Abstract
In this chapter we discuss personality disorders in older adults. After a brief look at the evolution of the DSM (Diagnostic and Statistical Manual of Mental Disorders; American Psychiatric Association) category Personality Disorders itself, and description of the disorders contained therein, our focus shifts to diagnosis and assessment of these Axis II disorders in older adults. Thereafter, we present viable treatment options available to the clinician. As we show, theoretical and research interest has varied greatly from disorder to disorder (Peterson, 1996), thus, treatment approaches for some disorders have a firmer empirical foundation than others.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Abrams, R. C. (1991). The aging personality. International Journal of Geriatric Psychiatry, 6 1–3.
Abrams, R. C., Alexopoulos, G. S., & Young, R. C. (1987). Geriatric depression and DSM-III-R personality criteria. Journal of the American Geriatrics Society, 35 383–386.
Abrams, R. C., Rosendahl, E., Card, C., & Alexopoulos, G. S. (1994). Personality disorder correlates of late and early onset depression. Journal of the American Geriatrics Society, 42 727–731.
Adler, D. A. (1990). Personality disorders: Treatment of the nonpsychotic chronic patient. New Direction for Mental Health Services, 47 3–15.
Alden, L. E. (1989). Short-term structured treatment for avoidant personality disorder. Journal of Consulting and Clinical Psychology, 57 756–764.
Alden, L. E., & Caperol, M. J. (1993). Avoidant personality disorder: Interpersonal problems as predictors of treatment response. Behavior Therapy, 24 357–376.
Allport, G. W. (1937). Personality: A psychological interpretation. New York: Holt.
American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Aronson, T. A. (1989). A critical review of psychotherapeutic treatments of the borderline personality: Historical trends and future directions. Journal of Nervous and Mental Disease, 177 511–528.
Barlow, D. H., & Durand, V. M. (1995). Abnormal psychology: An integrative approach. Pacific Grove, CA: Brooks/Cole.
Beck, A. T., & Freeman, A. (1990). Cognitive therapy of personality disorders. New York: Guilford.
Bellack, A. S., & Hersen, M. (Eds.). (1985). Dictionary of behavior therapy techniques. New York: Pergamon.
Blashfield, R. K., & Breen, M. J. (1989). Face validity of DSM-III-R personality disorders. American Journal of Psychiatry, 146 1575–1579.
Bolla-Wilson, K., & Bleecker, M. L. (1989). Absence of depression in elderly adults. Journal of Gerontology, 44 53–55.
Bullard, D. M. (1960). Psychotherapy of paranoid patients. Archives of General Psychiatry, 2 137–141.
Casey, D. A., & Schrodt, C. J. (1989). Axis II diagnoses in geriatric inpatients. Journal of Geriatric Psychiatry and Neurology, 2 87–88.
Cohen, G. D. (1990). Psychopathology and mental health in the mature and elderly adult. In J. E. Birren & K. W. Schaie (Eds.), Handbook of the psychology of aging (3rd ed., pp. 359–371). San Diego, CA: Academic.
Colligan, R. C., & Offord, K. P. (1992). Age, stage, and the MMPI: Changes in response patterns over an 85 year age span. Journal of Clinical Psychology, 48 476–493.
Colligan, R. C., Osborne, D., Swenson, W. M., & Offord, K. P. (1984). The MMPI: Development of contemporary norms. Journal of Clinical Psychology, 40 100–107.
Coolidge, F. L. (1993). Coolidge Axis II Inventory manual. Clermont, FL: Synergistic Office Solutions.
Coolidge, F. L., & Merwin, M. M. (1992). Reliability and validity of the Coolidge Axis II Inventory: A new inventory for the assessment of personality disorders. Journal of Personality Assessment, 59 223–238.
Coolidge, F. L., Burns, E. M., Nathan, J. H., & Mull, C. E. (1992). Personality disorders in the elderly. Clinical Gerontologist, 12 41–55.
Dulit, R. A., Marin, D. B., & Frances, A. J. (1993). Cluster B personality disorders. In D. L. Dunner (Ed.), Current psychiatric therapy (pp. 405–411). Philadelphia: Saunders.
