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COMITET DE REDACŢIE
Redactor şef: Dan PRELIPCEANU
Redactor-şefi
adjuncți: Dragoş MARINESCU
Aurel NIREŞTEAN
COLECTIV REDACŢIONAL
Doina COZMAN
Liana DEHELEAN
Marieta GABOŞ GRECU
Maria LADEA
Cristinel ŞTEFĂNESCU
REVISTA
Cătălina TUDOSE
Secretar de redacţie: Valentin MATEI
CONSILIU ŞTIINŢIFIC
Vasile CHIRIŢĂ (membru de onoare
al Academiei de Ştiinţe Medicale,
ROMÂNĂ
Iaşi)
de
Michael DAVIDSON (Professor, Sackler
School of Medicine Tel Aviv Univ.,
Mount Sinai School of Medicine,
New York)
Virgil ENĂTESCU (membru al Academiei de
Ştiinţe Medicale, Satu Mare)
Ioana MICLUŢIA (UMF Cluj-Napoca)
Şerban IONESCU (Universitatea
Paris VIII, Universitatea Trois-
Rivieres, Quebec)
Mircea LĂZĂRESCU (membru de onoare al
Academiei de Ştiinţe Medicale,
Timisoara)
Juan E. MEZZICH (Professor of Psychiatry
PSIHIATRIE
and Director, Division of Psychiatric
Epidemiology and International
Center for Mental Health, Mount
Sinai School of Medicine, New York
University)
Teodor T. POSTOLACHE, MD (Director,
Mood and Anxiety Program,
Department of Psychiatry,
University of Maryland School of
Medicine, Baltimore)
Eliot SOREL (George Washington
University, Washington DC)
Maria GRIGOROIU-ŞERBĂNESCU
(cercetător principal gr.I)
ARPP ROMANIAN JOURNAL OF PSYCHIATRY
ASOCIAŢIA ROMÂNĂ Vol XX Nr. 2 June 2018
DE PSIHIATRIE ŞI PSIHOTERAPIE
QUARTERLY
www.romjpsychiat.ro CNCSIS B+ p-ISSN: 1454-7848 e-ISSN: 2068-7176
CUPRINS
ARTICOLE DE SINTEZĂ
& Modelul atașamentului la adult. Influența asupra abilităților parentale 47
Carmen I. Truțescu, Iuliana Dobrescu
ARTICOLE SPECIALE
& Personalitatea și strategiile de adaptare în dinamica vârstelor 52
Aurel Nireștean, Andra Oltean, Emese Lukacs
& Dimensiunea conștiinței și personalități patologice 55
Emese Lukács, Aurel Nireștean, Andra Oltean
& Perspectiva dimensională a subvariantelor tulburării obsesiv-compulsive 57
Emese Lukács, Aurel Nireștean, Tudor Nireștean, Andra Oltean
ARTICOLE ORIGINALE
& Relația dintre depresie și factorii socio-economici 59
Ioana A. Pacearcă, Floris P. Iliuță, Oana Manea, Mirela Manea
& Comorbidități ale consumului abuziv de alcool 63
Maria Bonea, Mădălina C Neacșu, Ioana V Micluția
& Biomarker-ii tratamentului de monitorizare al alcoolismului cu comorbiditate hepatică.
Un studiu observațional 68
Claudiu I. Vasile
& Monitorizarea pacienților alcoolici folosind Testul Audit 75
Claudiu I. Vasile
CAZ CLINIC
& Diagnostic diferențial: tulburare delirantă - tipul somatic vs anorexia nervosa 83
Ana-Anca Talașman, Alexandra Dolfi
INSTRUCŢIUNI PENTRU AUTORI 86
Revista Română de Psihiatrie este indexată de Consiliul Naţional al Cercetării Ştiinţifice din
Învăţământul Superior la categoria B+. Apare trimestrial.
Colegiul Medicilor din România acordă abonaţilor la această publicaţie 5 credite EMC/an.
Articolele ştiinţifice publicate în revistă sunt creditate cu 80 credite EMC/articol.
Revista Română de Psihiatrie este editată de Asociaţia Română de Psihiatrie şi Psihoterapie
şi Asociaţia Medicală Română
REVIEW ARTICLES
ADULT ATTACHMENT PATTERN. INFLUENCE ON
PARENTING SKILLS
Carmen I. Truțescu1, Iuliana Dobrescu2
Abstract exercising the profession of parent and parental
The role of parents in raising and educating attachment pattern.
children is fundamental, and, in recent years, there is an Specialists in child psychology and psychiatry
increase in mentioning their active participation in carefully evaluate the attachment of young individuals,
maintaining the mental health of children. being considered an important determinant of the pattern
Beyond the rational approach to problems in of subsequent social relationships. The adult attachment is
raising the children, different structural factors, however a controversial topic, many authors assimilating
personality traits, and personal life experiences, it with personality traits while other sustain its substantial
sometimes with traumatic effects, can interfere with impact on social relationships, especially on couple and
adherence to the chosen parenting style. Adopting an family relationship.
inconsistent attitude in the application of self-imposed or This paper aims to review the data on adult
recommended educational rules or principles, emotional attachment and its relation to the individual's functionality
instability or expression of fluctuating feelings, as a parent.
