Attentional coping style in obsessive-compulsive personality disorder: a test of the intolerance of uncertainty hypothesis

Attentional coping style in obsessive-compulsive personalitydisorder: a test of the intolerance of uncertainty hypothesis

Natalie Gibbs Gallagher, Susan C. South, Thomas F. Oltmanns*

Department of Psychology, University of Virginia, 102 Gilmer Hall, PO Box 400400, Charlottesville, VA 22904-4400, USA

Received 13 August 1999; received in revised form 17 December 2001; accepted 21 January 2002

Abstract

We tested the hypothesis that individuals with elevated levels of obsessive-compulsive personality traitsexhibit a compromised ability to tolerate uncertainty. This hypothesis was tested by examining attentionalcoping style in the face of an ego-threatening event. The Personality Diagnostic Questionnaire-4 (PDQ-4)was administered to a pool of undergraduate students in order to recruit an obsessive-compulsive person-ality (OC) group (n=60), a normal control (NC) group (n=60), and an avoidant personality (AV) group(n=40). Both self-report and observational measures of information-seeking/avoidance were obtained dur-ing a laboratory procedure in which participants completed a cognitive ability test. As predicted, the OCPDgroup (1) spent more time listening to information about the test prior to taking the test, (2) spent less timelistening to music prior to taking the test, (3) tended to indicate that they wanted to know their test score moreoften, and (4) reported significantly higher levels of dispositional monitoring, relative to the two controlgroups. In addition, self-reported degree of dispositional monitoring was positively correlated with severity ofOCP symptoms but not with AVP symptoms. Results provided partial support for the hypotheses of an ele-vated degree of information-seeking behavior in OCPD. # 2002 Elsevier Science Ltd. All rights reserved.

Keywords: Obsessive-compulsive personality; Avoidant personality; Intolerance of uncertainty; Dispositional copingstyle; Information seeking; Monitoring; Peer assessment

Obsessive-compulsive personality disorder (OCPD) has a long and prominent history in theDSM and ICD classification systems of mental disorder, as well as in the psychoanalytic litera-ture. The DSM-IV defines OCPD as a pervasive pattern of preoccupation with orderliness, per-fectionism, and mental/interpersonal control, at the expense of flexibility, openness, andefficiency. The polythetic nature of the DSM-IV criteria for OCPD permits a variety of ways inwhich this personality disturbance can manifest itself (American Psychiatric Association, 1994).Salient descriptors range from ‘‘perfectionistic,’’ to ‘‘emotionally-constricted,’’ ‘‘cognitively

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* Corresponding author. Tel.: +1-434-982-4750; fax: +1-434-982-4766.

E-mail address: [email protected] (T.F. Oltmanns).

rigid,’’ and ‘‘low sensation-seeking’’ (Pfohl & Blum, 1995). Many researchers have recognized thenecessity of venturing beyond the mere listing of clinical descriptors and, instead, have focusedefforts on developing theories to account for the broad range of affective, cognitive and beha-vioral characteristics associated with OCPD.One theoretical perspective concerns the link between OCPD and a struggle for control that

stems from intolerance of uncertainty (Mallinger, 1984; Pollack, 1987; Starcevic, 1990). This dif-ficulty in decision-making, characterized by a cautious approach to information categorization,frequent requests for information repetition, and doubt about the correctness of decisions, hasalso been found in people with obsessive-compulsive disorder (OCD) (Obsessive CompulsiveCognitions Working Group, 1997). Individuals with OCPD may display similar cognitive andbehavioral patterns. According to this theoretical perspective, a compromised ability to acceptthe uncertain, unpredictable, and potentially dangerous nature of human existence lies at theheart of OCPD. In an effort to keep the resultant anxiety in check, these individuals presumablystrive to maintain a sense of control and mastery in their lives, however illusory it may be.Many of the traits associated with OCPD can be viewed as the products of control exerted

within the emotional, interpersonal, cognitive and behavioral domains. The cognitive styleinherent in OCPD (preoccupation with details, cognitive rigidity) may be organized to facilitate asense of control (Starcevic, 1990). In addition, the trait of emotional constriction has been viewedas a defense against the ambiguity and potential dangers of interpersonal relationships, whichinclude rejection, humiliation, disapproval and abandonment (Mallinger, 1984).The idea that intolerance of uncertainty constitutes a central, unifying dynamic underlying the

traits inherent in OCPD has gained increasing acceptance within the field. In fact, the essentialfeature of OCPD was modified in DSM-IV to include a preoccupation with mental and inter-personal control. The paucity of empirical investigations designed to test the intolerance ofuncertainty hypothesis is therefore surprising. Only one study has addressed this hypothesis.Hamilton (1957) compared the performance of 20 ‘‘obsessionals,’’ 20 ‘‘hysterics,’’ and 22 anxiousindividuals on a battery of tests purported to measure intolerance of ambiguity. He concludedthat both obsessionals and hysterics demonstrated more avoidance of ambiguity compared toanxious subjects. Unfortunately, these findings are compromised by a host of methodologicalproblems. The most serious limitation is that the obsessional group was comprised of individualswith symptoms of OCD, rather than obsessive-compulsive personality traits.Although performance on perceptual tasks may prove useful in the validation of the intolerance

of uncertainty hypothesis, another promising approach may be the examination of coping style inindividuals with OCPD. Particularly relevant to the present investigation is the manner in whichindividuals with OCPD cope when confronted with impending threatening/aversive events.