Dye, C. J., Bohm, A., Anderten, P., & Cho, D. W. (1983). Age group differences in depression on MMPI-D scale. Journal of Clinical Psychology, 39 227–234.
Ellison, J. M., & Adler, D. A. (1990). A strategy for the pharmacotherapy of personality disorders. New Directions for Mental Health Services, 47 43–63.
First, M. B., Gibbon, M., Spitzer, R. L., Williams, J. B. W., & Benjamin, L. S. (1997). Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II), Washington, DC: American Psychiatric Press.
Fleming, B., & Pretzer, J. L. (1990). Cognitive-behavioral approaches to personality disorders. Progress in Behavior Modification, 25 119–151.
Fogel, B. S., & Westlake, R. (1990). Personality disorder diagnosis and age in inpatients with, major depression. Journal of Clinical Psychiatry, 51 232–235.
Glasser, M. (1992). Problems in the psychoanalysis of certain narcissistic disorders. International Journal of Psychoanalysis, 73 493–503.
Graham, J. R. (1990). MMPI-2: Assessing personality and psychopathology. New York: Oxford University Press.
Greene, R. L. (1980). The MMPI: An interpretive manual. New York: Grune & Stratton.
Gunderson, J. G., Frank, A. F., Ronningstam, E. F., Wachter, S., Lynch, V. J., & Wolf, P. J. (1989). Early discontinuance of borderline patients from psychotherapy. Journal of Nervous and Mental Disease, 177 38–42.
Guze, S. B. (1976). Criminality and psychiatric disorders. New York: Oxford University Press.
Harmatz, J. S., & Shader, R. E. (1975). Psychopharmacological investigations in healthy elderly volunteers: MMPI depression scale. Journal of the American Geriatrics Society, 23 350–354.
Hathaway, S. R., & McKinley, J. C. (1983). The Minnesota Multiphasic Personality Inventory manual. New York: Psychological Corporation.
Hathaway, S. R., & McKinley, J. C. (1989). MMPI-2: Minnesota Multiphasic Personality Inventory-2: Manual for administration and scoring. Minneapolis: University of Minnesota Press.
Heimberg, R. G., & Barlow, D. H. (1991). New developments in cognitive-behavioral therapy for social phobia. Journal of Clinical Psychology, 52 21–30.
Herbert, J. D., Hope, D. A., & Bellack, A. S. (1992). Validity of the distinction between generalized social phobia and avoidant personality disorder. Journal of Abnormal Psychology 101, 332–339.
Higgitt, A., & Fonagy, P. (1992). Psychotherapy of borderline and narcissistic personality disorder. British Journal of Psychiatry, 161 23–43.
Hoke, L. A., Livori, P. W., & Perry, J. C. (1992). Mood and global functioning in borderline personality disorder: Individual regression models for longitudinal measurements. Journal of Psychiatric Research, 26 1–16.
Hyer, L., & Harrison, W. R. (1986). Later life personality model. Clinical Gerontologist, 5 399–416.
Hyler, S. E. (1994). Personality Diagnostic Questionnaire, 4th edition (PDQ-4). New York: New York State Psychiatric Institute.
Hyler, S. E., & Reider, R. O. (1987). PDQ-R: Personality Diagnostic Questionnaire-Revised. New York: New York State Psychiatric Institute.
Kavoussi, R., & Siever, L. J. (1992). Overlap between borderline and schizotypal personality disorders. Comprehensive Psychiatry, 33 7–12.
Kernberg, O. (1975). Borderline conditions and pathological narcissism. New York: Jason Aronson.
Kohut, H. (1971). The analysis of the self. New York: International Universities Press.
Kohut, H. (1977). The restoration of the self. New York: International Universities Press.
Kroessler, D. (1990). Personality disorders in the elderly. Hospital and Community Psychiatry, 41 1325–1329.
Kunik, M. E., Muisant, B. H., Rifai, A. H., Sweet, R. A., Pasternak, R., Rosen, J., & Zubenko, G. S. (1993). Personality disorders in elderly inpatients with major depression. American Journal of Geriatric Psychiatry, 1 38–45.