alternating between guilt and aggression may represent Key words: adult attachment, parenting,
just a few examples of behaviors that launch the hypothesis personality traits
of a fundamental relationship between the way of
The assessment of adult functionality includes behaviors. Inappropriate behaviors are sanctioned by
the global analysis of several perspectives. The role of coherent, not arbitrary or violent measures. Often
parent, with clearly defined goals related to the growth and behaviors are not punished, but the consequences of the
education of children, is fundamental. There are more and child's actions are explored and discussed, and the child
more debates in recent years about the more complex can see that behavior is inappropriate and should not be
implications of the adult personality in the psycho- repeated. (3) However, when a child is punished, the
emotional development of the offspring, directly and parent will explain the reason for the punishment adopted.
indirectly, the psychological balance of the parent Children respond to parental punishment because it is
contributing to the maintenance of the mental health of the reasonable and fair. As a result, children with democratic
children. education style parents are more likely to be successful,
The parenting style can be considered the result will be appreciated by those around them, generous and
of the educational process to which the adult who became a capable of self-determination. (2, 4, 5)
parent had access. Personal beliefs and parental values Authoritarian style. The parent has a low
influence and delineate the set of rules, expectations of response capacity and his requirements are absolutist;
performance, and interventional patterns used in education their children must follow the instructions formulated
of children. without any explanation. (3, 4) Body punishment is a
Darling and Steinberg, in a 1993 paper, bring common form of discipline. Some supporters of this
clarifications towards distinction between parenting parental style believe aggression from someone in the
practices and parenting styles; in the author's opinion, outside world will be less shocking for a child who is
parenting practices are defined as specific behaviors that accustomed to these forms of relationship.
parents use to socialize their children while parenting style Children raised using this type of parenting may
as the emotional climate in which parents grow up their have weaker social skills, tend to be conform, very
children. (1) obedient, quiet, but not very happy, with feelings of self-
Depending on the child's responsiveness and the culpability and being at risk for depression, which may
urgency of the requirements formulated for children, persist until maturity. Those who manage to develop self-
Diana Baumrind (2) defines three different types of confidence can present behavioral changes in teenagers,
parenting styles: democratic style, authoritarian style and while under-developed teenagers with low self-efficacy
permissive style. may resort to substance abuse or suicide. (4, 5)
Democratic style. The parent has a high Permissive style. Marked by high reactivity and
receptivity; the requirements and limits set out are clear, low absolutist requirements. (3) Studies on pre-school
allowing children to develop their autonomy, working children with permissive parents indicate that they tend to
maturely, independently, and developing appropriate child be immature, with poor or absent impulse control (5). In
1
MD, medic specialist psihiatrie pediatrică, Institutul Național pentru Sănătatea Mamei și Copilului – Alessandrescu-Rusescu, București
2
Prof. Univ., medic primar psihiatrie pediatrică, Spitalul Clinic de Psihiatrie “Alexandru Obregia”, UMF” Carol Davila” București,
Received February 26, 2018, Revised February 28, 2018, Accepted March 17, 2018
47
Carmen I. Truțescu, Iuliana Dobrescu: Adult Attachment Pattern. Influence on Parenting Skills
adolescence, they have a three times higher risk for another person. Attachment relationship refers to the
pathological alcohol consumption compared to the same connection one has developed with the person who
age population (6). represents the primary attachment figure, mainly the
Parenting (parenting practices) is a specific person providing the care; toward this person the child
behavior - taken over or acquired - that a parent chooses to reach or maintains the approach in a differentiated and
use in the care, growth and education of his child. (2) usually preferred way. (14)
Attachment and care systems are often activated There are two concepts of attachment
simultaneously. (7) development; on the one hand, the behaviorist, according
Apart from the parental attitudes mentioned to which attachment is learned, and the one detached from
above, special attention has been paid to Neglect; these psychoanalysis, which considers that individuals are born
parents have no expectations and do not react adequately with the ability to form their attachment.
to children's interactions, neglect the emotions and The behaviorist theory argues that attachment
opinions of the child, most of the times their parents and patterns are developed through classical or operative
children have contradictory behavior; the child will be full conditioning processes, as follows:
of resentment, and the parent will be indignant, lacking in ·Classical conditioning, in which emphasis is placed on
authority. Children get retreated into social situations, the importance of stimulus - response: children are born
with school absenteeism or delinquency. (3, 5) with hunger reflexes, and when fed, this reflex is
Literature data shows that there is a strong link diminished and a well-being, pleasure is established,
between the parent's attachment style and the parenting which is then associated with the person providing the
style to which he / she will adhere, the parent with secure food, searching for that person perpetuating beyond the
attachment, adopting an autocratic (democratic) moments of hunger, which leads to the learning of the
educational style, gives the child the opportunity to make attachment.
choices and to develop in a flexible, democratic, safe and ·Operational conditioning: behavior which leads to
assertive manner, while parents with anxious attachment rewards will be repeated, unlike the one that draws an
style tend to develop permissive parenting techniques. (7) unpleasant result that will not repeat itself. Feeding leads
Similar results have also been reported by Millings et al., to positive feelings that will lead to the perpetuation of the
who also emphasized that there are no significant generating behavior and will create a secure attachment.
