2013. Vol.4, No.12, 930-936
Published Online December 2013 in SciRes (http://www.scirp.org/journal/psych) http://dx.doi.org/10.4236/psych.2013.412134
Interpersonal Dependency Inventory: Its Construct Validity
and Prediction of Dysphoric Mood and Life Functioning via
Negative Life Events
Masayo Uji1*, Yukihiro Takagishi2, Keiichiro Adachi3, Toshinori Kitamura4
1Department of Bioethics, Kumamoto University Graduate School of Life Sciences, Kumamoto, Japan
2Department of Human Psychology, Kansai University of International Studies, Miki, Japan
3Department of Psychology, Kobe Shoin Women’s University, Kobe, Japan
4Kitamura Mental Health Institute Tokyo, Akasaka, Japan
Received October 5th, 2013; revised November 2nd, 2013; accepted November 28th, 2013
Copyright © 2013 Masayo Uji et al. This is an open access article distributed under the Creative Commons At-
tribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the
original work is properly cited. In accordance of the Creative Commons Attribution License all Copyrights ©
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Previous Dependency Inventory (JIDI) as well demonstrates how the interpersonal attitudes assessed by
the JIDI generate interpersonal negative life events (NLEs) and therefore results in dysphoric moods and
poor life functioning. The subjects of this study were 467 Japanese university students. The JIDI was ad-
ministered at Time 1, and the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM)
was administered at Time 2 for the purpose of assessing dysphoric mood and life functioning. NLEs oc-
curring between Times 1 and 2 were evaluated. The three-factor structure of the JIDI was confirmed by
confirmatory factor analysis. The structural equation modeling demonstrated that of the three factors, only
one, “emotional reliance”, predisposed individuals to dysphoric mood and poor life functioning, both di-
rectly and indirectly, via interpersonal NLEs. Although the other two factors did not increase vulnerability
to interpersonal NLEs or dysphoric mood, “lack of social self-confidence” worsened general functioning,
and “assertion of autonomy” led to poor functioning in close relationships, both directly. Furthermore,
“assertion of autonomy” decreased anxiety levels. As to gender differences, simultaneous analysis of
multi-groups showed that female subjects were more likely to become anxious following interpersonal
Keywords: Japanese Version of the Interpersonal Dependency Inventory; Factor Structure; Negative Life
Events; Mental Health Problems
The Interpersonal Dependency Inventory Japanese Short
Form (JIDI) was developed by McDonald-Scott (1988) by mo-
difying the original Interpersonal Dependency Inventory (IDI:
Hirschfeld et al., 1977). Among the 48 items in the original
version, those for which it was difficult to define corresponding
Japanese expressions were removed from the JIDI, resulting in
23 JIDI items. The reliability and internal consistency of the
JIDI were confirmed (McDonald-Scott, 1988). Despite the dif-
ferences between the IDI and JIDI in terms of language and
number of items, the two instruments are both able to assess the
concepts described below.
Hirschfeld et al.’s (1977) concept of interpersonal depend-
ency derives from the psychoanalytic theory of object relations,
the social learning theory of dependency, and the ethological
theory of attachment, resulting in the ability of the developed
inventory (the IDI) to evaluate both expressed behaviors and
intrapsychic elements such as thoughts, beliefs, and feelings.
As with the original version, the JIDI consists of three factors,
“emotional reliance”, “lack of social self-confidence”, and “as-
sertion of autonomy”.
According to Hirschfeld et al. (1977), the first factor, “emo-
tional reliance”, reflects the notions of attachment and depend-
ency: “Attachment-related items express a wish for contact with
and emotional support from specific other persons, as well as
expressing a dread of loss of that person. Dependency-related
items involve a general wish for approval and attention from
others” (Hirschfeld et al., 1977). Examples of items in this
category include “I need to have some person who puts me
above all others”, and “I have always had a terrible fear that I
will lose the love and support of people I desperately need”
(Hirschfeld et al., 1977).