1. Coping with impending threat

Miller (1980, 1987) has distinguished between two modes of coping with aversive events. Thefirst mode, monitoring, is the process of seeking information about aversive stimuli. The secondmode, blunting, is the process of avoiding information concerning aversive stimuli. Each mode ofmanaging threat-relevant information serves a distinct purpose. The principal function of mon-itoring behavior is the reduction of uncertainty that arises in the presence of an impending threat.

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The main goal of blunting behaviors is the reduction of somatic arousal (Krohne, 1993; Miller,1990; Miller, Brody, & Summerton, 1988).The relative utility of these strategies must be evaluated within a framework that incorporates

contextual factors (Miller, 1990; Suls & Fletcher, 1985). When, and under what circumstances,will each strategy have adaptive or detrimental consequences? The most influential contextualfactor is the controllability of the situation. Simply stated, blunting behavior (information-avoidance) is preferable in situations of uncontrollable threat, while monitoring behavior (infor-mation-seeking) is preferable if there is a possibility of controlling the nature of the threat. Themost adaptive coping style employs both monitoring and blunting in a flexible manner and inaccordance with the specific demands of the threatening situation.Even in situations that appear to demand one strategy, some individuals continue to use the

other. In order to account for this phenomenon, the concept of dispositional coping style hasbeen proposed (Miller, 1987, 1990). Dispositional coping style refers to the way in which anindividual habitually reacts in threatening situations. This habitual preference presumably reflectsthe person’s position on both the intolerance of uncertainty and intolerance of emotional arousalcontinuums (Krohne, 1993). People who are characterized as high on the intolerance of uncer-tainty continuum will consistently attend to threat-related information (monitors) and those whoare at the extreme end of the intolerance of emotional arousal continuum will consistently avoidthreat-related information (blunters).

1.1. Overview of the present investigation

This study was designed to test the hypothesis that individuals with OCPD possess a basicintolerance of uncertainty. This hypothesis was tested via an examination of attentional coping inthe face of threat. Given that the fundamental purpose of an information-seeking coping style(monitoring) is to reduce uncertainty about the nature of threatening/aversive events, we expectedthat people with elevated levels of obsessive-compulsive personality traits would more oftenmanifest a monitoring coping style in comparison to people who do not possess an abundance ofthese traits. In addition, we expected that these people would consistently demonstrate a pref-erence for information-seeking, even in situations in which information-avoidance is clearly moreadaptive.We tested attentional coping style in three groups of participants: an obsessive-compulsive

personality (OC) group, a normal control (NC) group, and an avoidant personality (AV) group.The AV group was tested in order to determine whether findings were specific to individuals withOCPD features as opposed to other personality disorder features. AV participants were chosenbecause AV and OC diagnoses share traits of anxiousness that might contribute to informationseeking.Coping style was assessed using self-report measures and observational measures derived from

the laboratory portion of the study, which was adapted from a procedure developed by Miller(1987). Participants completed a cognitive ability test that presumably predicted academic successin college. Their attentional coping was measured at two separate time periods. The first obser-vational measure of information-seeking behavior was obtained prior to the test, when partici-pants were allowed to either listen to music or listen to a cassette tape containing informationabout the test. Information-seeking behavior was then assessed during the test by measuring how

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often feedback on current level of performance was requested and by asking the participant toindicate whether s/he wanted to learn the test score upon completion of the test.Participants were randomly assigned to one of two instructional conditions concerning the

effects of feedback on subsequent test performance. One half of the participants were told thatfeedback during the test typically improves overall test performance (Improve Condition), whilethe remaining participants were told that feedback has no effect on performance and may, in fact,hinder performance (Hinder Condition). This manipulation created two identical situations thatdiffered only in the degree of perceived control a participant had over the outcome of the situa-tion (test performance).The following hypotheses were tested: (1) the OC group would report higher levels of self-

reported monitoring behavior and lower levels of self-reported blunting behavior in comparisonto the two control groups; (2) self-report measures of monitoring behavior and blunting behaviorwould be significantly associated with self-report measures of OCPD, but not with self-reportmeasures of AVPD; (3) the OC group would spend more time listening to the information tape andless time listening to music in comparison to the two control groups; (4) the OC group wouldrequest feedback more frequently during the cognitive test in comparison to the two controlgroups; (5) laboratory measures of monitoring and blunting behavior would be significantly asso-ciated with self-report measures of OCPD, but not with self-report measures of AVPD; (6) therewould be a differential effect of instruction condition on the groups, such that there would be nodifference in feedback request for OC participants in the two instructional conditions, while controlparticipants (both NC and AV) in the Improve condition would request feedback more frequentlythan control participants in the Hinder condition; (7) a greater proportion of individuals in theOC group would indicate that they want to know their test score after completing the test.

2. Method

2.1. Participants

Undergraduate students (n=1340) who were enrolled in various psychology courses at theUniversity of Virginia completed the Personality Diagnostic Questionnaire-4 (PDQ-4; Hyler,1994). This questionnaire was used to select the three groups of participants for the study. TheOC group contained individuals who exceeded the threshold number of criteria (at least four ofeight) for a diagnosis of OCPD. These individuals may or may not have met criteria for addi-tional personality disorders.1 The AV group was comprised of individuals who exceeded thethreshold number of criteria (at least four of seven) for a diagnosis of avoidant personality dis-order. In addition, these individuals met no more than two diagnostic criteria for OCPD, andmay or may not have met criteria for other personality disorders.2 The NC group consisted of

1 The proportion of OC participants who qualified for additional personality disorder diagnoses on the PDQ-4 wereas follows: Antisocial (17%), Avoidant (35%), Borderline (20%), Dependent (2%), Histrionic (17%), Narcissistic(23%), Paranoid (37%), Schizoid (2%), and Schizotypal (20%).2 The proportion of AV participants who qualified for additional personality disorder diagnoses on the PDQ-4 were

as follows: Antisocial (15%), Borderline (18%), Dependent (3%), Histrionic (13%), Narcissistic (10%), Paranoid(23%), Schizoid (3%), and Schizotypal (20%).