differences between mothers and fathers, the type of For example, the child will show desire for proximity with
attachment being a predictor of the parenting style (8). a smile, looking for the mother, as she responds with the
Psychotherapy, particularly psychodynamic and same type of reaction, thus enhancing his behavior. (15,
systemic, recognize the importance of understanding the 16, 17)
intrapsychic dynamics of the adult becoming a parent and Behaviorism therefore supports the idea that any rewarded
addressing the family. Therefore, we start from behavior will be reproduced. (15) The hypothesis was
recognizing that previous experiences of the individual taken up and supplemented by further research which
make their presence felt in all inter-human relationships, considers that parents teach their children to love them
including in the parent-child relationship, both at the level through three mechanisms (Theory of Social Learning):
of educational principles and at the level of ·Direct training, when asking the child to show his
communication and emotional relationship. (9, 10) attachment, for example by telling them to embrace them;
Personality traits, individual communication ·Modeling by mimicking emotional behavior of parents,
skills, developed and trained coping techniques, as when the parents caress the child, and he does the same
assertiveness level, or pre-clinical psycho-emotional gesture;
conditions all can be considered variables that interfere
·Social encouragement which parents apply after
with the parenting style practiced (5).
observing children's behavior towards others, trying to
From the perspective of attachment, adequate
modify behavioral errors by explaining why it is not good
parenting skills require the congruent action of the areas of
to act in a certain way. For example, when a child reacts
sensation and perception, reward, executive functions,
violently when another takes his toy, parents explain that it
motor skills and learning abilities. (10) The authors also
is not good to scream and hit the other child. (15, 18)
talk about the role of working memory in allowing parents
One of the limitations we can observe regarding
to plan their parental actions based on the information
behaviorist theory is that it is unable to explain why
transmitted to the child, the context and previous
attachment relationships persist for long periods of time,
experiences, and correlates them with the mother's ability
even when persons to which an individual shows
to focus and keep attention in the tasks as well as her
attachment are missing and they don't meet his needs. (9,
spatial memory. (11)
15)
Personal experiences at the expense of an
Psychoanalytic theory, explaining the mother-
attachment relationship, such as childhood mistreatment
child relationship centered on the need for food, sees this
or neglect, can reduce the feeling of safety among peers
feeding relationship as a means rather than as a goal. From
and may exacerbate reactions to later tensions or
the point of view of psychoanalysis, satisfying the basic
conflictual situations. (7, 10) Although it seems to
need of the child gives him the opportunity to shift his
influence the relationship with age equals, the state of
attention from the primary needs, for which he knows he
insecurity may appear in relation to one's own children, of
will always have support, to the environment, which he
which, approaching a persistent attitude can be difficult.
begins to discover, and in which gradually establishes its
(12, 13)
own position, thus achieving a strong affection towards
In general terms, attachment can be understood as
the mother, based on safety and trust, which goes beyond
an emotional bond that an individual can establish with
48
Romanian Journal of Psychiatry, vol. XX, No.2, 2018
the physiological dependence relationship. The early 1.Anxious-preoccupied attachment - Children with this
mother-child relationship is imperative for the type of attachment have a dual, duplicate attitude towards
harmonious development of the child's subsequent their parents. They will develop a "sticky" and addictive
personality, the emotional safety that mother transmits to behavior, but when they interact with their parents, they
her child being responsible for the cognitive ability of the reject them. (16) They are unable to develop feelings of
child and also for his social assessment skills. safety in relation to attachment figures, unable to move
Supplements to psychoanalytic theory have argued that away from them to explore the environment.
newborns, like animal babies, are born with a series of When a stressful situation occurs, they cannot be
abilities which form a psychological system that dissuaded and do not want to relate to their parents. This is
facilitates the creation of an attachment behavioral system caused by the inconsistency of parents in meeting their
with respect to the primary caregiver. (14, 19) needs, these children not knowing when their requests will
Growing, the inner work pattern of the Ego and of be heard and when they will be ignored. All these
others is gradually developed, especially of their relationship traits between children and parents will
caregivers, and children can differentiate behaviors and gradually lead to the creation of a negative self-image of
emotional feelings associated with them, simultaneously the child and to a series of exaggerated actions and
appropriating some of the observed behavioral reactions. manifestations to achieve attention (12, 25).
(14, 19) 2.Avoiding attachment - In this psychological context,
These behavior patterns end up being biologically children lose their confidence in adults, do not feel that
rooted and activated throughout their later life by various they can provide the help they need and then they start to
environmental stimuli and conditions generated by avoid the significant person. Also, these children do not
different social circumstances, such as the need for have the necessary safety to explore the environment in
protection and care. The attachment theory emphasizes which they live, they are independent of the parents'
learning through observation and reinforcement, which presence, both physically and emotionally. (12) They do
children take in their future interactions with their not seek contact with a person in a stressful situation.
classroom mates, in the classrooms, and ultimately in their Parents of these children refuse to help when they
family relationships (17, 20), and the role that attachment ask for it, they are insensitive, and evade when facing more
plays it as a buffer against stress (12). difficult tasks, most often their support is mossing in
Moreover, the attachment theory represented other emotional stresses situations (26).
