disinhibition

.20

.05

237°

.57

Emotional Lability

.22

.13

56°

.85

Anxiousness

.11

.08

313°

.68

Submissiveness

.10

.16

289°

.93

Separation Insecurity

.13

.10

307°

.86

Hostility

.19

.16

84°

.82

Perseveration

.16

.02

152°

.47

Restricted Affectivity

.10

.06

95°

.60

Withdrawal

.15

.08

327°

.68

Intimacy Avoidance

.15

.10

54°

.85

Anhedonia

.13

.05

4°

.59

Depressivity

.15

.07

307°

.78

Suspiciousness

.14

.05

53°

.71

Callousness

.18

.22

84°

.89

Manipulativeness

.20

.13

57°

.97

Grandiosity

.18

.22

58°

.86

Attention Seeking

.24

.13

45°

.73

Deceitfulness

.16

.15

67°

.81

Impulsivity

.18

.04

247°

.75

Distractibility

.10

.11

234°

.86

Risk Taking

.22

.08

300°

.85

Irresponsibility

.17

.04

69°

.35

Rigid Perfectionism

.15

.12

33°

.85

Eccentricity

.16

.08

9°

.91

Unusual Beliefs and Experiences

.16

.07

348°

.87

Perceptual Dysregulation

.13

.14

346°

.81

Domains

Facets

Note. Interpretable angular displacements, amplitudes, and elevations are bolded. Elevation = average correlation/ general level of aversiveness; Amplitude = difference between mean and highest correlation, or interpersonal specificity; Angular Displacement = location (in degrees) of highest association between trait and ISC, or interpersonal theme; R2 = fit of cosine curve, or interpersonal prototypicality.

trait, informants may have thought of a person who struggles to maintain focus in conversations, in which case it is reasonable that they find this person irritatingly aloof or unresponsive. To contrast this result with the previous traits (e.g., hostility), it seems that others are bothered by distractible people because they seem to disengage from interactions. In the case of antagonism, informants were perhaps motivated to avoid getting close to the individual and became most irritated when this motive was frustrated by that individual trying to become close, whereas with distractible individuals the informant’s

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motive to command their focus may be frustrated by the individual’s coldsubmissive behavior. Implications

The present study builds on research relating personality pathology to selfreported interpersonal problems (e.g., Pincus & Wiggins, 1990) by examining how perceptions of personality pathology seem to bother informants. In other words, we clarified how certain pathological personality traits are aversive using a well-regarded framework for classifying interpersonal behaviors. The current findings can be integrated with the interpersonal transaction cycle (Kiesler, 1983; Wagner, Kiesler, & Schmidt, 1995), which posits that one person’s overt interpersonal behavior leads the person with whom they interact to have a covert reaction and respond with another overt interpersonal behavior that perpetuates this cycle. From this perspective, people with PDs engage in overt dysfunctional behaviors that others covertly experience as aversive. The aversion others experience likely affects their responses, such that they may respond in a way that helps to reinforce pathological beliefs that the person with the PD holds about themselves and others (Eagle, 2000; McLemore & Brokaw, 1987; Pincus, Lukowitsky, & Wright, 2010). This study provides insight into such cycles, for instance, by suggesting that grandiose individuals seek attention in ways that others find aversive (e.g., self-enhancement). Such grandiosity when coupled with vulnerability may lead an individual to have a sense of self-esteem contingent upon the admiration of others, as in the case of pathological narcissism (Morf & Rhodewalt, 2001; Roche, Pincus, Lukowitsky, Ménard, & Conroy, 2013). As others become irritated with such an individual and attempt to avoid them, this person may experience considerable distress, as their desire for the admiration is frustrated (Horowitz et al., 2006). This distress might lead narcissistic individuals to feel vulnerable and trigger a further need to self-enhance, thereby exhibiting additional behaviors that irritate others (McLemore & Brokaw, 1987). Knowledge of such self-defeating interpersonal patterns and their relation to personality pathology may assist clinicians in working with PD patients (Bernier & Dozier, 2002, Hopwood et al., 2013; Tracey, 1993). Conclusions, Limitations, and Future Directions

This study relied on questionnaire data supplied by informants. In future studies it would be useful to compare informant data to self-reports, and more generally to incorporate multi-method assessment approaches. A specific limitation related to our measurement strategy was the possibility that asking participants to select someone they perceive as pathological might inherently lead them to choose someone who irritates them. However, it is worth noting that viewing someone as dysfunctional does not necessarily imply that one is irritated with that individual. It also seems unlikely that such a bias would confound relations between traits and specific aversive behaviors. Another issue was that the actual level of pathology characterizing targets was unclear because ratings of target pathology were left to participants and

Aversive Interpersonal Behaviors 837

no formal diagnosis was conducted. It might be that different associations between traits and aversive behaviors would be found in a more carefully diagnosed clinical sample. Nevertheless, it is likely the targets rated in this sample would have a higher level of personality pathology than is typical of average individuals using more conventional assessments (i.e., no instructions regarding target selection). Overall, this study further attests to the validity of an informant report version of the ISC and of brief informant ratings of DSM-5 pathological personality traits. For the ISC, scale reliabilities were all greater than .72, the CI was .75, and the scales showed validity in relation to DSM-5 traits. The results from this study also provide initial support for single-item informant ratings of DSM-5 traits in terms of the higher-order structure and patterns of associations with aversive interpersonal behavior. This is important given that clinicians may tend to use single-item ratings of DSM-5 traits in lieu of longer rating forms. It is also notable that previous work indicates that similar single-item measures have validity (e.g., Samuel, Mullins-Sweatt, & Widiger, 2013). Regardless, future researchers should examine the associations between personality pathology and aversive behaviors with full-length measures, given their superior content coverage and internal consistency (Credé, Harms, Niehorster, & Gaye-Valentine, 2012). This study provided a more systematic and comprehensive examination of the relationship between personality pathology and aversive interpersonal behaviors than previous investigations, and in particular illustrates the utility of using informant reports of personality pathology. Results suggest that pathological traits are generally aversive to others and that, in general, people do not want individuals with elevated pathological traits to become close to them. These findings can be integrated with what is already known about interpersonal dysfunction to create a more complete understanding of personality pathology. APPENDIX Participant Instructions

The following series of questions ask you to describe an individual you know. Please think of only one individual that fits the following description and answer all of the questions in reference to this one person. Think of someone you know who has personal and/or interpersonal difficulties that seem to relate to their personality. For example, this person might have such personal difficulties as acting like a completely different person in different situations, seeming “fake” about who he/she really is in front of others, appearing to feel empty inside, showing difficulties achieving personal goals, or feeling that life lacks purpose and meaning. He or she might also have difficulties with relationships, such as not being able to understand how others are feeling, having difficulties becoming or staying close to other people, being selfish, having questionable moral standards, or not accurately understanding other people’s motivations or behaviors.

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The difficulties this person has in the ways mentioned above should be present across a variety of situations and should have been descriptive of this individual for at least the past couple of years (since he/she was a teenager). Finally, these difficulties should not be the result of any medical condition, or only as a result of alcohol or drug use. Please rate how each of the following questions and descriptions applies to the individual you are now thinking of. [Questions omitted]

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