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individuals who met two or less diagnostic criteria for OCPD and who were at least two criteriabelow the threshold for all other DSM-IV personality disorders.A total of 650 individuals in the pretesting sample were eligible for inclusion in the OC group,

while a much smaller number of individuals were eligible for inclusion in the AV (n=42) and NC(n=73) groups. This disparity in number of eligible individuals was partly the result of the addi-tional exclusion criteria for both the AV and NC groups. Given the large number of individualswho qualified for the OC group, inclusion criteria were subsequently modified so that only indi-viduals who met six or greater OCPD criteria (n=125) were eligible for inclusion in the OCgroup. From the pool of eligible participants, a total of 60 OC individuals, 60 NC individuals,and 40 AV individuals were invited to participate in the study.Several procedures were implemented to assess the validity of the OC and the AV groups. First,

the stability of scores on the respective PDQ-4 diagnostic scale was assessed by re-administeringthe items that comprise that diagnostic scale when the participant later completed the experi-mental session. Second, the Clinical Significance Scale of the PDQ-4 was administered during thestudy (see description below). Third, a peer rating of personality disorder was obtained for OCparticipants and AV participants by asking a designated peer (e.g. friend, roommate, relative) torespond to the relevant PDQ-4 items regarding the participant’s personality. Finally, the OCPDdimensional scale and the Propriety and Workaholism trait scales of the Schedule for Non-Adaptive and Adaptive Personality (SNAP; Clark, 1993) were used as an additional method ofvalidating the group selection process.

2.2. Stimulus materials

2.2.1. Cognitive ability taskThe cognitive task utilized in this study consisted of a modified version of the Mental Rotations

Test (MRT; Vandenberg & Kuse, 1978). This 20-item test measures spatial visualization byrequiring participants to identify which two of four choices contain an object that is identical to acriterion figure but shown in a rotated position. Participants were given 15 min to complete the 20items. These items were presented on paper; however, participants indicated their answer choiceby pressing the appropriate key on a computer keyboard. A computer program prompted parti-cipants to select a letter that corresponded to their answer for the test item. After each test item,the computer program prompted participants to indicate whether they wished to receive feedbackregarding the accuracy of their last response. The computer program did not provide accuratefeedback of test performance. Instead, feedback was standardized across participants such thatthey were told that they answered incorrectly on every third request for feedback. This was doneto insure that participants’ individual ability on the task did not influence the degree of feedbackthey requested. The computer recorded the participant’s responses to the actual test items, as wellas the number of times s/he requested feedback.

2.2.2. Information tapeInformation concerning the cognitive ability test was contained on a mini-cassette recorder. The

information was designed to reduce participants’ uncertainty about the nature of the test. Thetape contained a 5-min description of the Mental Rotations Test. Specifically, it provided factsabout the background of the test, the number of items, the type of items, and the time limit for

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the test. Information concerning the psychometric properties of the test and normative data oncollege student performance were also included. In addition, the tape described the test as a goodmeasure of general cognitive ability that is strongly associated with other measures, including theSAT. The test was also described as a strong predictor of grade point average in college studentpopulations.

2.2.3. MusicParticipants were given the option of listening to music instead of the Information Tape. Par-

ticipants were given a combination tape recorder/radio and told they could listen to music on theradio instead of listening to the information tape. They were allowed to switch freely betweenstations.

2.3. Procedure

All participants were tested individually. Upon arrival at the laboratory, they were greeted byan experimenter and asked to sign a consent form. Participants were then told that they wereabout to complete the MRT, which would provide an estimate of general cognitive ability. Theexperimenter gave the participant the option of listening to either music on the radio or a tapecontaining information about the MRT; participants were allowed to switch back and forth freelybetween the tape and the radio, but were instructed not to listen to both at the same time. Theexperimenter then left the room and entered an adjacent room to observe the participant’s behaviorfrom behind a one-way mirror. The experimenter used a stopwatch to record the amount of timethe participant listened to the information tape and/or music during the 5-min time period.After 5 min, the experimenter returned to the laboratory and provided the participant with

written instructions on the cognitive ability test and administered three practice items. After theparticipant read the instructions and completed the practice items, the experimenter set up thecomputer program. At this point, the participant was given one of two sets of instructions. Par-ticipants who were randomly assigned to the Improve Condition were told the following:

If you are interested, you can follow how well you are doing on the test. After you answereach test question, the computer will ask you whether you would like feedback. If you indi-cate Yes, it will tell you whether your answer to the previous question was correct or incor-rect. If you indicate No, it will proceed to the next question. Research has demonstrated thatobtaining feedback during testing generally improves overall test performance, since it allowsyou to learn from your mistakes. However, it is completely up to you to determine how muchfeedback you want during the test. We have observed that some people desire a lot of feed-back, while others bypass feedback altogether.

Participants assigned to the Hinder Condition were given the same set of instructions, with theexception of the italicized sentence, which was replaced with the following instruction:

Research has demonstrated that obtaining feedback during testing does not lead to improvedperformance. In fact, it may hinder your performance by decreasing the time available tocomplete the test.

