Stability and change in personality traits from late adolescence to early adulthood: a longitudinal twin study

We conducted a longitudinal-biometric study examining stability and change in personality from ages 17 to 24 in a community sample of male and female twins. Using Tellegen's (in press) Multidimensional Personality Questionnaire (MPQ), facets of Negative Emotionality (NEM) declined substantially at the mean and individual levels, whereas facets of Constraint (CON) increased over time. Furthermore, individuals in late adolescence who were lowest on NEM and highest on CON remained the most stable over time, whereas those exhibiting the inverse profile (higher NEM, lower CON) changed the most in a direction towards growth and maturity. Analyses of gender differences yielded greater mean-level increases over time for women as compared to men on facets of CON and greater mean-level increases for men than women on facets of Agentic Positive Emotionality (PEM). Biometric analyses revealed rank-order stability in personality to be largely genetic, with rank-order change mediated by both the nonshared environment (and error) as well as genes. Findings correspond with prior evidence of a normative trend toward growth and maturity in personality during emerging adulthood.     

The longitudinal study of personality disorders: history, design considerations, and initial findings

The Longitudinal Study of Personality Disorders (LSPD) began in 1990 and it is the first NIMH-funded prospective multiwave longitudinal study of all DSM-defined personality disorders (PDs). The LSPD, now in its 16th year, has focused on several major issues including: (a) the epidemiology of the PDs; (b) the stability of individual differences and mean levels of PD features over time; (c); patterns of individual growth in PD features over time; (d) the development of a neurobehavioral model that links personality and personality disorder; (e) specification of those neurobehavioral systems predicting change in borderline personality disorder; and (f) illumination of simultaneous growth processes in neurobehavioral systems and PD. The LSPD possesses a number of methodological enhancements designed to increase the validity of the longitudinal findings such as a prospective multiwave design, use of a validated structured interview and well-known self-report instrument for Axis II assessments, double measurement of all major constructs under study, use of blinded interviewers for all interview Axis II assessments, and use of a community sample. The history and context in which the LSPD was developed is reviewed, methodological issues related to the study of PDs are discussed, primary LSPD findings to date are summarized, and future directions of the LSPD are introduced.     

Personality Trait Change Across Late Childhood to Young Adulthood: Evidence for Nonlinearity and Sex Differences in Change

We explored patterns of self‐reported personality trait change across late childhood through young adulthood in a sample assessed up to four times on the lower order facets of Positive Emotionality, Negative Emotionality (NEM), and Constraint (CON). Multilevel modelling analyses were used to describe both group‐ and individual‐level change trajectories across this time span. There was evidence for nonlinear age‐related change in most traits, and substantial individual differences in change for all traits. Gender differences were detected in the change trajectories for several facets of NEM and CON. Findings add to the literature on personality development by demonstrating robust nonlinear change in several traits across late childhood to young adulthood, as well as deviations from normative patterns of maturation at the earliest ages. Copyright © 2015 European Association of Personality Psychology     

Personality disorders and personality dimensions in anorexia nervosa

Information on the relationship between anorexia nervosa (AN) and personality disorders (PDs) and dimensions of temperament and character (measured by the Temperament and Character Inventory [TCI; Cloninger, Przybeck Svrakic, & Wetzel, 1994]) is limited. This study examines the predictive validity of the TCI for PD diagnoses assessed by the International Personality Disorder Examination-ICD-10 (IPDE-ICD-10; Loranger, Janca, & Sartorius, 1997) interviews of 46 women with DSM-IV-defined AN. Patients with a PD reported higher levels of harm-avoidance and lower levels of self-directedness than those without a PD. Scores on the TCI were predictive of the number of PD features present, particularly for those PDs in the anankastic, anxious, and dependent groups accounting for 40% to 51% of the variance. Cluster analysis based on scores on the TCI identified a subgroup of patients characterized by low levels of novelty seeking, self-directedness, and cooperativeness and high levels of harm avoidance. This cluster included the majority of those with avoidant, anxious, or dependent PDs. Assessment of particular personality dimensions was able to predict PDs in an anorexic sample. Since normal personality dimensions have greater validity than the categorical PDs, a consideration of normal temperament and character may assist in clinical decisionmaking and considerations concerning treatment.     

