‘Acting out’ and ‘acting in’ behavioural stress responses: the relevance of anxiety and personality style

Objective: To look for links between ‘acting out’ and ‘acting in’ behavioural stress responses with anxiety and disordered personality function. Method: Depressed patients completed a self-report measure of behavioural responses to stress 1 year after baseline assessment of anxiety levels, personality functioning and other study variables. Results: Patients were assigned to four factorial groups on the basis of variable ‘acting out’ and ‘acting in’ scale scores, and effects of individual scale scores also examined. ‘Acting in’ styles were indicative of high trait anxiety, disordered personality functioning and, in particular, a Cluster C personality disorder style. ‘Acting out’ was linked most clearly with a Cluster B personality disorder style. Conclusions: We demonstrate links between behavioural stress responses and anxiety levels and disordered personality functioning. Assessing behavioural stresses responses may shape the clinical expression of some depressive disorders and inform the clinician about the likely salience of anxiety and personality styles.