The items that comprise the second factor, “lack of social
self-confidence”, express one’s “wishes for help in decision-
making, in social situations, and in taking initiative”. McDon-
ald-Scott (1988) further explains the two psychological proc-
esses behind these behaviors. The first is the fear of whether
specific others will give their approval, and the other is diffi-
culty with autonomous behaviors due to a lack of self-confi-
M. UJI ET AL.
dence in one’s own judgment. Sample items are “When I have a
decision to make, I always ask for advice”, and “It is hard for
me to ask someone for a favor” (Hirschfeld et al., 1977).
The items that constitute the third factor, “assertion of auto-
nomy”, “tend to deny either attachment or dependency”. Mc-
Donald (1988) wrote that individuals who score highly on this
factor have an intense need to rely on others; however, because
of the fear of rejection, these emotional needs are either sup-
pressed or denied. Examples of inventory items include, “When
I am sick, I prefer that my friends leave me alone”, and “I don’t
need anyone” (Hirschfeld et al., 1977). This category can be
regarded as a defense against dependence shown by the sig-
nificant correlation between “assertion of autonomy” and “in-
terpersonal sensitivity” (Hirschfeld et al., 1977). Interpersonal
sensitivity indicates fear of disapproval or rejection.
This study had three aims. The first was to confirm the hy-
pothesized three-factor structure of the JIDI (Figure 1).
The second was to determine whether the three factors of the
JIDI cause dysphoric mood and poor life functioning. With
regard to the second aim, the relationship between these three
factors and mental health indices has been demonstrated by
calculating the correlations between them (Hirschfeld et al.,
1977; McDonald-Scott, 1988). Previous researchers (Hirschfeld
et al., 1977; McDonald-Scott, 1988) demonstrated almost the
same results: the two factors “emotional reliance” and “lack of
social self-confidence” were related to negative mental health
indices such as depression and anxiety. This relation was not
found for “assertion of autonomy”.
In this study, we focused on the process whereby high “emo-
tional reliance” or high “lack of social self-confidence” results
in negative mental health outcomes. More specifically, we used
structural equation modeling (SEM) to examine whether these
processes are associated with negative life events (NLEs).
The three-factor structure model of the JIDI.
Several studies have examined the tendency of specific per-
sonality types to generate NLEs (Bolger & Schilling, 1991;
Daley, Hammen, Davila, & Burge, 1998; Magnus, Diener, Fu-
jita, & Pavot, 1993; McLennan & Bates, 1993; Ormel & Wohl-
farth, 1991) as well as depression (Daley et al., 1997; Davila,
Hammen, Paley, & Daley, 1995; Hammen, 1991). Personality
describes a wide range of mental activities, such as cognitions,
emotions, and attitudes, and also influences behavioral patterns.
Simons, Angell, Monroe, and Thase (1993) noted that cognitive
factors influence not only the definition and severity evaluation
of NLEs, but also the actual triggering of NLEs by way of an
individual’s behavior. Thus an individual’s personality influ-
ences how the NLE is defined, how its intensity is evaluated,
the nature of the emotional reaction it elicits, and what kinds of
coping behaviors are chosen. To achieve the second aim of this
study, we examined whether interpersonal dependency as a per-
sonality trait impacts one’s tendency to generate interpersonal
NLEs, and consequently, to result in negative mental health
Concerning the pathways from each JIDI factor to mental
health indices, we hypothesized that people with either high
“emotional reliance” or “lack of social self-confidence” pro-
voke interpersonal NLEs (Figure 2: W1 and W3) that eventu-
ally undermine mental health, for the following reasons. With
regard to the first factor, excessive “emotional reliance” would
result in the experiencing of intense needs and expectations that
others cannot fulfill. This would increase the individual’s levels
of dependency, manipulation, and control of specific others.
Feeling overwhelmed, the specific others may then keep their
distance from him or her. The individual may experience feel-
ings of rejection, resulting in an interpersonal NLE.