Genetic and environmental contributions to the co-occurrence of depressive personality disorder and DSM-IV personality disorders

One of the main controversies with regard to depressive personality disorder (DPD) concerns the co-occurrence with the established DSM-IV personality disorders (PDs). The main aim of this study was to examine to what extent DPD and the DSM-IV PDs share genetic and environmental risk factors, using multivariate twin modeling. The DSM-IV Structured Interview for Personality was applied to 2,794 young adult twins. Paranoid PD from Cluster A, borderline PD from Cluster B, and all three PDs from Cluster C were independently and significantly associated with DPD in multiple regression analysis. The genetic correlations between DPD and the other PDs were strong (.53-.83), while the environmental correlations were moderate (.36-.40). Close to 50% of the total variance in DPD was disorder specific. However, only 5% was due to disorder-specific genetic factors, indicating that a substantial part of the genetic vulnerability to DPD also increases the vulnerability to other PDs.     

Modeling stability and change in borderline personality disorder symptoms using the revised Interpersonal Adjective Scales-Big Five (IASR-B5)

Personality disorders have been defined as "stable over time." However, research now supports marked change in the symptoms of these disorders and significant individual variability in the trajectories across time. Using the Longitudinal Study of Personality Disorders (Lenzenweger, 2006), we explore the ability of the Revised Interpersonal Adjective Scales--Big Five (IASR-B5; Trapnell & Wiggins, 1990) to predict individual variation in initial value and rate of change in borderline personality disorder symptoms. The dimensions of the IASR-B5 predict variability in initial symptoms and rates of change. Interaction effects emerged between Dominance and Conscientiousness, Love and Neuroticism, and Conscientiousness and Neuroticism in predicting initial symptoms; and between Dominance and Love and Love and Neuroticism in predicting rates of change, suggesting that the effects of broad domains of personality are not merely additive but conditional on each other.     

Development of personality and the remission and onset of personality pathology

The current study used the Longitudinal Study of Personality Disorders data set (Lenzenweger, 1999) to examine the development of personality traits in the context of the remission and onset of personality disorder (PD) symptoms. Despite high levels of stability, past research on the development of basic personality traits has also found a mean trend toward increased maturity and that individuals vary in their trajectories of trait development. Research on PD change has shown a similar pattern. We employed individual growth curve modeling to examine the relationship between personality trait development and PD symptom course. We found that both are indeed related and that remission in PD symptoms is associated with patterns of trait development associated with more rapid maturity. In contrast, deviating from the mean of trait development either through no change (i.e., stagnation) or change in the opposite direction (i.e., regression) was associated with developing PD symptoms over the course of the study.     

Opinions of personality disorder experts regarding the DSM-IV personality disorders classification system

OBJECTIVE: To survey the opinions of personality disorder (PD) experts on possible revisions in the classification system for PDs in the DSM-V. METHOD: Four hundred members of two international associations, the Association for Research on Personality Disorders, and the International Society for the Study of Personality Disorders, were asked to take a 78-item web survey. RESULTS: Of the experts who completed the survey (N = 96), 74% felt that the DSM-IV's categorical system of PD diagnosis should be replaced. Eighty percent felt that PDs are better conceived of as personality dimensions or illness spectra, than as categories. The most frequently endorsed alternative system for PDs was a mixed system of categories and dimensions. Most experts preferred the PDs to remain on Axis II. Only 31.3% wanted the term, "Borderline Personality Disorder," retained in the DSM-V. CONCLUSIONS: A clear majority of the PD experts were dissatisfied with the current diagnostic system for PDs.     

