Interactions, Pt. 2: The Paradox of "Opposites"

A thought that often occurs to me when I come across the accounts of various "opposites," such as "inhibition" vs. "disinhibition," "positive affect" vs. "negative affect," parental "overinvolvement" vs. "underinvolvement," etc., in papers on the nature and etiology of psychological disorders, is: how "opposite" are these, really? My former P.I. at Mass General, who conducts longitudinal studies examining the role of temperamental inhibition and disinhibition in predicting future psychopathology, was somewhat surprised to find that extreme disinhibition as well as extreme inhibition in 2-5-year-old children predicted the development of social anxiety by the the time those kids hit adolescence. What was so surprising about this result? According to the BIS/BAS model my P.I. was working from, behavioral inhibition is supposed to predispose individuals to fearful responding and avoidance of unfamiliar or novel stimuli, which in turn leads to shyness and difficulty initiating and sustaining social interaction; disinhibition, on the other hand, is thought to manifest in impulsive, risk-taking behavior and a low threshold for approaching and initiating interactions. Now, as someone intimately acquainted with the toxic cocktail that can be mixed from the combination of disinhibited, extraverted temperamental traits with a neurotic personality style with a school full of mean kids who have very little patience for an oversensitive chatterbox, I found nothing remotely unexpected in my P.I.'s finding. Again, as I think the articles we read this week shed a great deal of light on, it is not "inhibition" or "disinhibition" or "negative affect" or "positive affect" or any other single variable that causes anxiety; it is the interaction of these characteristics in a way that produces a common phenomenon of anxiety. 

Wait - "common phenomenon"? Am I talking about a single underlying characteristic that all anxious people have in common after all? Well, let's say the phenomenon of pathological "anxiety" always reduces to something like what Barlow suggests in the article we read this week: a chronically low perceived control over those aspects of one's environment and experience which one cares about. But this can already broken down into a million different parts that can be arrived at in a million different ways: for instance, does a person's "perceived" lack of control arise from an actually erratic, capricious environment (e.g. from authoritarian parents who arbitrarily punish and overcriticize them, or "helicopter parents" who exert excessive control over every nook and cranny of their lives)? Or from a temperamental tendency to act impulsively and a deficiency in self-regulation? Or from a learned selective attention bias for negative, threatening stimuli? Or (what seems likeliest) from some combination and reciprocal interaction of many or all of these? And the same kinds of questions can be asked about the other part of the sentence, "those aspects... which one cares about": what determines which aspects of one's environment and experience one "cares about" and finds positively or negatively reinforcing? Perhaps the intensity of one's emotional experiences - positive or negative - in reaction to certain kinds of stimuli has more to do with it than the particular valence (if either) that tends to be more common and prominent for a particular individual; and perhaps intensity is positively reinforcing for some and negatively reinforcing for others, depending on their temperament or their biological wiring or their current cortisol level or their level of social connectedness or some other characteristic (or interaction of characteristics) altogether.

Long story short, I'm struck by the degree to which etiological explanations are interactive - so much so that seemingly opposite extremes of a given variable (such as temperamental inhibition) can produce potentially identical results, depending on the way they interact with other variables (such as neuroticism, locus of control, or a class full of cruel and intolerant middle schoolers).