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Participants indicated on the computer whether they wanted to receive their test score at theend of the session. After the participant began the test, the experimenter left the room andreturned to the adjacent room. The experimenter used a stopwatch to determine the length oftime the participant required to complete the test. After 15 min or when the participant indicatedthat s/he was finished with the test (whichever came first), the experimenter returned to thelaboratory and had the participant complete two manipulation check items.Next, s/he completed several questionnaires, including a demographic questionnaire, a measure

of behavioral coping style, and a measure of obsessive-compulsive personality traits. Participantsin the OC group also completed a re-administration of the PDQ-4 OCPD diagnostic scale, as wellas the Clinical Significance Scale. Likewise, participants in the AV group completed a re-admin-istration of the PDQ-4 avoidant personality disorder diagnostic scale, as well as the ClinicalSignificance Scale.Afterwards, the participant was asked to supply the name and phone number of a peer (e.g.

friend, roommate) and the experimenter requested permission to contact this person in order todetermine how the participant’s personality is viewed by other people. Finally, the participantanswered a series of questions to determine whether the experimental manipulations were effec-tive. After completion of these questions, the participant was fully debriefed about the truepurpose of the study.

2.4. Manipulation checks

Participants rated the extent to which they agreed that their performance on the cognitiveability test was a good predictor of future success in college (1=‘‘Strongly Disagree’’; 7=‘‘Strongly Agree’’). In addition, degree of effort during the test was assessed via a 7-point scale(1=‘‘No Effort’’; 7=‘‘Extreme Effort’’), as well as degree of anticipatory anxiety (1=‘‘Not AtAll Anxious’’; 7=‘‘Extremely Anxious’’). In order to determine the effectiveness of the Instruc-tion manipulation, participants rated the extent to which they agreed that feedback during thetest could improve overall test performance (1=‘‘Strongly Disagree’’; 7=‘‘Strongly Agree’’).

2.4.1. Personality disorder measuresPersonality Diagnostic Questionnaire-4 (PDQ-4). The PDQ-4 (Hyler, 1994) is a self-reportquestionnaire designed to assess the 10 DSM-IV personality disorders. Each of the 85 true/falseitems corresponds directly to a single DSM-IV diagnostic criterion and a response of Trueindicates that the item is to be scored as pathological. In addition to the 10 diagnostic scales,the PDQ-4 also contains two validity scales to assess both random responding and a defensivetest-taking approach. In accordance with DSM-IV, the OCPD diagnostic scale requires an indi-vidual to meet four out of a possible eight criteria to qualify for an OCPD diagnosis. Similarly,four out of a possible seven criteria are required for a diagnosis of Avoidant Personality Dis-order. Although this instrument has been used extensively, data regarding its psychometricproperties are inconsistent. Reliability and validity data regarding the PDQ-IVs immediatepredecessor, the PDQ-R, were encouraging. Validity studies which compared the results ofassessment with the results of structured clinical interviews such as the SCID-II and the Per-sonality Disorders Examination (PDE) indicated that the PDQ-R demonstrated high sensitiv-ity and moderate specificity for most Axis II disorders (Hyler, Skodol, Kellman, Oldham, &

N.G. Gallagher et al. / Personality and Individual Differences 34 (2003) 41–57 47

Rosnick, 1990; Hyler, Skodol, Oldham, Kellman, & Doidge, 1992). More recent studies haveraised questions about the internal consistency of some PDQ-IV scales (Fossati et al., 1998; Wil-berg, Dammen, & Friis, 2000).One problematic aspect of the PDQ-R is that it produces a large number of false positive

diagnoses. The PDQ-4 attempts to alleviate this problem by incorporating a Clinical SignificanceScale into the assessment process. This scale is a mini-structured interview that determines: (1)whether the participant made a mistake in endorsing the questionnaire items, (2) whether thetraits have been present over the past several years, (3) whether the traits are due primarily toAxis I conditions such as an anxiety or mood disorder, substance/alcohol abuse, or due primarilyto a physical condition, (4) whether the traits have caused significant difficulty for the participantat home, school, or in relationships, and (5) whether the participant is bothered about himself/herself because of the traits. The purpose of this component of the PDQ-4 is to generate person-ality disorder diagnoses that approximate those obtained through structured interviews in a moretime-efficient manner (Hyler, 1994).

2.4.2. Peer assessmentRecent evidence suggests that peers provide important information regarding the presence of

personality disorder traits (Oltmanns, Turkheimer, & Strauss, 1998). Therefore, we also imple-mented a peer assessment procedure to assess the validity of the PD groups. Peer assessment ofpersonality disorder for both the OC and AV groups consisted of the peer’s responses to theappropriate set of PDQ-4 items (e.g. the eight items from the OCPD diagnostic scale for partici-pants in the OCP group). Peer assessment was completed over the phone by undergraduateresearch assistants who called the designated peer after the participant had completed theexperiment.

2.4.3. Schedule for non-adaptive and adaptive personality (SNAP)The SNAP is a factor-analytically derived self-report inventory designed to assess trait dimen-

sions important in the domain of personality disorders (Clark, 1993). The SNAP is composed of12 specific trait scales, three temperament scales, and 11 diagnostic scales for the assessment ofDSM-III-R personality disorders. Three specific SNAP measures relevant to OCPD were admi-nistered: the OCPD diagnostic scale (dimensional rating), and the Propriety and Workaholismtrait scales.