Concerning the second factor, if one is lacking in social
self-confidence, they may repress their opinions in order to
maintain the favor of others. As a result, they may not be re-
spected, and may sometimes be disregarded, because they seem
to be too submissive toward others. This in turn might lead to
stress in interpersonal relationships, and possibly the develop-
ment of resentment toward others.
In contrast to the two factors mentioned above, the third fac-
tor, “assertion of autonomy”, would offer protection from in-
terpersonal NLEs (Figure 2: W5) because it involves avoiding
interaction with others. However, an alternative hypothesis is
possible. Beck’s (1983) concept of autonomy seems to be
Interperso nal NLE
(CORE-OM su bc ategory scor e)
Lack of social self -confidence
Assertion of autonomy
Emotio nal r e lianc eW1
The hypothesis pathway from each JIDI factor to negative mental
Open Access 931
M. UJI ET AL.
closely related to the JIDI’s “assertion of autonomy” in terms of
an individual’s attitudes. Beck (1983), however, does not spec-
ify whether or not he sees autonomy as a defense against de-
pendency, and writes that although an individual in “the auto-
nomous mode” has his or her “own set of internal standards,
goals, criteria for achievement”, as well as a “high level of self-
confidence and self-esteem”, he or she is “less sensitive to oth-
ers’ needs and wishes” and tends to be “dogmatic” and “autho-
ritarian.” Some “assertion of autonomy” items in the JIDI, such
as “I hate it when people offer me sympathy” or “I rely on my-
self”, infer rejection or hatred for affectionate care rather than
independence. Based on these characteristics, people who score
highly on this factor might have difficulty recognizing their
need for others, and therefore also lack empathy for others’
feelings. These characteristics suggest that such individuals
would encounter antipathy from others. Indeed, Daley et al.
(1997) used Beck’s Sociotropy-Autonomy Scale (SAS) to
demonstrate that in contrast to an individual with sociotropy,
one with high autonomy tends to cause interpersonal stress in
others even after psychiatric status is taken into account.
Therefore, we hypothesized that as with the first and second
factors, the third factor, “assertion of autonomy”, would cause
We also hypothesized that there are direct pathways from all
three factors to negative mental health outcomes (Figure 2: W2,
W4, W6). The third factor, “assertion of autonomy,” could also
cause dysphoric mood and poor life functioning, because indi-
viduals scoring highly on this factor are not able to seek help
from others when they need it. This makes it difficult for them
to accomplish their goals, leading to feelings of anxiety and
depression as well as poor life functioning (Figure 2: W6).
Indeed, there is also evidence of a close relationship between
autonomy and undermined mental health. For instance, Bieling,
Beck, and Brown (2000) write that the concept of autonomy
consists of two factors: first, “sensitivity to others’ control”,
and second, “independent goal attainment”. The JIDI’s “asser-
tion of autonomy” seems to be closely related to the first factor,
which was presented as having a positive correlation with
psychopathology by Bieling et al. (2000). In this study, we not
only examined correlations, but also aimed to verify the causal
relationship between “assertion of autonomy” and impaired
mental health (Figure 2: W6).
The third aim of this study was to assess the gender differ-
ences regarding the above pathways. Prior studies have shown
that women are more likely to report interpersonal stresses than
men (Mezulis, Funasaki, Charbonneau, & Hyde, 2010; Ru-
dolph & Hammen, 2003; Kendler, Thornton, & Prescott, 2001).
From this, it can be assumed that either women are more sensi-
tive in recognizing interpersonal conflicts, or they actually ex-
perience interpersonal NLEs more often. If the former is the
case, the above hypothesized pathway from interpersonal de-
pendency to negative mental health through interpersonal NLEs
could be identified more clearly among women. On the other
hand, men might be less likely to recognize interpersonal NLEs,
and therefore among male subjects it might not be difficult to
identify an indirect pathway from JIDI subscales to negative
mental health indices by way of interpersonal NLEs. Rather, we
might only find a direct pathway.
