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Dependency, Detachment, and Health-Related Behavior in Adult Primary Care Patients

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Abstract

This investigation examined links between three related personality styles as assessed with the Relationship Profile Test—destructive overdependence, dysfunctional detachment, and healthy dependency—and indices of health and health-related behavior in a mixed-sex (74% female) sample of 100 primary care patients with a mean age of 38.62 (SD = 12.99). Fourteen primary care physicians also participated. As hypothesized, destructive overdependence and dysfunctional detachment scores were positively correlated with number of contacts with the emergency department; healthy dependency scores were inversely related to emergency department contacts and number of overnight hospitalizations. Healthy dependency scores were associated with an array of positive health behaviors; destructive overdependence scores were negatively associated with positive health behaviors. In addition, healthy dependency scores were inversely related to physician ratings of a difficult doctor-patient relationship. These results demonstrate that destructive overdependence, dysfunctional detachment and healthy dependency scores are associated in expected ways with indices of health and health-related behavior, and help illuminate the underlying factors that contribute to comparatively poor health and variations in health service use among overdependent and detached medical patients.

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Data Availability

The dataset for this study is available from the corresponding author on reasonable request.

Code Availability

Not applicable.

Notes

  1. A small number of participants omitted RPT data for destructive overdependence (2 participants), dysfunctional detachment (1 participant), or healthy dependency (2 participants); these participants were assigned mean scores for the omitted items. One participant omitted the HSST entirely; as a result, N of participants was 99 rather than 100 for analyses involving the HSST.

  2. In this context, it is important to note that although there is some conceptual overlap between attachment style and dependency-detachment, evidence confirms that RPT scores are only modestly related to indices of attachment in adolescents and adults, with r’s typically in the .2-.3 range (Bornstein et al., 2003; Haggerty et al., 2016).

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Funding

This work was supported in part by National Institute of Mental Health Grant 1R21MH097781-01A1 to Robert F. Bornstein.

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Authors and Affiliations

  1. Derner School of Psychology, Adelphi University, Garden City, NY, USA

    Robert F. Bornstein

  2. Department of Psychology, University of Detroit Mercy, Detroit, MI, 48221-3038, USA

    John H. Porcerelli

  3. United States Air Force, Wilford Hall Ambulatory Surgical Center, San Antonio, TX, USA

    John R. Jones

  4. Doctoral Program in Clinical Psychology, University of Detroit Mercy, 4004 W. McNichols Road, 142 Reno Hall, Detroit, MI, 48221-3038, USA

    John H. Porcerelli

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Contributions

All three authors contributed to the development and design of the study. Material preparation, data collection and analysis were performed by JJ and JP. The first draft of the manuscript was written by RB and JP and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to John H. Porcerelli.

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Conflicts of interest

Robert F. Bornstein, John H. Porcerelli and John R. Jones of the authors have conflicts of interest or competing interests to report.

Ethical Approval

The study was approved by the Wayne State University IRB.

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Clinic participants were fully informed of the study prior to participation.

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The study was performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Bornstein, R.F., Porcerelli, J.H. & Jones, J.R. Dependency, Detachment, and Health-Related Behavior in Adult Primary Care Patients. J Clin Psychol Med Settings 30, 699–707 (2023). https://doi.org/10.1007/s10880-023-09943-7

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