2.5. Dependent measures

2.5.1. Self-reported dispositional coping styleThe Miller Behavioral Style Scale (MBSS) was employed to obtain a self-report measure of

dispositional coping style. This scale asks the individual to imagine four hypothetical stress-invoking scenes. Each scene is followed by eight statements that represent different behavioralstrategies for coping with the stressful event. Four statements following each scene represent aninformation-seeking strategy, and four represent an information-avoidance strategy. Two scalesare derived from this instrument, a monitoring scale and a blunting scale. Researchers havedevised and implemented a new version of the MBSS in which strategies are rated on a five-pointscale instead of the original dichotomous Yes/No scale (van Zuuren & Muris, 1993; van Zuuren

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&Wolfs, 1991). This modification has been shown to increase the reliability of the two scales (vanZuuren & Wolfs, 1991).

2.5.2. Laboratory-derived measures of coping styleAs mentioned previously, three measures of coping style were obtained during the laboratory

procedure. First, the amount of time (in seconds) the participant spent listening to the informa-tion tape and/or listening to music during a 5-min observational period was measured. Second,the computer recorded the frequency of requests for feedback during the cognitive test. Third,participants were asked whether they wished to receive their percentile score on the MRT aftercompleting the test.

3. Results

3.1. Preliminary analyses

3.1.1. Sample descriptionTable 1 summarizes the demographic characteristics of the study sample. Participants were

predominantly female (67%) and Caucasian (73%), with a mean age of 18.9 years. Seven percentof the sample indicated that they had been diagnosed with a mental disorder, with majordepression and eating disorders as the most common diagnoses. Although only three percent ofthe sample admitted to seeking mental health treatment at the time of the study, 21% stated thatthey had been treated by a mental health professional at some point during their lives. There wereno significant group differences on any of the demographic variables.

3.1.2. Validity of experimental groupsIn order to examine the stability of the screening measure, the PDQ-4 OC items were re-admi-

nistered to the OC Group during the experiment. Likewise, AV participants completed a secondadministration of the PDQ-4 AV items at the time they completed the experiment. Paired groupst-tests revealed a decline in total number of endorsed PDQ-4 OCPD items for the OC Groupfrom pretesting (M=6.45, SD=0.57) to re-administration (M=5.37, SD=1.41) (P<0.0001), aswell as a decline in total number of endorsed PDQ-4 AVPD items for the AV Group from

Table 1Demographic characteristics of study sample

OC (n=60) AV (n=40) NC (n=60) P

Caucasian race 43 (72%) 28 (70%) 45 (75%) 0.51

Female gender 42 (70%) 24 (60%) 42 (70%) 0.50Diagnosed with psychiatric disorder 5 (8%) 4 (10%) 2 (3%) 0.36Currently in treatment for psychiatric disorder 2 (3%) 2 (5%) 1 (2%) 0.62Ever in treatment for psychiatric disorder 11 (18%) 8 (21%) 14 (23%) 0.80

Age 0.54M 18.80 18.78 19.08(SD) (1.10) (1.12) (2.24)

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pretesting (M=4.92, SD=1.13) to re-administration (M=4.31, SD=1.38), (P<0.01). Despitethis decline in scores, 37 (93%) of the AV participants and 59 (98%) of the OC participantscontinued to endorse the requisite number of PDQ-4 subscale items in order to qualify for theirrespective DSM-IV diagnosis.A one-way MANOVA was conducted in order to detect potential group differences on the

three SNAP indicators of OCPD. As expected, the SNAP OCPD measures differed across groups[Wilk’s Lambda F (6, 308)=19.28, P<0.0001]. Univariate follow-up analyses revealed significantgroup differences on the SNAP OCPD Dimensional Scale [Mean and (SD) for OC=14.12 (3.16);for AV=9.51 (2.96); for NC=8.52 (3.09)], the SNAP Workaholism Scale [Mean and (SD) forOC=10.87 (3.30); for AV=5.67 (3.62); for NC=5.72 (3.16)], and the SNAP Propriety Scale[Mean and (SD) for OC=12.93 (2.91); for AV=8.85 (3.73); for NC=8.32 (3.91)], (allP’s<0.0001). Fisher’s LSD tests revealed that, as predicted, the OC Group scored significantlyhigher than both the AV Group and the NC Group on all three scales and that these later groupsdid not differ from one another on any of the three scales.Next, the proportion of participants in the AV and OC groups who qualified for a personality

disorder diagnosis based on the PDQ-4 Clinical Significance Scale was determined. Eighty-eightpercent of OC participants qualified for a diagnosis, whereas a significantly smaller proportion ofAV participants (71%) qualified for a diagnosis using the Clinical Significance Scale, w2 (1,n=99)=5.24, P<0.05.A final method of assessing the validity of the personality disorder groups in this study was to

obtain peer ratings of personality disorder for each participant. Most of the designated peers werefriends of the participant (63%). Twenty-six percent were described as roommates, seven percentwere romantic partners, two percent were family members, and the remaining two percent werecategorized as ‘‘Other.’’ Consistent with the results obtained with self-report data, a significantlygreater percentage of the OC participants qualified for a diagnosis (72%) compared to the AVparticipants (41%) when peer assessment data were utilized, w2 (1, n=99)=9.95, P<0.01.