An additional hypothesis is that women are more likely to
place an emphasis on interpersonal relationships, and socially,
it is more acceptable for them to depend on others. Therefore,
we theorized that they would score more highly than male sub-
jects on assessments of “emotional reliance”. Furthermore,
negative mental health indices could be more strongly influ-
enced by JIDI subscales as well as interpersonal NLE scores
among women as compared to men.
To summarize, the purposes of this study were as follows:
1) to confirm the hypothesized three-factor structure of the
JIDI using confirmatory factor analysis (CFA);
2) to examine whether the factors that comprise the JIDI
caused dysphoric mood and poor life functioning directly or
indirectly via interpersonal NLEs, using SEM; and
3) to determine whether the pathways varied with gender.
This study consisted of self-reported questionnaires con-
ducted on two occasions. The JIDI (evaluated on the first occa-
sion), and Clinical Outcomes in Routine Evaluation-Outcome
Measure (CORE-OM) and an assessment of interpersonal NLE
(evaluated on the second occasion), were included in the ques-
tionnaires. In this study, Time 1 represents the first occasion
and Time 2 represents the second occasion. The interval be-
tween the Time 1 and Time 2 was six weeks.
Four hundred sixty-nine students from two universities, two
nursing schools, and one vocational school in Kumamoto at-
tended both Times 1 and 2. Of these students, two declined to
participate, resulting in a study population of 467 students.
Questionnaires were distributed to the students during classes.
The subjects’ mean (SD) age was 19.3 (3.5), and the numbers
of female and male respondents were 342 and 125, respectively.
The research protocol was approved by the Ethical Committee
of Kumamoto University (Institutional Review Board). Partici-
pation was voluntary, and subjects were assured of anonymity.
For the purpose of anonymity, aliases were used.
JIDI (McDonald-Scott, 1988)
As noted in the introduction, the JIDI was developed as a re-
vision of the IDI (Hirschfeld et al., 1977). The JIDI consists of
23 items in total: six for “emotional reliance”, nine for “lack of
social self-confidence”, and eight for “assertion of autonomy”.
Each item is rated from 1 (strongly disagree) to 5 (strongly
agree). Therefore, the total score of the JIDI ranges from 23 to
115. Higher scores indicate greater identification with each of
the three factors. McDonald-Scott (1988) attested to the JIDI’s
reliability and internal consistency.
Clinical Outcomes in Routine Evaluation-Outcome
Measure (CORE-OM: Evans et al., 2002)
The CORE-OM was developed as a standardized brief out-
come measure for use in both routine clinical practice and psy-
chotherapy research (Evans et al., 2002). The reliability and
validity of the Japanese version of the CORE-OM have been
demonstrated (Uji, Sakamoto, Adachi, & Kitamura, 2012). Of
the 34 items, eight dysphoric mood items (four anxiety and four
depression) and twelve life functioning items (four close func-
tioning, four general functioning, and four social functioning)
were chosen for this study. Each item is rated from 1 (strongly
M. UJI ET AL.
Open Access 933
disagree) to 5 (strongly agree). Higher scores indicate more
serious mental problems. Therefore, the total scores of each
subcategory (anxiety, depression, close functioning, general
functioning, and social functioning) range from 4 to 20.
The following ad hoc question was used to assess interper-
sonal NLEs: “Please evaluate the distressful experiences you
had in the past two weeks in terms of relationships with the
following people: 1) your friends, 2) your boyfriend/girlfriend,
3) your mother, 4) your father, 5) faculty members, and 6) your
coworkers”. Each interpersonal relationship was evaluated with
a score ranging from 0 (no distressful experience) to 100 (ex-
tremely distressful experience). Therefore, the total score of the
interpersonal NLE assessment ranges from 0 to 600.