Distinguishing general and specific personality disorder features and implications for substance dependence comorbidity

Clinical and population-based samples show high comorbidity between Substance Use Disorders (SUDs) and Axis II Personality Disorders (PDs). However, Axis II disorders are frequently comorbid with each other, and existing research has generally failed to distinguish the extent to which SUD/PD comorbidity is general or specific with respect to both specific types of PDs and specific types of SUDs. We sought to determine whether ostensibly specific comorbid substance dependence-Axis II diagnoses (e.g., alcohol use dependence and borderline personality disorder) are reflective of more pervasive or general personality pathology or whether the comorbidity is specific to individual PDs. Face-to-face interview data from Wave 1 and Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions were analyzed. Participants included 34,653 adults living in households in the United States. We used hierarchical factor models to statistically partition general and specific personality disorder dimensions while simultaneously testing for specific PD-substance dependence relations. Results indicated that substance dependence-Axis II comorbidity is characterized by general (pervasive) pathology and by Cluster B PD pathology over and above the relationship to the general PD factor. Further, these relations between PD factors and substance dependence diagnoses appeared to largely account for the comorbidity among substance dependence diagnoses in the younger but not older participants. Our findings suggest that a failure to consider the general PD factor, which we interpret as reflecting interpersonal dysfunction, can lead to potential mischaracterizations of the nature of certain PD and SUD comorbidities.     

Associations between four types of childhood neglect and personality disorder symptoms during adolescence and early adulthood: findings of a community-based longitudinal study

Data from a community-based longitudinal study were used to investigate the association between childhood neglect and personality disorder (PD) symptom levels during adolescence and early adulthood. Psychosocial and psychiatric interviews were administered to a representative sample of 738 youths and their mothers from upstate New York in 1975, 1983, 1985-1986, and 1991-1993. Evidence of childhood cognitive, emotional, physical, and supervision neglect was obtained from the maternal interviews that were conducted in 1975, 1983, and 1985-1986, and from New York State records. PDs were assessed among the youths in 1985-1986, when they were adolescents, and in 1991-1993, when they were young adults. Findings indicated that childhood emotional, physical, and supervision neglect were associated with increased risk for PDs and with elevated PD symptom levels during adolescence and early adulthood, after age, sex, childhood physical or sexual abuse, other types of childhood neglect, and cooccurring PD symptoms were controlled statistically. Childhood emotional neglect was associated with increased risk for avoidant PD and with paranoid and Cluster A PD symptom levels during adolescence and early adulthood. Childhood physical neglect was associated with increased risk for schizotypal PD and with Cluster A PD symptom levels during adolescence and early adulthood. Childhood supervision neglect was associated with increased risk for passive-aggressive and Cluster B PDs and with borderline, paranoid, and passive-aggressive PD symptom levels during adolescence and early adulthood. The present findings suggest that childhood emotional, physical, and supervision neglect may play a role in the etiology of some PDs.     

A developmental perspective on personality in emerging adulthood: childhood antecedents and concurrent adaptation

Personality and competence were examined in a community sample of 205 children ages 8-12 who were followed up 10 years later in emerging adulthood (ages 17-23). Adult Positive Emotionality (PEM), Negative Emotionality (NEM), and Constraint (CON) were presaged by childhood personality. PEM was associated with current success in social and romantic relationships. Low CON was associated with childhood and current antisocial conduct. NEM was broadly linked to childhood and current maladaptation, consistent with the possibility that failure in major developmental tasks increases NEM. Findings highlight the pervasive linkage of NEM to maladaptation and suggest that adult personality may develop from processes embedded in childhood adaptation as well as childhood personality.     