processes by which parents can lead to social competence, Therefore, children with an avoidant attachment
arguing that safe relationships with caregivers in early are considered unworthy and unacceptable by others
childhood predicted later competence in several areas (21, because of the parental rejection. (12, 25)
22). Social competence is also associated with attachment 3.Anxious-avoiding attachment - This type of attachment
security, attachment among infants being a good predictor is absolutely dysfunctional and installs in children who
for social competence during childhood and adolescence have been abused and who have been deprived of the
(20). presence of an attachment figure. The behavior of these
Considering the fact that the individual's children is unpredictable, it is lacking coherence and
interpersonal relationships and experiences are unique, a predictability towards others. It's named also a
multitude of variables that relate both to that person and to disorganized attachment type. Their reactions are
his / her relational, social and economic background, can generally difficult to predict. (12.26)
influence the development of the attachment. (14, 19) By reviewing the above attachment types,
Depending on the degree of deviation from normality, attachment can be said to be an evolutionary mechanism,
attachment is classified into two broad categories: secure developed at the individual's psychological level, to
and insecure. overcome the stressful situations that they encounter
Secure attachment is the ideal attachment type in throughout their lives. Among the protagonists of this
which all the information received by the individual has process are the people who constitute the early universe of
induced the idea of security, self-confidence and freedom the individual, respectively the mother. (26) Their
of knowledge. Children who have developed such an unavailability or abuse will result in an insecure
attachment are those who have always felt that someone is attachment pattern, each defining some subsequent
near to help them and that the family is a secure behavior and representing a risk factor for it (27).
environment. As a form of manifestation, these children The attachment theory, as described by Bowlby
are those who get upset when the mother / parents leave, in 1969, refers to the attachment of children to the primary
trying to resist, but after a few minutes they can be easily attachment figure, (14) but it can be extended to personal
reconciled by someone else and continue their activities relationships developed in adulthood (13, 28).
because they know that separation is a temporary one and The child, in the relationship he develops with
that parents will always come back. the caregiver, develops working patterns and relationships
From a relational point of view, these children with others, influencing the patterns of cognitive,
learn to express their needs and emotions directly, they emotional and behavioral response. These attachment
feel able to create social relationships and enjoy it. The models are characterized by two dimensions, called
basis of this attachment is a healthy emotional process, anxiety and avoidance (9, 29).
which includes empathy, harmony, emotional resonance, When the comfort and safety needs are
all mediated by the brain and associated with a positive constantly met, the child develops a secure connection to
affective state (23, 24). the attachment figure (15) characterized by a positive
In turn, insecure attachment is divided into three image of the self. However, if the attachment figure does
types (12, 16, 19): meet his needs, it develops a relationships pattern in which
49
Carmen I. Truțescu, Iuliana Dobrescu: Adult Attachment Pattern. Influence on Parenting Skills
individual fears are manifested, and the individual expects childhood violence (10, 38).
rejection from others. People with this type of attachment, Anxiety disorders are characterized by
named anxious-fearing, feel the anxiety at high level, dysfunctions of the stress control system and response to
mostly the anxious preoccupation for relations with fear that develop in the context of life experiences and
others. (12, 30). persist throughout life, generating the idea of involving
If the individual experience is a neglect one, early attachment to the etiology of subsequent anxiety
which is repeated consistently enough, the individual can disorders. (10, 13, 15) Activation of the attachment system
develop the belief that the relationship with others is accompanies therefore anxiety and stress response. (27,
untrustworthy, considering himself as autonomous and 37)
self-sufficient. These people can then avoid, during the A comparative analysis of the relationship
development close relationships, fearing that the between communication skills and the parental
relationship with others will only bring them relationship in parents of ADHD's children versus typical
disappointment. People with this model of work are at risk children's parents shows that exaggerating personal
for developing the evasive attachment, defined as a weaknesses and coercive behavior as well as promoting
tendency to dismiss or avoid intimate relationships (30). self-devaluation makes parents with anxious attachment
Preoccupation for adult attachment relationships to engage in non-constructive communication in
began in the early 1970s with studies on responses toward relationship with the child with ADHD (39), while
loses, initially death of partners (31) and marital mothers with secure attachment more often have the
separation (32). More recently, the interest in adult ability to overcome stressful moments and adapt to
attachment has been extended to include marital parental status requirements (7, 11, 17).
relationships that have translated attachment models Knowing the association between individual
described by Ainsworth in models encountered at adults. psychological variables and the relational-educational
Thus attachment patterns (security, avoidance or style that an adult develops in parenting provides the
ambivalence) are recognized in terms of romantic possibility of early psycho-educational intervention
relationships, patterns that can also be reported to the (primary screening and prophylaxis of psychological
parent-child relationship. (19, 32) disorders and even some of the psychiatric disorders of
When discussing the adult's attachment, it is a children and adolescents) as well the implementation of
matter of differentiating it from personality, making it some complex psychotherapies programs that include not
difficult to establish the causal relationship between the only the child's symptomatology but also the modification
two aspects and, above all, their correspondence, if we of the psycho-familial framework.
accept that they exist. (15) There are some individual
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51
SPECIAL ARTICLES
PERSONALITY AND COPING STRATEGIES IN
AGE DYNAMICS
Aurel Nireștean1, Andra Oltean1, Emese Lukacs1
Abstract of interpersonal relationships. They sustain the subjective
Any attempt to describe the human personality wellbeing, and thus the self-esteem of the human person.
always implies looking a the roles and stages of life. In the From the dimensional perspective of the Big-Five model,
various stages of life, the coping mechanisms that must be agreeability and openness, along with self-determination
developed are the ones that prove to be the most efficient underlie the most important coping mechanisms and give
and valuable in the shaping of a personal destiny. In their value to the human person.
