Reduced Specificity of Autobiographical Memory in Cluster C Personality
Disorders and the Role of Depression, Worry, and Experiential Avoidance
Philip Spinhoven
Leiden University
Lotte Bamelis
Maastricht University
Marc Molendijk and Rimke Haringsma
Leiden University
Arnoud Arntz
Maastricht University
The study objective was to investigate whether, compared with nonclinical controls, participants with an
avoidant, dependent, or obsessive– compulsive Cluster C personality disorder (PD) manifested reduced
levels of memory specificity and whether the association of Cluster C PDs with memory specificity is
mediated by repetitive negative thoughts and experiential avoidance. The Autobiographical Memory Test
(R. J. McNally, N. B. Lasko, M. L. Macklin, & R. K. Pitman, 1995) was administered along with
self-report measures (translated into Dutch) for repetitive, uncontrollable, and negative thinking in the
form of worry (Penn State Worry Questionnaire; T. J. Meyer, M. L. Miller, R. L. Metzger, & T. D.
Borkovec, 1990) and experiential avoidance (Acceptance and Action Questionnaire; S. C. Hayes et al.,
2004) to 294 clinical participants diagnosed with Axis I disorders (assessed with the Structured Clinical
Interview for DSM–IV Axis I Disorders [SCID-I]; M. B. First, R. L. Spitzer, M. Gibbon, & J. B. W.
Williams, 1994) and Axis II disorders (assessed with the SCID-II; M. B. First, R. L. Spitzer, M. Gibbon,
& J. B. W. Williams, 1997)—202 with avoidant, 49 with dependent, and 120 with obsessive– compulsive
PD—and to 108 matched nonclinical controls. Participants with a Cluster C PD showed lower levels of
memory specificity than did nonclinical controls. Depression and worry mediated the effect of Cluster C
PDs on memory specificity. Besides depression severity, repetitive, uncontrollable, and negative thinking
may constitute a general mechanism mediating the association of various Axis I and II disorders with
memory specificity.
Keywords: autobiographical memory, personality disorder, depression, worry, experiential avoidance
Autobiographical memory concerns the recollection of person-
ally experienced past events. This aspect of memory contributes to
an individual’s sense of self and his ability to remain oriented in
the world and to pursue goals effectively in light of past problem
solving (Conway & Pleydell-Pearce, 2000). Overgenerality is one
feature of autobiographical memory found to be closely linked
with the psychopathology of emotion. In extending the mood-
congruent memory paradigm to suicidal patients, Williams and
Broadbent (1986), using a Galton cue-word paradigm, observed
that suicidal patients, in many of their responses to positive and
negative cue words, failed to provide a specific memory. Instead,
they tended to respond with a memory that summarized a category
of similar events (e.g., “I used to walk the dog every morning”). In
this cuing methodology, overgenerality refers to the tendency to
retrieve general memories despite instructions to describe specific
autobiographical events.
Given the central importance of autobiographical memory for
human functioning and an individual’s sense of self in particular
(Conway, Singer, & Tagini, 2004), the dearth of studies concern-
ing memory overgenerality in Axis II personality disorder (PD)
according to the Diagnostic and Statistical Manual of Mental
Disorders (4th ed., text rev.; DSM–IV–TR; American Psychiatric
Association, 2000) other than borderline PD is striking. It can be
hypothesized that persons with a Cluster C PD will likely manifest
memory overgenerality. The category of Cluster C PD refers to
anxious or fearful PDs and comprises the following three PDs:
avoidant PD (characterized by social inhibition, feelings of inad-
equacy, extreme sensitivity to negative evaluation, and avoidance
of social interaction); dependent PD (characterized by pervasive
psychological dependence on other people); and obsessive–
compulsive PD (characterized by rigid conformity to rules and
moral codes, as well as excessive orderliness). A common char-
acteristic of persons with a Cluster C PD is self-related anxiety,
whether social and emotional– experiential anxiety in avoidant PD,
anxiety due to abandonment and independence in dependent PD,
Philip Spinhoven, Departments of Psychology and Psychiatry, Leiden
University, Leiden, The Netherlands; Lotte Bamelis and Arnoud Arntz,
Department of Clinical Psychological Science, Maastricht University,
Maastricht, The Netherlands; Marc Molendijk and Rimke Haringsma,
Department of Psychology, Leiden University.
This research was funded by Grant OG-945-06-406, awarded to Arnoud
Arntz by ZonMw, the Netherlands Organisation for Health Research and
Development. We wish to thank the participants in our study and express
our appreciation to the participating psychiatric sites for their recruitment
efforts.
Correspondence concerning this article should be addressed to Philip
Spinhoven, Leiden University, Departments of Psychology and Psychiatry,
Wassenaarseweg 52, 2333 AK Leiden, The Netherlands. E-mail:
spinhoven@fsw.leidenuniv.nl
Journal of Abnormal Psychology © 2009 American Psychological Association
2009, Vol. 118, No. 3, 520 –530 0021-843X/09/$12.00 DOI: 10.1037/a0016393
520