Drinking motives as mediators in the relation between personality disorder symptoms and alcohol use disorder

Research shows high comorbidity between Cluster B Personality Disorders (PDs) and Alcohol Use Disorders (AUDs). Studies of personality traits and alcohol use have identified coping and enhancement drinking motives as mediators of the relation among impulsivity, negative affectivity or affectivity instability, and alcohol use. To the extent that certain PDs reflect extreme expression of these traits, drinking motives were hypothesized to mediate the relation between PD symptoms and presence/absence of an alcohol use disorder (AUD). This hypothesis was tested using a series of cross-sectional and prospective path models estimating the extent that coping and enhancement drinking motives mediated the relation between cluster A, B, and C PD symptom counts and AUD diagnosis among a sample of 168 young adults between ages 18 and 21. Enhancement motives mediated the cross-sectional relation between Cluster B symptoms and AUD. Prospectively, enhancement motives partially mediated the relation between Cluster B personality symptoms and AUD through the stability of Year 1 AUD to Year 3 AUD. Results suggest that enhancement motives may be especially important in understanding the relation between Cluster B personality disorders and AUDs.     

The kids are alright: growth and stability in personality development from adolescence to adulthood

This longitudinal study provides a comprehensive analysis of continuity and change in personality functioning from age 18 to age 26 in a birth cohort (N = 921) using the Multidimensional Personality Questionnaire (A. Tellegen, 1982). Data were analyzed using 4 different methods: differential continuity, mean-level change, individual differences in change, and ipsative change. Convergent evidence pointing toward personality continuity, as opposed to change, was found. The personality changes that did take place from adolescence to adulthood reflected growth in the direction of greater maturity; many adolescents became more controlled and socially more confident and less angry and alienated. Consistent with this, greater initial levels of maturity were associated with less personality change over time. The results indicate that the transition from adolescence to young adulthood is marked by continuity of personality and growth toward greater maturity.     

Development and validation of a new procedure for the diagnostic assessment of personality disorder: the Multidimensional Personality Disorder Rating Scale (MPDRS)

Data from a community-based prospective longitudinal study were used to investigate the utility of a structured assessment of the DSM-IV General Diagnostic Criteria for a Personality Disorder (PD). The Structured Clinical Interview for DSM-IV PDs (SCID-II) was administered to 154 adults. After completing the interview, an experienced clinician assessed the General Diagnostic Criteria for a PD using a structured rating scale. PD diagnoses, based solely on the rating scale data, demonstrated strong agreement with diagnoses obtained using the diagnostic thresholds for specific PDs (Kappa = 0.89). The sensitivity, specificity, predictive power, and internal reliability of the rating scale were satisfactory. PD diagnoses, based on both of the assessment procedures, were associated with substantial impairment and distress. These findings suggest that a structured assessment of the DSM-IV General Diagnostic Criteria for a Personality Disorder may constitute a useful alternative or supplement to standard assessments of the diagnostic thresholds for specific DSM-IV PDs.     

Measuring the core features of personality disorders in substance abusers using the Temperament and Character Inventory (TCI)

Personality disorders (PDs) are still classified through categorical taxonomies that are at odds with current research findings. Dimensional models provide a suitable alternative for measuring individual differences. However, as they have traditionally lacked a clear definition of the "disorder" construct, the clinical utility of these models has been limited. This study tests whether Cloninger's dimensional model is able to capture two domains: the features that differentiate PD subtypes from each other and the common core features underlying all PDs. Seventy-four drug dependent patients were independently assessed using the SCID-II and Cloninger's TCI. There was a slight relationship between TCI temperament dimensions and the DSM personality disorder subtypes, but the association was not specific enough to allow differential diagnosis. The character dimension Self-Directedness was strongly associated with the presence and severity of all PDs, irrespective of subtype, correctly classifying 77% of subjects. Character dimensions are a reliable, valid and low-cost tool for detecting PDs in drug abusers and may help to provide an operational definition of the common core features underlying all PDs.     