great diversity, coping mechanisms express the level of Key words: personality, coping mechanism, Big Five
individual maturity. Irregardless of age, they are dimensional model
conditioned by the personality dimensions and the quality
Any attempt to describe personality necessarily Mind theory says that human beings have the
implies looking at life roles and the temporal dimension of capacity to intuit and anticipate the psychic content of the
human existence. The latter is the foundation of personal people around them, which constitutes a major coping
destiny, and influences self-awareness and the ways in attribute. There is a complex inter-conditioning between
which one connects with others. A person's subjective the dimensions of the individual personality and the
wellbeing, in both its cognitive and affective components, psyche. Thus, the psychic functions and the dominant
is dependent upon the quality of human relationships, and personality structures mature and manifest themselves
favors coping capacities in the diversity of life roles simultaneously, and sustain a person's coping abilities (1).
throughout all its stages. The relationship between the emotional life of
Considered to be a major existential aim, being the individual and the diversity and hierarchy of personal
“yourself” means self-knowledge and self-acceptance. motivations plays a special role. Precocious affective
Likewise, it implies a harmony between self-image and experiences decisively influence ulterior biological and
self-esteem, and gives a person the natural feeling of socio-cultural motivations, as well as the ways a person
belonging to humanity. Human nature includes the responds or reacts to external stimuli. The ability to cope
individual dimension of personality as well as an and resonate emotionally, their depth and persistence are
important part of the personal and collective archetypes, particularly involved in the representation of the self and
confirming in a special way the concept of “unity in of the outside world – inner working model. They
diversity”. Thus, being yourself favors and at the same determine self-knowledge and self-esteem as well as the
time transcends inter-human differences. Genetics, society coping ability and the ways in which one influences one's
and culture simultaneously determine these differences surroundings.
and confirm the diversity of the human condition. The process of individual maturation is also
Throughout the various stages and in the diverse determined by the ability for self-determination – a
roles one plays in life, the personal attributes that should be personological character dimension whose value rises
developed are the ones that favor the most efficient coping progressively – in normal people – throughout the various
mechanisms, while also taking into account the fact that stages of maturation (2). This is confirmed also by the fact
age can enhace or diminish them. that self-determination is optimized by cognitive-
Man is not born an adult, and all childhood behavioral therapies and the administration of anti-
experiences - among which the relationship with family depressants.
and people close to you play a major role – form the Whether we look at it as reality or myth,
foundations of a person's emotional life, cognitive adulthood/maturity implies the passage/progression from
strategies, and major existential motivations for the an immature and dependent human condition/state, to an
following stages of life. Man also has one body – independent and socially inter-dependent one, in which
biological maturation precedes the psychological one, and an individual is free to make decisions and select
decisively influences it. Together they shape one's self- interpersonal relationships and existential values and
image. But man is also a social being, one's internal world beliefs.
being a projection of the external one. The binoms Individual self-determination – whose major
activism/passivity, dominant/submissive, interpersonal aim is self-fulfillment – constitutes thus a tiered process
closeness/detachment dominate the individual's life and that is partially conscious and partially unconscious. Such
shape the maturation process. is the passage of human beings from one age to another.
1
Psychiatric Clinic No.II, UMF Tg.Mures
Received February 26, 2018, Revised February 28, 2018, Accepted March 17, 2018
52
Romanian Journal of Psychiatry, vol. XX, No.2, 2018
Personhood is thus a temporary structure whose professional one being dominant – nowadays for females
dimensions are conditioned both genetically and socio- as well – and has complicated relationships with others.
culturally. Genetically they are stable throughout life, An enhanced sense of responsibility for one's opinions and
while environmental and interpersonal relationship actions is present, and self-esteem goes hand-in-hand with
factors shape the dimensional facets which are dominantly self-image.
thrown into the dynamics of existence (2). The 3rd age is characterized usually by a certain
In the contemporary social and cultural context devolution of the somatic state and of the ability to
dominated by post-modern attributes, man is a duplicitous function in the various life roles. They are diminished, as
being who simultaneously cultivates narcissistic are social contacts and relationships. The fear of
tendencies and pro-social abilities. It grabs selfishly what dependency, of poverty, and of death can appear at this
is “good” and tackles “evil” subjectively as being the stage along with the various ways of dealing with
exclusive attribute of others. In relating to others, morality impotence and of accepting it. The tendency to undervalue
is conjectural/relative, egocentric or altruistic. Virtues are oneself, lower self-esteem, and social isolation are often
displayed – often ostensive – only to enhance one's value. evident at this stage. But this stage of life also means
The destiny of an individual is in great measure psychological maturity and spiritual growth, the
influenced by one's coping abilities, which in turn are acceptance of one's personal biography, the capacity to
undergirded by the personality dimensions, the quality select what is valuable in life, and the promotion of its true
and complexity of interpersonal relationships, the quality sense. The wisdom which inspires and guides those who
of one's motivations, and last but not least, by the specific are younger can protect against age discrimination which
stages of life. is so present nowadays. The elderly can also pursue a
The coping mechanisms of the individual allow symbolic “eternal life” through their children's
the anticipation and control of the negative and positive accomplishments or through religion (6).