To examine whether the JIDI fit the hypothesized three-fac-
tor model (Figure 1), we conducted a CFA. Furthermore, to
assess whether our hypothesized pathways from each JIDI fac-
tor to negative mental health outcomes (Figure 2) fit the data,
we conducted SEM. To examine the gender influence on the
parameters in Figure 2, simultaneous analyses of multi-groups
were conducted. A critical ratio with a magnitude of 1.96 or
more indicates a significant difference (p < 0.05) in the parame-
ters between the pair of subgroups.
SPSS version 21.0 and Amos version 21.0 were used for
CFA and SEM. The fit of the hypothesized models to our data
(Figures 1 and 2) was evaluated using the following indices:
Goodness of Fit Index (GFI), Adjusted Goodness of Fit Index
(AGFI), and Root Mean Square Error of Approximation
(RMSEA) (Arbuckle & Wothke, 1995).
CFA of the JIDI
The model that presumed the covariance between “lack of
social self-confidence” and “assertion of autonomy” to be zero
demonstrated the best fit (GFI = 0.88, AGFI = 0.85, RMSEA =
0.08). The covariance between “emotional reliance” and “lack
of social self-confidence,” as well as that between “emotional
reliance” and “assertion of autonomy,” were significant (p <
The Influence of Gender on the JIDI Subscale Scores
There was no gender influence identified on any JIDI sub-
scale score (Table 1).
Pearson’s C o rrelations of Eac h JIDI Subsca l e wit h
Mental Health Consequences as Well as with
Regarding the correlations between each JIDI subscale and
mental health consequences, almost all the CORE-OM sub-
category scores were found to be significantly correlated with
the JIDI subscales, the exception being non-significant correla-
tions between “assertion of autonomy” and both anxiety and
general functioning (Table 1).
Concerning the correlations between each JIDI subscale and
interpersonal NLEs, only “assertion of autonomy” did not have
a significant correlation with interpersonal NLEs (Table 1).
The Pathways from JIDI Subscales to Negative
Mental Health Outcom es
The results of SEM are shown in Table 2. “Emotional reli-
ance” was the only factor that generated interpersonal NLEs
(Figure 2: W1, standardized causal coefficient (scc) was 0.34 -
0.35 (p < 0.001)), which in turn resulted in increased anxiety
and depression levels and decreased close and social function-
ing (Figure 2: W7, sccs were 0.20 (p < 0.001), 0.18 (p < 0.001),
0.16 (p < 0.001), and .22 (p < 0.001), respectively). There were
also direct pathways from “emotional reliance” to these mental
health outcome indices (Figure 2: W2) (scc was 0.43 (p <
0.001) for anxiety, 0.37 (p < 0.001) for depression, 0.23 (p <
0.001) for close functioning, and 0.34 (p < 0.001) for social
functioning). In contrast, “emotional reliance” had no impact on
general functioning, either directly or indirectly. “Lack of social
self-confidence” directly lowered general functioning (Figure 2:
W4, scc was 0.41, p < 0.001). In comparison, “assertion of
autonomy” lowered close functioning (Figure 2: W6, scc was
0.18 (p < 0.001), whilst alleviating anxiety (Figure 2: W6, scc
was −0.15, p = 0.006). The fitness of the hypothesized model to
our data (Figure 2) for each mental health index was acceptable:
GFI: 0.86 - 0.87, AGFI: 0.83 - 0.84, and RMSEA: 0.07).
Simultaneous analyses of multi-groups were conducted to de-
termine the gender influence on each parameter. The only dif-
ference between the genders was that the influence of interper-
sonal NLEs on anxiety was significantly higher among female
respondents (critical ratio: 2.29).
Differences in mean scores (SD) between females and males and correlations between JIDI subscale scores and CORE-OM subscale scores.
Emotional relianceLack of social self-confidence Assertion of autonomy
male 16.2 (4.5) 27.2 (6.3) 16.7 (6.1)
Mean scores (SD) female 15.5 (4.4) 27.4 (6.3) 15.9 (5.9)
p value 0.11 0.68 0.22
anxiety 0.37** 0.23** −0.04
depression 0.35** 0.24** 0.15**
social functioning0.33** 0.20** 0.18**
general functioning0.20** 0.33** 0.03
Correlations with the CORE-OM subcategory
close functioning 0.24** 0.15** 0.23**
Correlation with Interpersonal NLEs 0.28** 0.15** 0.04
Note: **p < 0.01.