3.1.3. Mental rotations testAnalyses were conducted to assess the extent to which the Mental Rotations Test served as a

sufficiently threatening stimulus. Descriptive analyses of the manipulation check questionnaireitems revealed that participants expressed a modest degree of belief that the test was a goodmeasure of cognitive ability (M=4.14, SD=1.23). Participants’ responses also indicated that theyexperienced a moderate amount of anticipatory anxiety immediately prior to taking the test(M=4.03, SD=1.53) and that they put forth a reasonable degree of effort while taking the test(M=5.40, SD=1.07). A series of one-way ANOVAs were performed in order to assess for thepotential confound of a group difference in perceived threat. The groups did not differ ondegree of effort, level of anticipatory anxiety, or belief that the test is a good measure of cog-nitive ability.

3.1.4. FeedbackIn order to evaluate the effectiveness of the instruction manipulation, participants in the

Improve Condition were compared to participants in the Hinder Condition on the degree towhich they agreed that feedback during the test could improve overall test performance. Asexpected, individuals assigned to the Improve Condition expressed stronger agreement with this

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statement (M=4.45, SD=1.38) compared to individuals assigned to the Hinder Condition(M=3.00, SD=1.34), t (158)=6.75, P<0.001.

3.2. Principal analyses

3.2.1. Group comparisons: laboratory measuresTable 2 presents the means and standard deviations for both laboratory and self-report mea-

sures for each of the three groups. There was a trend for the three groups to differ on the length oftime spent listening to the information tape, F (2, 157)=2.82, P=0.06. Multiple comparison testsrevealed that the OC Group tended to spend a greater amount of time seeking out informationabout the test during the pre-test phase of the experiment compared to both the AV and NCGroups. The AV and NC Groups did not differ significantly from one another. OC, AV, and NCparticipants significantly differed with regard to the length of time spent listening to music duringthe pre-test phase of the experiment, F (2,157)=4.76, P<0.01. Fisher’s LSD tests demonstratedthat the OC Group spent significantly less time listening to music compared to both the NC andAV Groups and that these latter two groups did not differ significantly from one another.A Chi-square test was conducted to test the prediction that a greater proportion of the OC

Group would choose to obtain their test score following completion of the test. This analysisrevealed a trend in the expected direction [w2 (1, n=160)=3.35, P=0.07], with 92% of OC par-ticipants and 81% of participants in the two control groups requesting test score.Next, a 3 (Group) � 2 (Instruction Condition) ANOVA with frequency of feedback request

serving as the dependent measure was performed in order to test the hypotheses that (1) the OC

Table 2Means and standard deviations of laboratory and self-report measures

OC(n=60)

AV(n=40)

NC(n=60)

P Results of multiplecomparisons test(Fisher’s LSD)

Time listening to tape (s) 0.06 OC>NCM 235.1 189.9 186.9

(SD) (110.7) (116.7) (133.9)

Time listening to music (s) 0.01 OC<AV=NCM 32.3 84.8 85.7(SD) (79.6) (110.3) (123.2)

Percentage of feedback requests N/AM 0.60 0.57 0.56(SD) (0.45) (0.46) (0.45)

MBSS monitoring score 0.002 OC>NCM 62.8 59.5 57.2(SD) (7.2) (9.0) (9.2)

MBSS blunting score 0.18 N/AM 42.8 42.6 40.8

(SD) (6.2) (8.0) (5.8)

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Group would engage in a greater degree of monitoring (information-seeking) behavior during thetest compared to the control groups, and (2) the OC Group would consistently demonstrate ahigh level of monitoring behavior, regardless of the demands of the situation, while the twocontrol groups would engage in less monitoring behavior when placed in a situation in whichblunting behavior was clearly more adaptive. Feedback requests were operationalized as theproportion of answered test items for which feedback was requested (e.g. 87% for an individualwho answered a total of 15 questions and asked for feedback on 13 questions). A main effect forInstruction Condition was revealed [F (1, 154)=63.51, P<0.001], with participants in theImprove Condition (M=0.81, SD=0.35) exhibiting a significantly greater proportion of feed-back requests than participants in the Hinder Condition (M=0.33, SD=0.40), thus providingevidence of the effectiveness of the instruction manipulation. Contrary to expectations however,no main effect for Group was detected, F (2, 154)=0.08, ns. In addition, the predicted interactioneffect was not found, F (2, 154)=0.03, ns. Mean proportions of questions with feedback requestsfor each of the three groups are as follows: M=0.53 (SD=0.46) for the OC group, M=0.49(SD=0.47) for the AV group, and M=0.56 (SD=0.46) for the NC group.

3.2.2. Group comparisons: self-report measuresExamination of Table 2 reveals that the groups differed significantly on MBSS Monitoring

scale score, F (2, 156)=6.68, P<0.01. Multiple comparisons tests revealed that the OC Groupscored significantly higher than both the AV and NC Groups on this measure; in addition, theAV Group scored significantly higher than the NC Group. No group difference on MBSSBlunting scale scores was found, F (2, 156)=1.74, ns.