events of life. They consist of stable personality traits as The life coping abilities of the human person
well as the ability to consciously mobilize one's affective, integrate the levels and ways of self-expression, their
cognitive, volitional and motivational resources (3). dominant existential motivations, and their age-specific
Coping mechanisms are individual traits. From the personological dimensional perspective of
psychological attributes that play a major existential role the Big Five model – neuroticism and extraversion are the
manifested throughout a person's life, and which produce most studied dimensions at any age. Together with
a great variety of strategies and behaviors. They are aimed conscientiousness, they condition and differentiate the
at more or less specific aspects of one's life such as states of subjective wellbeing (7). This subjective
personal safety, interpersonal relationships, reproduction, wellbeing is enhanced but fragile in youth, less strong in
parental attributes, professional options and involvement, adults, and once again higher in the elderly, mostly in its
social status (4). affective/emotional component. The subjective wellbeing
In the constant search for self-fulfillment – grows in time, provided that adulthood is lived at higher
happiness – as a support for one's subjective wellbeing, the level of conscientiousness, agreeability and openness to
contemporary human being feels the need to surpass experience (8).
oneself. That is why, in the spirit of competitiveness which The level of extraversion diminishes with age
has been promoted since the first stages of life, - the need leading to a less active social life, except for people with
to be “someone” in other people's eyes is born and high levels of openness. The heightened level of
becomes dominant. The attachments people form with introversion can become an important coping mechanism
others are thus based only on common interest. when the environment is uncertain or dangerous.
The most intense and complex implication of a Enhanced extraversion spells success in finding a partner
person in life's roles takes place in adulthood, while or a friend, but is also risky. When the environment is
relating in the most meaningful way to life's experiences harmonious and safe, the heightened levels of
and events happens in youth and with the elderly. The extraversion are coping factors and favor exploring the
quality of the involvement in existential roles depends environment, especially in youth. Together with
thus on the quality of the coping mechanisms which agreeability, extraversion influences interpersonal
differs from person to person and from age to age, relationships no matter the age.
especially in the presence of stress factors. Neuroticism grows with age – especially in
In youth, the processes of biological and females – and it means affective instability, pessimism,
psychological maturation harmonize, emotional life is low sense of wellbeing and self-esteem. Extreme
intense, and self-knowledge is in its beginning stages. neuroticism is expressed by hypervigilance toward danger
Special aptitudes and talents often become evident and in adults and the elderly, but at the same time it favors
professional options are being formulated. While self- episodes of anxiety and depression. The depression and
searching, young people are curious, non-conformist, anxiety are aggravated when associated with low levels of
thirst for novelty, give importance to appearance, are conscientiousness. Dysfunctional relationships between
pragmatic and idealistic, and often abuse drugs. Self- youth and adults – especially parents – appear frequently
esteem is fragile and inter-personal relationships are many when, in this context, the level of extraversion is also low.
and mostly short-lived and shallow (5). On the other side, high levels of both neuroticism and
Adulthood is the age of maturity, in which self- agreeability favor work efficiency in adults and enhance
knowledge and self-acceptance are reached. It is the age of the cognitive component of their subjective wellbeing (9).
stable, adaptable emotions, of introspection and Besides, low neuroticism associated with high
reflection, and of elaborate cognitive strategies. The adult levels of conscientiousness and extraversion enhance the
is intensely involved in a multitude of roles – the diversity and quality of interpersonal relationships in
youth and adults. Low neuroticism and low extraversion
53
Aurel Nireștean, Andra Oltean, Emese Lukacs: Personality and Coping Strategies in Age Dynamics
favor the ability to climb in the social and professional magical thinking, faith, a capacity for self-transcendence,
hierarchy in adults, while high levels of extraversion are a and is, at any age, a major adaptive factor. Its heightened
supportive factor in the commercial and artistic levels sustain artistic abilities, the ability for self-
professions, as is openness to experience. transcendence, and a heightened state of subjective
Neuroticism ad extraversion are believed to be wellbeing in both its affective and cognitive forms. These
shaped at any age by material gain. In adults they are heightened levels can also explain the high intensity of
shaped also by the quality of personal relationships, and in certain depressive episodes, especially in women. Still,
the elderly, especially males, by their marital status. At the correlation between age and openness to experience
these stages, if the levels of neuroticism and extraversion remains strictly individual, thus underlining the
are also joined by an enhanced level of openness, an specificity of the other.
efficient coping mechanism appears which protects a The human person's coping mechanisms are
person's state of subjective wellbeing and emotional shaped by structural dimensions of personality and
balance (8). psychological peculiarities of age. In this context, self-
T h e d i m e n s i o n s o f a g r e e a b i l i t y, determination together with agreeability and openness to
conscientiousness and openness to experience are less the experience constitute the most relevant elements of
subject of study as they relate to age, but their levels must adaptive support.
constantly be related to those of neuroticism and
extraversion with which they correlate in complex ways. REFERENCES:
For example, high agreeability associated with high 1. Nirestean, A., Lukacs, E., Buicu, G., Bilca, M., Pokorny, V. The
extraversion positively influence subjective wellbeing. spiritual dimension of personality and its role in mental health.