M. UJI ET AL.
subcategory N standardized causal coefficient (scc) in Figure 2
Absolute value of critical ratio > 1.96 between male
and female groups in Figure 2
W1 W2W3 W4 W5 W6 W7 GFIAGFIRMSEA
Anxiety 405 0.35*** 0.43*** 0 0 0 −0.15** 0.20*** 0.870.840.07 W7: female (scc was 0.26) > male (scc was 0.07)
Depression 402 0.35*** 0.37*** 0 0 0 0 0.18*** 0.870.840.07 none
Close functioning 405 0.35*** 0.23*** 0 0 0 0.18*** 0.16*** 0.870.830.07 none
General functioning 406 0.35*** 0 0 0.41*** 0 0 0 0.860.830.07 none
Social functioning 405 0.34*** 0.34*** 0 0 0 0 0.22*** .87.840.07 none
Note: **p < 0.01, ***p < 0.001.
CFA of the JIDI
The result of the CFA supported the hypothesized three-fac-
tor structure of the JIDI. Despite the fact that “assertion of auto-
nomy” showed no significant correlation with “lack of social
self-confidence”, it was significantly correlated with “emo-
tional reliance”. Therefore, as McDonald-Scott (1988) noted, an
intense need for others could underlie both “emotional reliance”
and “assertion of autonomy”. The difference is that an individ-
ual with high “emotional reliance” is able to recognize their
needs, while an individual with high “assertion of autonomy” is
apt to deny their needs because of fear of disapproval and rejec-
tion by significant others.
The other significant correlation, between “emotional reli-
ance” and “lack of social self-confidence”, can be interpreted as
follows: people with high levels of “emotional reliance” always
need others’ approval and care, which means that they do not
have sufficient “social self-confidence”. If they have high “so-
cial self-confidence” and no need for others’ approval, then
they do not have to be so reliant on others.
Lack of Significant Influences of Gender on the JIDI
Contrary to our hypothesis, there were no gender differences
in the evaluation of the JIDI subscales. In traditional Japanese
society, men were required to be masculine and assertive, and
women feminine and passive. However, in contemporary times,
these socially required gender roles are less widely recognized,
which has hypothetically led to the lack of differences between
genders in JIDI subscale scores.
The Direct and Indirect Influe nc e s o f “Emotiona l
Reliance” on D ysphoric Mo od a nd Poor Life
As predicted, “emotional reliance” triggered interpersonal
NLEs, which in turn led to dysphoric mood and poor life func-
tioning. The exception was the lack of impact of “emotional
reliance” on general functioning. An individual with high
“emotional reliance” seems to be deficient in the “capacity to
be alone” (Winnicott, 1958), and seeks instant gratification
through a dependence on others. These attitudes and behaviors
may provoke interpersonal NLEs, and eventually result in dys-
phoric mood and poor life functioning. Therefore, the deterio-
rated mental health experienced by those with high “emotional
reliance” can be partially due to these individuals’ cognitive
styles, attitudes, and behaviors. The direct pathways from
“emotional reliance” to dysphoric mood and poor life function-
ing were also determined.
Absence of Significant Influences of “Lack of Social
Self-Confidence” on G e neration of Interpersonal
NLEs or Dysphoric Mood, and Its Negative Impact on
“General Functioning Level”
Despite the significant Pearson’s correlations of “lack of so-
cial self-confidence” with anxiety, depression, social function-
ing, close functioning and interpersonal NLEs, the SEM results
showed that “lack of social self-confidence” provoked none of
these. The reason for this discrepancy may be that SEM takes
into account all factor relationships, such as correlations within
the three JIDI subscales. There would be an alternative reason
why “lack of social self-confidence” did not influence interper-
sonal NLEs: an individual with severe “lack of social self-con-
fidence” tends to be ego-centric, and thus does not have the
mental capacity to recognize interpersonal conflicts.