3.2.3. Correlational analyses: laboratory measuresTable 3 presents the correlations between the dependent measures of monitoring/blunting (both

self-report and laboratory), and the five relevant personality disorder scales (three SNAP scalesand two PDQ-4 scales) across the entire sample of participants (n=160). These results are con-sistent with the group comparison analyses. Both pretest variables (time spent listening to tapeand time spent listening to music) were significantly associated with the majority of the OCPDscales in the expected direction (with the exception of the SNAP Propriety Scale) and were notassociated with the PDQ-4 AVPD scale. In addition, a statistical test designed byMeng, Rosenthal,

Table 3

Pearson correlation coefficients: laboratory/self-report measures and personality disorder measures (n=160)a

SNAP 1 SNAP 2 SNAP 3 PDQ-4 OCPD PDQ-4 AVPD

Tape time 0.16* 0.16* 0.08 0.15 �0.06Music time �0.17 �0.19* �0.08 �0.20* 0.08% Feedback �0.02 0.00 �0.08 0.01 0.03

MBSS monitoring 0.30** 0.26** 0.32** 0.29** 0.12MBSS blunting �0.02 �0.09 0.01 0.08 0.08

a SNAP 1=SNAP OCPD Dimensional Scale; SNAP 2=SNAP Workaholism Scale; SNAP 3=SNAP ProprietyScale.

* P<0.05** P<0.01

52 N.G. Gallagher et al. / Personality and Individual Differences 34 (2003) 41–57

and Rubin (1992) to compare correlation coefficients between a dependent variable and a set ofindependent variables revealed a significant difference between the magnitude of the Tape Time/PDQ-4 OCPD relation (r=0.15) and the Tape Time/PDQ-4 AVPD relation (r=�0.06), z=2.02,P<0.05. Similarly, the strength of the relation between Music Time and PDQ-4 OCPD score(r=�0.20) was significantly greater than the relation between Music Time and PDQ-4 AVPDscore (r=0.08), z=�2.70, P<0.01. In keeping with group comparison findings, proportion offeedback requests during the test was not associated with any of the personality disorder mea-sures. Furthermore, there was not a statistically reliable difference between the magnitude of thePDQ-4 OCPD/Feedback correlation (r=0.01) and the PDQ-4 AVPD/Feedback correlation(r=0.03), z=0.02, ns.

3.2.4. Correlational analyses: self report measuresExamination of Table 3 reveals that the results of the correlational analyses with self-report

data are in agreement with results obtained via group comparison analyses. Specifically, theMBSS Monitoring scale was positively associated with all measures of OCPD but was not asso-ciated with the PDQ-4 AVPD scale. In addition, the strength of the relation between MBSSMonitoring score and PDQ-4 OCPD score (r=0.29) was significantly greater than the strength ofthe relation between MBSS Monitoring score and PDQ-4 AVPD score (r=0.12), z=2.24,P<0.05. Self-reported information-avoidance behavior, as measured by the MBSS Bluntingscale, was not related to any of the OCPD measures, nor was it related the PDQ-4 AVPD scale.In addition, the magnitude of the PDQ-4 OCPD/MBSS Blunting correlation coefficient was notsignificantly different from the magnitude of the PDQ-4 AVPD/MBSS Blunting correlationcoefficient, z=0.00, ns.

4. Discussion

The current investigation was designed to provide an empirical test of the hypothesis thatindividuals with elevated levels of OC personality traits possess an intolerance of uncertainty.This hypothesis was tested within a stress and coping framework in which attentional coping stylein the face of an ego-threatening event was examined. Multiple methods of measurement (bothobservational and self-report) were utilized across multiple time periods (before and during theevent). Results of this investigation provide partial support for the specific hypotheses of an ele-vated degree of information-seeking behavior (monitoring) and a decreased level of information-avoidance (blunting) in OCPD.During the pretest period, OC participants engaged in significantly less blunting behavior (lis-

tening to music) relative to the two control groups. In addition, they tended to engage in mon-itoring behavior (listening to the information tape) for a longer period of time in comparison toboth the NC and AV groups. Correlational analyses corroborated between-group findings bydemonstrating an association between pretest measures of monitoring/blunting and various rat-ing scales of OCPD severity in the predicted direction. Interestingly, this association held true forthe SNAP Workaholism trait scale, but not for the SNAP Propriety trait scale. This pattern offindings suggests that the association between monitoring/blunting and OC personality may bemediated by a relationship between monitoring/blunting and a specific constellation of OC

N.G. Gallagher et al. / Personality and Individual Differences 34 (2003) 41–57 53

personality traits involving perfectionism and a devotion to work. This conclusion is in line withother investigations that have emphasized the heterogeneous nature of OCPD and the utility ofexamining particular clusters of traits (Gibbs & Oltmanns, 1995). Results also demonstrated thatthis association is unique to OCPD, since observational measures of attentional coping wereunrelated to the severity of AVPD symptomatology.During the test period, additional evidence for elevated levels of monitoring behavior was

found; a statistical trend indicated that a greater proportion of OC participants chose to obtaintheir test scores at the end of the session. Contrary to expectations, however, no between-groupdifferences in frequency of feedback requests during the test were found. In addition, the expectedinteraction between instruction condition and group status on monitoring behavior (frequency offeedback requests) was not found. The tendency for individuals with OCPD to acquiesce toauthority and to demonstrate rigid adherence to rules may be responsible for these negativefindings (Pollack, 1987). The experimenter may have been perceived as an authority figure withinthe context of the experiment. Therefore, OC participants were likely to carefully comply withany guidelines provided by the experimenter (i.e. information on how feedback could affect testperformance). This would have the effect of compromising the utility of this behavior as anindicator of monitoring during the test. One potential solution to this problem would have beento employ a third instruction condition in which participants were given no information regardingthe effects of feedback on test performance. This would have permitted observation of the naturaloccurrence of monitoring behavior during the aversive event. In addition to a lack of between-group differences in feedback frequency, there was no relation between feedback frequency andrating scales of OCPD severity.Laboratory measures of attentional coping were supplemented with self-report measures. Self-

