Pathological concern: Scale construction, construct validity, and associations with attachment, self-cohesion, and relational entitlement.

Abstract

Based on clinical evidence and theoretical writings on pathological forms of concern and the destructive role they might play in close relationships, we conducted 2 studies aimed at developing and validating the Pathological Concern Questionnaire (PCQ). This scale comprises items tapping a fragile view of the self, as well as a compulsive need to care for others. Findings indicated that all questionnaire items loaded on a single factor of pathological concern, which was significantly associated with egocentric motivations, attachment insecurities, imbalanced forms of relational entitlement, low self-esteem, low life satisfaction, and negative emotionality. In addition, the PCQ was found to tap a unique psychological construct that differs from constructs of healthy concern and unmitigated communion. The discussion focuses on the developmental and psychodynamic sources of pathological concern as well as its significance in the intrapersonal and interpersonal domains.

Self-compassion and forms of concern for others

“…This finding converges with a previous study (Shavit & Tolmacz, 2014) which indicated that pathological concern may evolve from an egocentric motivation for caregiving (as a means of obtaining a sense of control, receiving help, or gaining some reward in the future); healthy concern, by contrast, seems to express more altruistic motives.…”

“…Our findings, however, indicate the existence of a more complex relationship between the three constructs. Individuals high in PC may appear to be deeply interested in the other and in interpersonal relationships; our findings, as well as previous ones (Shavit & Tolmacz, 2014), suggest that this display is nevertheless better understood as a strategy to cope with their fragile sense of self and an attempt to establish a sense of competence through satisfying others' needs at the expense of their own self-needs. In other words, they allegedly employ a selfas-object and other-as-subject form of relationship.…”

“…If both the self and the other can be experienced as both subject and object, then there are four forms these relationships can take: selfsubject and other-subject, self-subject and other-object, self-object and other-subject, and self-object and other-object (Tolmacz, 2013;Shavit & Tolmacz, 2014). Distinguishing among the four relationship patterns enables us to understand the distinction between healthy and pathological concern.…”

“…Similarly, Barbanel (2006) termed this kind of concern as caretaker personality disorder and applied it to individuals who devote themselves emotionally, physically, and psychologically to others while leaving their own needs unfulfilled. Research findings suggest that pathological concern is significantly positively associated with egocentric motivations, silencing of the self, attachment insecurities, imbalanced forms of relational entitlement, low self-esteem, low life satisfaction, negative emotionality and covert narcissism (Shavit & Tolmacz, 2014;Friedemann, Tolmocz & Doron, in press). …”

“…We utilized the Revised Pathological Concern Questionnaire (PCQ; Shavit & Tolmacz, 2014). The PCQ in its original version is an 18-item scale assessing thoughts, feelings and behavior related to two core components of pathological concern: (a) repression and denial of selfneeds and (b) overinvestment in satisfying others' needs.…”