Anxious traits, anxious attachment, and anxious-cluster personality disorders

This paper proposes a predisposition-stress model for the pathogenesis of anxious-cluster personality disorders. In this model, genetically influenced anxious traits predispose individuals to such disorders, while psychological factors promoting anxious attachment, as well as social factors leading to discrepancies between traits and social expectations, constitute stressors. Three hypotheses are derived from this model: (1) anxious traits are necessary conditions for the anxious cluster, but disorders develop as a result of cumulative adversities; (2) gene-environment interactions increase the likelihood of adversities associated with these disorders; and (3) social context has an important effect on the pathogenesis of this group of disorders. This theoretical model could have clinical implications for the management of a problematic group of patients.