report measures provided a converging pattern of results. First, the OC group reported a higherlevel of dispositional monitoring in comparison to both control groups. In contrast, the hypoth-esis that OC individuals would report lower levels of dispositional blunting was not supported.Correlational analyses corroborated the pattern of results obtained with group comparison data.Specifically, self-reported dispositional monitoring was positively associated with severity ofOCPD symptomatology (across four different rating scales), but was unrelated to severity ofAVPD symptomatology. In addition, self-reported dispositional blunting was not associated withany of the personality disorder severity measures. These findings provide support for the notionthat monitoring and blunting are orthogonal dimensions of coping (Miller, 1987; Miller et al.,1988; van Zuuren & Wolfs, 1991), since higher levels of dispositional information-seeking in theOC group were not accompanied by lower levels of dispositional information-avoidance.The results obtained using self-report measures of blunting contradict findings associated with

observational measures during the pre-test period. This may be a reflection of the state-trait dis-tinction between these two indicators of information-avoidance. That is, the observationalmeasure (time spent listening to music) represented behavior at a single time point, whereas theself-report measure was designed to assess the trait of dispositional information-avoidance.Alternatively, the consistent failure to uncover a relation between self-reported blunting andOCPD severity may simply be a consequence of the poor discriminant/predictive validity of theMBSS Blunting scale which has been documented in several other investigations (Miller et al.,1988; van Zuuren & Wolfs, 1991). At present, the nature of the relation between OCPD andblunting remains elusive.

54 N.G. Gallagher et al. / Personality and Individual Differences 34 (2003) 41–57

Perhaps the most surprising finding in this investigation was the large proportion of individualsin the pretesting sample (49%) who qualified for inclusion in the OC group. This figure isremarkably higher than Bernstein, Cohen, Velez, Schwab-Stone, Siever, and Shinsato’s (1993)prevalence rate of 8.8% for moderate OCPD (i.e. more than one standard deviation above themean on a continuous diagnostic scale) in a sample of 18–21-year-old adolescents. In stark con-trast, only 3% of the pretesting sample qualified for inclusion in the AV group, a proportioncomparable to the prevalence rate reported by Bernstein and colleagues for moderate AVPD(3.3% across males and females) in similarly-aged adolescents. These results reveal a high falsepositive rate for the PDQ-4 OCPD diagnostic scale when not used in conjunction with the Clin-ical Significance Scale. Interestingly, the proportion of participants who met our final (morestringent) criteria for inclusion in the OC group (9%) was almost identical to that of Bernsteinand colleagues.Several limitations of the present investigation should be mentioned. Because this study utilized

college students, the extent to which the results can be generalized to other populations isunknown. Therefore, future studies should utilize alternative populations (e.g. clinical and com-munity samples) in an effort to cross-validate the current findings.Another limitation concerns the assessment procedure used to select individuals for the two

personality disorder groups. Selection of these individuals was based solely on the PDQ-4. Therehave been few studies to date investigating the psychometric properties of this instrument. Tworecent studies have found low internal consistency coefficients and poor agreement between thePDQ-4 and both the SCID-II and LEAD standard (Fossati et al., 1998; Wilberg et al., 2000).Results of analyses on our data also indicated poor internal reliability for the PDQ-IV, withCronbach’s alphas below 0.30 for both the OC and AV scales at Pretesting and Experiment. Sincethis questionnaire is not a diagnostic instrument, difficulties also exist in interpreting elevatedscale scores as indicative of a personality disorder. However, this study supplemented rating scaledata with the semi-structured interview component of the PDQ-4. In addition, repeated assess-ment across multiple informants was employed. Together, the results of these various assessmentmethods suggest that the participants in both the OC and AV groups exhibited a high number oftraits that comprise these personality disorders. Even so, this does not guarantee that these indi-viduals would necessarily meet diagnostic criteria for a personality disorder if a more completeassessment had been conducted.Despite these limitations, the current investigation improved upon a number of methodological

weaknesses found in most previous laboratory investigations of OCPD. Specifically, our designincluded a normal control group, as well as a personality disorder control group, in order todetermine whether an elevated level of monitoring was specific to OCPD. To date, no otherinvestigation of OCPD has employed this type of design. Additional strengths of the currentinvestigation include: a large sample size, the use of DSM-IV criteria for sample selection, and theuse of multiple dependent measures. In addition, several methods were used to assess the validityof the personality disorder groups.In conclusion, the results of the present investigation suggest that individuals with elevated

levels of OC personality traits exhibit an attentional coping style that is characterized by a dis-positional tendency to seek out information regarding threatening events. This finding is con-sistent with the theoretical notion of a compromised ability to tolerate uncertainty in individualswith OCPD. Additional studies that explore the intolerance of uncertainty hypothesis are needed

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in order to assess the generalizability of the results obtained in this investigation. Future studiesshould employ non-student populations and should attempt to operationalize monitoring andblunting in an alternative manner. If replicated, these findings may be consequential for under-standing the clinical management and treatment of individuals with OCPD.

Acknowledgements

This study was supported by grant MH51187 from the National Institute of Mental Health andby a grant from the Department of Psychology at the University of Virginia. It is based on thefirst author’s dissertation, completed under the supervision of the third author. The authorswould like to thank Richard Castle, Danielle Dick, Brian D’Onofrio, and Elizabeth Martin, whoran participants through the experimental protocol and completed data entry. In addition, wewould like to express our appreciation to Daniel Wegner, Eric Turkheimer, and Janet Warren fortheir assistance with both theoretical and methodological aspects of this investigation.

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