PERSONALITY STYLE, DIFFERENTIAL VULNERABILITY, AND CLINICAL COURSE INIMMUNOLOGICAL AND CARDIOVASCULAR-DISEASE

Recent formulations of two broad personality styles, a dependent (anac litic) and a self-critical (introjective) personality style (Blatt, 19 74, 1990; Blatt & Shichman, 1983), provide a theoretical model for int egrating a diversity of findings linking personality factors to the on set and clinical course of immunological and cardiovascular disease. T he model of a dependent (anaclitic) personality style appears to provi de a structure for integrating, within an independently established co nceptual system, the use of repressive defenses, feelings of helplessn ess, emotional lability, and preoccupations with interpersonal relatio nships, which have each been found to be predictive factors in neoplas tic disease. The model of a self-critical (introjective) personality s tyle appears to provide a conceptual structure for integrating the div erse findings indicating that personality factors Of social isolation and mistrust, along with preoccupations with anger, autonomy, assertio n, control, and self-worth (e.g., failure and achievement), are import ant in cardiovascular disease. The formulation of these two personalit y styles also contributes to understanding the role of personality fac tors in vulnerability to these two types of disease by suggesting that dependent individuals are more responsive to interpersonal disruption and generally respond to this type of stresser with passivity and res ignation, while self-critical individuals are primarily responsive to loss of self-control and self-worth, and generally react to these stre ssors with heightened behavioral and autonomic arousal. These formulat ions also suggest that these personality styles are linked to clinical course because they make it difficult for individuals to alter behavi or and life-style habits in ways that could facilitate obtaining care from medical staff and assistance from social support systems to cope with the impact of the disease process. Furthermore, these formulation s have implications for considering different types of psychological i nterventions as part of comprehensive treatment programs; they raise q uestions about the role of depression in neoplastic and cardiovascular disease; and they indicate directions that should be explored in futu re research on the role of personality factors in physical health and illness.