Dramatic-erratic personality disorder symptoms: II. Developmental pathways from early adolescence to adulthood

This study examined the relationship over time between Cluster B personality disorder symptoms (borderline, histrionic, and narcissistic symptoms) and comorbid internalizing and externalizing symptoms in a community sample of 407 adolescents. Cross-lagged longitudinal models tested (a) the hypothesis that Cluster B symptoms reflect primary disturbances that give rise to co-occurring internalizing and externalizing symptoms; and (b) the alternative hypothesis that these Axis I symptom clusters reflect primary problems that interfere with normal personality development. Internalizing and externalizing symptoms each predicted subsequent Cluster B symptoms in girls, although these effects occurred only at specific developmental stages. Cluster B symptoms in boys and girls at ages 10 to 14 years predicted externalizing symptoms two years later. Instead of clearly supporting one hypothesis over the other, longitudinal models suggested gender-specific developmental effects that were partially consistent with both hypotheses.