Concerning life functioning, individuals demonstrating “lack
of social self-confidence” showed reduced general functioning.
This may be due to their self-esteem being low, which is related
to impaired ego functioning (Bellak, Hurvich, & Gediman,
1973), causing the individuals to lose their capacity to deal with
The Absence of a Significant Impact of “Assertion of
Autonomy ” o n Interpersonal NLEs, and Its Impact
on Dysphoric Mood and Close Functioning
As noted, “assertion of autonomy” can be regarded as a de-
fense against “emotional reliance,” thus functioning as a strat-
egy to avoid interpersonal NLEs that are followed by dysphoric
mood. However, as noted in the introduction, it is conceivable
that individuals who assert their autonomy will invite the an-
tipathy of others. However, the dispositions of these individuals
do not take into account others’ feelings, and therefore they
might be more likely to disregard interpersonal NLEs.
Furthermore, “assertion of autonomy” directly alleviated
anxiety. While this may be interpreted as a positive occurrence,
it can also be interpreted in a different way: it is possible that an
individual who does not report anxiety is simply denying its
existence. An individual with a high level of “assertion of
autonomy” may lack the ability to recognize their own weak-
ness and may be prone to using reaction formation (Freud, 1926)
as a defense mechanism. Although “assertion of autonomy” did
M. UJI ET AL.
not provoke interpersonal NLEs or dysphoric mood, it lowered
close functioning. Individuals who cannot respect or seek help
from others because of a fear of rejection cannot establish trust-
worthy or intimate relationships.
The Impact of Gender on the Pathways
The only difference between males and females was the im-
pact of interpersonal NLEs on anxiety. This means that even
though males experienced interpersonal NLEs, they did not
necessarily become as anxious as females. This can be inter-
preted that males tend to avoid recognizing anxious feelings
caused by interpersonal conflicts.
Application to Clinical Settings
When we see patients who suffer from depressive mood,
anxiety, or other mental symptoms, it is crucial to evaluate their
personalities. In particular, the cognitive patterns, attitudes, and
behaviors of patients with an intense “emotional reliance” on
others are apt to elicit interpersonal distresses, resulting in un-
dermined mental health. Therefore, removal of symptoms alone
is not sufficient. It is necessary to provide support enabling
these patients to obtain insight into their own personalities, thus
helping to prevent future relapse.
On the other hand, individuals with a high level of “assertion
of autonomy” tend to repress or deny interpersonal distresses or
dysphoric moods. In the same way, those with a “lack of social
self-confidence” cannot recognize interpersonal distresses, and
focus predominantly on low self-esteem in a masochistic way.
Therefore, we have to consider the possibility of existing inter-
personal conflicts and negative emotions in these individuals’
With regard to gender, females seem to be more likely to
recognize their anxiety in regard to interpersonal NLEs. For
males, anxious feelings are less likely to be indicators of inter-
In this study, we defined NLEs within interpersonal rela-
tionships; however, it is uncertain whether the reported NLEs
were provoked by the respondents’ cognitive and behavioral
patterns. Therefore, further research based on face-to-face in-
terviews or clinical records are required.
The results of this study showed that “emotional reliance”
can cause dysphoric mood and poor functioning in a manner
mediated by interpersonal NLEs. The two JIDI factors that did
not provoke interpersonal NLEs, “lack of social self-confi-
dence” and “assertion of autonomy”, directly reduced “general
functioning” and “close functioning”. Intense dependency as
well as a lack of the ability to depend on others appears likely
to undermine an individual’s mental health.
We would like to express deep gratitude to respondents of
this study. This research received no specific grants from any
funding agency in the public, commercial, or not-for-profit sec-
tors. There is no conflict of interest to declare.
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