Romanian Journal of Psychiatry, 1, pp.1-4, 2016
The low values of agreeability and conscientiousness 2. Lazarescu, M., Nirestean, A. Tulburarile de personalitate, Iasi, Ed.
favor disinhibited behavior and delinquency. Polirom, 2007
High levels of conscientiousness have a 3. Ionescu, S., Jacquet Marie-Madeleine, Lhote, C. Mecanismele de
multitude of adaptive effects. For example, they influence aparare, Iasi, Ed. Polirom, 2007
4. Norbert, S. Dictionar de psihologie, Bucuresti, Ed.Univers
the professional orientation in youth, and ensure Enciclopedic, 1996
heightened efficiency in conventional activities. They also 5. McCrae, R.R. & Costa, P.T., Jr. Age, personality, and spontaneous self-
ensure stability in professional roles and the quality of concept. Journal of Gerontology: Social Sciences, 43, S77-S185, 1988
marital status with the elderly. High quality academic 6. Laplanche, J., Pontalis, J.B. Vocabularul psihanalizei, Bucuresti,
Ed.Humanitas, 1994
performance is associated with high levels of openness to 7. McCrae, R.R., Costa, P.T., Jr. The Five Factor Theory Of Personality,
experience, especially in young people, while low levels in John, O.P., Robins, R.W., Pervin, L.A. (Eds) Handbook of Personality,
of conscientiousness explain in great measure the The Guilford Press, pp.159-181, 2008
behavioral disorders in youth and ADHD in adults (8). 8. Costa, P.T, Jr., Widiger, T.A. (Eds) Personality Disorders and the five-
facto Model (2nd ed.), Washington DC: American Psychological
The openness to experience is a special Association, 2002
dimension which evens out the differences between 9. McCrae, R.R. The maturation of personality psychology: Adult
individuals and often compensate for the maladaptive personality development and psychological well-being. Journal of
values of the other dimensions of personality. It implies Research in Personality, 36, 307-317, 2002a
originality, curiosity, artistic and aesthetic sense, as well as
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54SPECIAL ARTICLES
CONSCIENTIOUSNESS DIMENSION AND
PATHOLOGICAL PERSONALITIES
Emese Lukács1, Aurel Nireștean1, Andra Oltean1
Abstract Thus, the psychobehavioral manifestations of Obsessive-
Personality disorders must also be approached from a Compulsive Personality Disorder, Borderline Personality
dimensional perspective always, as it allows more subtle Disorder, Antisocial Personality Disorder and Narcissistic
assessments of the dominating temperament and Personality Disorder, but also of Avoidant Personality
character. Disorder and Histrionic Personality Disorder may be
As it has both genetic conditionings and social-cultural dimmed, exacerbated or nuanced by the values of
ones, the Conscientiousness dimension – closely related to Conscientiousness. These are also predictive factors for a
activism – centers the personality's structure and it may diversity of episodes and mental illnesses, in the case of
favor or disadvantage the individual destiny. which the therapeutic compliance influences in a decisive
The adaptive variants of Conscientiousness favor manner.
personal self-directedness process, self-control and the Key words:
subjective well-being. In return, the maladaptive variants Conscientiousness, personality disorders, self-
– in terms of extremely high or low values, accompany directedness
most of the personality disorders.
3 front of obstacles. Usually prefers an organized and well-
The Conscientiousness dimension – a component of the structured style of activity, is cautious in his decisions,
Big Five model, also called Five Factor Model – is one responsible, perseverant and completes all the assumed
of the basal dimensions of personality, easy to tasks. His emotional manifestations are controlled,
investigate by means of the current instruments of slightly expansive and contagious, less flexible and
personological assessment. It may be correlated both to spontaneous. Such a person is trustworthy, complies
the Persistence dimension – temperament factor – and to easily with norms and authorities and adopts very easily a
Self-directedness – character factor – from Cloninger's 7 balanced and healthy lifestyle regimen.
factors model. So, Conscientiousness – both genetically An excessive high Conscientiousness transforms
conditioned and shaped by interpersonal and educational these traits in their maladaptive variants. Thus, a person
experiences within the personogenesis – is a mouldable with very high values of this dimension has in perspective
dimension (1)(5). a higher and higher level of performance, and he self-
Its assessment, allows to estimate the self-control imposes exaggerated and unrealistic standards. He
ability, a must in any personological characterization. prefers algorithmic actions, but rigid and monotone ones,
Conscientiousness represents the foundation of Self- has much difficulty in adapting to any change and to
directedness on a medium and long-term basis of the novelty in general. He is disadvantaged by indecision,
human person and conditions – along with the meticulousness and difficulty in synthesizing. Due to his
agreeableness dimension – the person's ability to learn great effort, mostly wasted, his actions are less lucrative.
from experience (2). His excessive and disturbing need of order is a
Its extreme variants in a positive or negative sense, compensatory one, that gives him the feeling of having
may define pathological personality traits, which are everything under control (4).
easily recognized from a clinical point of view. However, A person with a high Conscientiousness in a
they are also frequently encountered in the absence of a maladaptive sense, is dominated by professional
proper categorical diagnosis. ambitions at the expense of the interpersonal relationships
The Conscientiousness dimension characterizes best quality, which remain distant and formal. He always gives
the manner in which the person relates to activity. It himself credit to know the best variant and action strategy
contains several facets such as trust in one's own abilities – and does not make any compromise. Despite the
that correlates best with self-esteem – to which is added exaggerated perfectionism, he is not satisfied with the
caution, need of rigor and order, responsibility, results of his involvement. He abides excessively by
persistence, efficiency in action and moral integrity. norms and regulations, and as a consequence of the lack of
A person with high values of Conscientiousness – in spontaneity and flexibility, he can never unwind, his
an adaptive sense – is characterized by a high level of self- relaxation abilities being always limited.
