A Unifying Perspective on Personality Pathology Across the Life Span: Developmental Considerations for the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders

Overview

Journal Dev Psychopathol

Publisher Cambridge University Press

Specialties Psychiatry
Psychology

Date 2009 Jul 9

PMID 19583880

Citations 28

Authors

Jennifer L Tackett

Steve Balsis

Thomas F Oltmanns

Robert F Krueger

Affiliations

Soon will be listed here.

Abstract

Proposed changes in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) include replacing current personality disorder (PD) categories on Axis II with a taxonomy of dimensional maladaptive personality traits. Most of the work on dimensional models of personality pathology, and on personality disorders per se, has been conducted on young and middle-aged adult populations. Numerous questions remain regarding the applicability and limitations of applying various PD models to early and later life. In the present paper, we provide an overview of such dimensional models and review current proposals for conceptualizing PDs in DSM-V. Next, we extensively review existing evidence on the development, measurement, and manifestation of personality pathology in early and later life focusing on those issues deemed most relevant for informing DSM-V. Finally, we present overall conclusions regarding the need to incorporate developmental issues in conceptualizing PDs in DSM-V and highlight the advantages of a dimensional model in unifying PD perspectives across the life span.

Citing Articles

A Longitudinal Network of Borderline-Related Trait Vulnerabilities from Childhood to Adolescence.

Franssens R, Costantini G, Kaurin A, De Clercq B Res Child Adolesc Psychopathol. 2023; 52(3):443-455.

PMID: 37947955 DOI: 10.1007/s10802-023-01132-2.

Personality traits and disorders in Alzheimer's disease.

Henriques-Calado J Brain Behav. 2023; 13(4):e2938.

PMID: 36919197 PMC: 10097140. DOI: 10.1002/brb3.2938.

Adverse Childhood Experiences, Personality, and Crime: Distinct Associations among a High-Risk Sample of Institutionalized Youth.

Barra S, Aebi M, dHuart D, Schmeck K, Schmid M, Boonmann C Int J Environ Res Public Health. 2022; 19(3).

PMID: 35162246 PMC: 8835310. DOI: 10.3390/ijerph19031227.

Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): III. Emotional dysfunction superspectrum.

Watson D, Levin-Aspenson H, Waszczuk M, Conway C, Dalgleish T, Dretsch M World Psychiatry. 2022; 21(1):26-54.

PMID: 35015357 PMC: 8751579. DOI: 10.1002/wps.20943.

Mediators and Theories of Change in Psychotherapy for Young People With Personality Disorders: A Systematic Review Protocol.

Volkert J, Taubner S, Barkauskiene R, Mestre J, Sales C, Thiele V Front Psychol. 2021; 12:703095.

PMID: 34616334 PMC: 8488151. DOI: 10.3389/fpsyg.2021.703095.

References

Fonagy P, Bateman A . The development of borderline personality disorder--a mentalizing model. J Pers Disord. 2008; 22(1):4-21. DOI: 10.1521/pedi.2008.22.1.4. View

Miller A, Muehlenkamp J, Jacobson C . Fact or fiction: diagnosing borderline personality disorder in adolescents. Clin Psychol Rev. 2008; 28(6):969-81. DOI: 10.1016/j.cpr.2008.02.004. View

Ames A, Molinari V . Prevalence of personality disorders in community-living elderly. J Geriatr Psychiatry Neurol. 1994; 7(3):189-94. DOI: 10.1177/089198879400700311. View

Frick P, Bodin S, Barry C . Psychopathic traits and conduct problems in community and clinic-referred samples of children: further development of the psychopathy screening device. Psychol Assess. 2001; 12(4):382-93. View

Livesley W, Jang K . Toward an empirically based classification of personality disorder. J Pers Disord. 2000; 14(2):137-51. DOI: 10.1521/pedi.2000.14.2.137. View

Barry C, Frick P, Killian A . The relation of narcissism and self-esteem to conduct problems in children: a preliminary investigation. J Clin Child Adolesc Psychol. 2003; 32(1):139-52. DOI: 10.1207/S15374424JCCP3201_13. View

Jablensky A . The classification of personality disorders: critical review and need for rethinking. Psychopathology. 2002; 35(2-3):112-6. DOI: 10.1159/000065129. View

Rogosch F, Cicchetti D . Child maltreatment, attention networks, and potential precursors to borderline personality disorder. Dev Psychopathol. 2006; 17(4):1071-89. PMC: 1474024. DOI: 10.1017/s0954579405050509. View

Agronin M . Personality is as personality does. Am J Geriatr Psychiatry. 2007; 15(9):729-33. DOI: 10.1097/JGP.0b013e318145b5fe. View

10.

Crawford T, Shaver P, Cohen P, Pilkonis P, Gillath O, Kasen S . Self-reported attachment, interpersonal aggression, and personality disorder in a prospective community sample of adolescents and adults. J Pers Disord. 2006; 20(4):331-51. DOI: 10.1521/pedi.2006.20.4.331. View

11.

Chen H, Cohen P, Kasen S, Johnson J . Adolescent axis I and personality disorders predict quality of life during young adulthood. J Adolesc Health. 2006; 39(1):14-9. DOI: 10.1016/j.jadohealth.2005.07.005. View

12.

Levy K, Becker D, Grilo C, Mattanah J, Garnet K, Quinlan D . Concurrent and predictive validity of the personality disorder diagnosis in adolescent inpatients. Am J Psychiatry. 1999; 156(10):1522-8. DOI: 10.1176/ajp.156.10.1522. View

13.

Johnson J, Cohen P, Smailes E, Skodol A, Brown J, Oldham J . Childhood verbal abuse and risk for personality disorders during adolescence and early adulthood. Compr Psychiatry. 2001; 42(1):16-23. DOI: 10.1053/comp.2001.19755. View

14.

Tyrer P . Temporal change: the third dimension of personality disorder. J Pers Disord. 2005; 19(5):573-80. DOI: 10.1521/pedi.2005.19.5.573. View

15.

Guzder J, Paris J, Zelkowitz P, Marchessault K . Risk factors for borderline pathology in children. J Am Acad Child Adolesc Psychiatry. 1996; 35(1):26-33. DOI: 10.1097/00004583-199601000-00009. View

16.

Houston R, Bauer L, Hesselbrock V . Effects of borderline personality disorder features and a family history of alcohol or drug dependence on P300 in adolescents. Int J Psychophysiol. 2004; 53(1):57-70. DOI: 10.1016/j.ijpsycho.2004.02.003. View

17.

Krueger R, Markon K, Patrick C, Iacono W . Externalizing psychopathology in adulthood: a dimensional-spectrum conceptualization and its implications for DSM-V. J Abnorm Psychol. 2005; 114(4):537-50. PMC: 2242352. DOI: 10.1037/0021-843X.114.4.537. View

18.

Costa Jr P, McCrae R . Personality in adulthood: a six-year longitudinal study of self-reports and spouse ratings on the NEO Personality Inventory. J Pers Soc Psychol. 1988; 54(5):853-63. DOI: 10.1037//0022-3514.54.5.853. View

19.

Kasen S, Cohen P, Skodol A, Johnson J, Smailes E, Brook J . Childhood depression and adult personality disorder: alternative pathways of continuity. Arch Gen Psychiatry. 2001; 58(3):231-6. DOI: 10.1001/archpsyc.58.3.231. View

20.

Gelhorn H, Sakai J, Price R, Crowley T . DSM-IV conduct disorder criteria as predictors of antisocial personality disorder. Compr Psychiatry. 2007; 48(6):529-38. PMC: 2764329. DOI: 10.1016/j.comppsych.2007.04.009. View