Emotional reactivity and self-regulation in relation to personality disorders

Associations of both reactive and regulative temperamental features with personality disorders (PDs) are investigated in a sample of 162 normal controls and 89 psychiatric inpatients. Reactive and regulative temperamental features were assessed by means of the BIS/BAS Scales and the Attentional Control Scale. Dimensional PD scores were obtained by using the ADP-IV. All PDs were characterized by low levels of effortful control, cluster C PDs by high BIS and cluster B PDs by high BAS. For several PDs, BIS and effortful control interacted: BIS was only related to severe PD pathology if effortful control was low. Clinical implications of these findings are discussed.     

Beliefs in personality disorders: a test with the personality disorder belief questionnaire

The hypothesis that each personality disorder (PD) is characterized by a specific set of beliefs was tested in a sample of 643 subjects, including non-patient controls, axis-I and axis-II patients, diagnosed with SCID-I and -II interviews. Beliefs of six PDs (avoidant, dependent, obsessive-compulsive, paranoid, histrionic, borderline) were assessed with the Personality Disorder Belief Questionnaire (PDBQ). Factor analyses supported the existence of six hypothesized sets of beliefs. Structural equation modeling (SEM) supported the hypothesis that each PD is characterized by a specific set of beliefs. Path coefficients were however in the medium range, suggesting that PDs are not solely determined by beliefs. Nevertheless, empirically derived cutoff scores of the six belief subscales were reasonably successful in classifying subjects, percentages ranging form 51% to 83%. It appeared that there was a monotonical increase in scores on each belief subscale from non-patient controls, to patients without any PD, to patients with PDs (other than the pertinent PD), to patients with the pertinent PD. This suggests that PD-related beliefs are at least partly associated with (personality) psychopathology in general. Another explanation is that many patients' position on the underlying dimensions is not high enough to lead to a DSM PD diagnosis, but high enough to lead to an elevated belief score.     

Emotional reactivity and self-regulation in relation to personality disorders

Associations of both reactive and regulative temperamental features with personality disorders (PDs) are investigated in a sample of 162 normal controls and 89 psychiatric inpatients. Reactive and regulative temperamental features were assessed by means of the BIS/BAS Scales and the Attentional Control Scale. Dimensional PD scores were obtained by using the ADP-IV. All PDs were characterized by low levels of effortful control, cluster C PDs by high BIS and cluster B PDs by high BAS. For several PDs, BIS and effortful control interacted: BIS was only related to severe PD pathology if effortful control was low. Clinical implications of these findings are discussed.     

Screening for personality disorders

A brief but valid self-report measure to screen for personality disorders (PDs) would be a valuable tool in making decisions about further assessment and in planning optimal treatments. In psychiatric and nonpsychiatric samples, we compared the validity of three screening measures: the PD scales from the Inventory of Interpersonal Problems, a self-report version of the Iowa Personality Disorder Screen, and the selfdirectedness scale of the Temperament and Character Inventory. Despite their different theoretical origins, the screeners were highly correlated in a range from .71 to .77. As a result, the use of multiple screeners was not a significant improvement over any individual screener, and no single screener stood out as clearly superior to the others. Each performed modestly in predicting the presence of any PD diagnosis in both the psychiatric and nonpsychiatric groups. Performance was best when predicting a more severe PD diagnosis in the psychiatric sample. The results also highlight the potential value of multiple assessments when relying on self-reports.     

Continuity of axes I and II: toward a unified model of personality, personality disorders, and clinical disorders

In the current standard psychiatric nomenclature, the DSM-IV-TR (APA, 2000), mental disorders are divided into two groups: Clinical Disorders (CDs) and Personality Disorders (PDs), and CD and PD diagnoses are recorded on two separate axes (Axes I and II, respectively). This article considers evidence regarding putative bases for distinguishing between CDs and PDs, and finds that these constructs are more similar than distinct. Links between the domains may be better understood by focusing on how personality connects CDs and PDs. This perspective underlines the need to work toward a more unified model of personality, PDs, and CDs in research and in future editions of the DSM.