control and trust in his own abilities, high expectations and A person with a low Conscientiousness – adaptively
standards, being always eager to rise and progress. He is a – is less interested in a professional rising career. He is
neat and pedantic person, meticulous and tenacious in
1
Psychiatric Clinic No2 Târgu Mureș, University of Medicine and Pharmacy Târgu Mureș
Received February 26, 2018, Revised February 28, 2018, Accepted March 17, 2018
55Emese Lukács, Aurel Nireștean, Andra Oltean: Conscientiousness Dimension and Pathological Personalities
characterized by a high flexibility, spirit of adventure, In the case of the other pathological personalities, the
prefers assuming risks and frequent changes. He has a Conscientiousness dimension may be commented more
high tolerance to unstructured tasks and adapts himself from the quality point of view, according to its various
easily and quickly to new situations. He is a spontaneous, facets, its values, overall, are not near to the extreme ones
casual and nonconformist person who tends to resist any (3).
form of authority when he feels restrained from The perfected self-control of the paranoid
manifesting himself freely and naturally. personality, decreases under the circumstances in which
Low Conscientiousness in a maladaptive sense, he loses control over the entourage that he usually selects
manifests itself by a very low self-control, lack of and dominates. The schizoid is restrained and
professional enthusiasm and a total lack of respect to hypercontrolled apparently, in fact being indifferent and
social norms and regulations. A person with excessive low affectively detached. The schizoid is meticulous and
values of this dimension lacks discipline and perseverant only in his eccentric and bizarre behavior.
perseverance, is unpredictable, and does not respect his The narcissistic personality controls his attitude
promises and initial plans. He is very easy to distract, selectively according to the “quality and value” of the
excessively relaxed as to the tasks received, disorganized entourage.
and inefficient in actions. He is characterized by In the avoidant personality, reserved and retreated,
immaturity, deficiency in searching the meaning of life the exaggerated self-control derives from the lack of trust
and irresponsibility. From a professional point of view, in his own abilities, especially in the social and relational
his achievements are usually below the level of his ones. The dependent personality, also with low self-
aptitudes. He is a stubborn person, hard to lead, who takes esteem, is undecided, lacks initiative and spontaneity, he
decisions impulsively ignoring the consequences and who may be resistant and perseverant in routine activities,
often commits toxic excesses and immoral acts (4). sometimes even in unpleasant tasks if the dependence
The high or low values of the Conscientiousness relation imposes it.
dimension, in an adaptive sense, substantiates specific Knowledge and assessment of the Conscientiousness
personological attributes that can be commented and dimension allow the recognition of a specific individual
understood always in connection with the other vulnerability with a predictive and prophylactic role,
dimensions of the person (1). particularly within the context of some of its extreme
Maladaptive Conscientiousness is sometimes a values, even in the absence of a categorical personological
characteristic of pathological personalities. In its extreme diagnosis.
variants is defining for the obsessive-compulsive It may condition the clinical and evolutional feature
personality, at its the opposite pole being the borderline of the psychopathological pictures and the therapeutic
and antisocial type personalities. They are the most compliance, that its high values may simultaneously favor
representative correspondences of personological or disadvantage.
categorical diagnosis, uniting attributes that derive The dysfunctionality corresponding to the extreme
directly from the high or low values of the variants – may be potentiated, masked or compensated by
Conscientiousness dimension. the other dimensions.
Thus, a very high Conscientiousness, in the case of As it is tightly connectable to activism, the
obsessive-compulsive personality disorder, it manifests Conscientiousness dimension is a measure of efficiency in
through the tendency of controlling his own behavior and roles of the human person and a permanent support of self-
that of the persons around him, in an exaggerated manner, determination.
in excessive devotion for work, perfectionism, rigidity,
excessive preoccupation for organization, order and References:
details, joining social norms and beliefs, incapacity to 1.Lăzărescu, M., Nireștean, A. (2007) – Tulburările de personalitate.
relax and enjoy himself. In borderline and antisocial type (Personality Disorders) Polirom Publishing, Iași
2.Lăzărescu, M., Bumbea, O. (2008) – Patologie obsesivă. (Obsessive
personality disorders, an excessively low Pathology) Academiei Române Publishing, Bucharest
Conscientiousness is manifested by total lack of self- 3.Lukacs, E., Nireștean, A. (2012) – Primul episod psihotic între
control due to pathological impulsiveness and dimensiuni și categorii personologice. (First psychotic episode between
disconsideration for the other persons around him, dimensions and personological categories) PhD Thesis, Târgu-Mureș
4.Lukacs, E., Nireștean, A. (2018) – Obsesionalitatea – între ego-
affective and attitudinal instability, relational sintonie și ego-distonie în Persoana umană – un model de diversitate
hypersensitivity and low tolerance to frustration. Severe antropologică (Obsessionality – between ego-syntonic and ego-dystonic
behavior disorders are associated with the violation of in the Human Person – a model of anthropological diversity), University
legal and moral norms, irresponsibility, ignoring the Press Publishing, Târgu Mureş
5.Sava, F. (2008) – Inventarul de personalitate DECAS. Manual de
hazard, incapacity to learn from experience (2). utilizare. (DECAS Personality Inventory. User Manual.) ArtPress,
The histrionic personality disorder is characterized Timișoara
by such low values of Conscientiousness that explain low
self-control and recurrent impulsive conducts in case of ***
this personality.
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