Leon, G. R., Gillum, B., Gillum, R., & Gouze, M. (1979). Personality stability and change over a 30 year period middle age to old age. Journal of Consulting and Clinical Psychology, 47 515–524.
Libb, J. W., Murray, J., Thurstin, H., & Alarcon, R. D. (1992). Concordance of the MCMI-II, the MMPI., and Axis I discharge diagnosis in psychiatric inpatients. Journal of Personality Assessment, 58 580–590.
Loranger, A. W., Sartorius, N., Andreoli, A., Berger, P., Channabassavanna, S. M., Coid, B., Dahl, A., Diekstra, R. F. W., Fegeson, B., Jacobsberg, L. B., Mombour, W., Pull, C., Ono, Y., & Regier, D. (1994). The International Personality Disorder Examination: The World Health Organization/Alcohol, Drug Abuse, and Mental Health Administration international pilot study of personality disorders. Archives of General Psychiatry, 51 215–224.
Loranger, A. W., Susman, V. L., Oldham, J. M., & Russakof, L. M. (1987). The Personality Disorder Examination: A preliminary report. Journal of Personality Disorders, 1 1–13.
Martin, R. L., Cloninger, C. R., & Guze, S. B. (1982). The natural history of somatization and substance abuse in women criminals: A six year follow-up. Comprehensive Psychiatry, 23 528–537.
Mavissakalian, M., & Hamann, M. S. (1986). Correlates of DSM-III personality disorder in agoraphobia. Comprehensive Psychiatry, 27 471–479.
Mavissakalian, M., & Hamann, M. S. (1988). Correlates of personality disorders in panic disorder and agoraphobia. Comprehensive Psychiatry, 29 535–544.
Mavissakalian, M., Hamann, M. S., & Jones, B. (1990). Correlates of DSM-III-R personality disorder in obsessive-compulsive disorder. Comprehensive Psychiatry, 31 481–489.
Mavissakalian, M., Hamann, M. S., Haidar, S. A., & de Groot, C. M. (1993). DSM-III personality disorders in general anxiety, panic/agoraphobia, and obsessive-compulsive disorders. Comprehensive Psychiatry, 34 243–248.
McCann, J. T., (1989). MMPI personality scales and the MCMI: Concurrent validity. Journal of Clinical Psychology, 45 365–369.
McCann, J. T. (1991). Convergent and discriminant validity of the MCMI-II and MMPI personality disorder scales. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 3 9–18.
McCrae, R. R., & Costa, P. T. (1984). The search for growth or decline in personality. In R. R. McCrae & P. T. Costa (Eds.), Emerging lives, ednduring dispositions: Personality in adulthood (pp. 13–28). Boston: Little, Brown.
Mehlum, L., Friis, S., Mon, T., Johns, S., Karterud, S., Vaglum, P., & Vaglum, S. (1991). Personality disorders 2-5 years after treatment: A prospective follow-up study. Acta Scandinavica, 84 72–77.
Mezzich, T. E., Fabrega, H., Coffman, G. A., & Gavin, Y. (1987). Comprehensively diagnosing geriatric patients. Comprehensive Psychiatry, 28 68–76.
Millon, T. (1981). Disorders of Personality: DSM-III, Axis II. New York: Wiley.
Millon, T. (1983). Millon Clinical Multiaxial Inventory. Minneapolis, MN: Interpretive Scoring Systems.
Millon, T. (1987). Millon Clinical Multiaxial Inventory II (MCMI-II) manual. Minneapolis, MN: National Computer Systems.
Millon, T. (1990). Toward a new personology: An evolutionary model. New York: Wiley-Inter-science.
Millon, T. (1992). Millon Clinical Multiaxial Inventory: I & II. Journal of Counseling and Development, 70 421–426.
Millon, T. (1994). Millon Clinical Multiaxial Inventory III (MCMI III) manual. Minneapolis, MN: National Computer Systems.
Morey, L. C., Waugh, M. H., & Blashfield, R. K. (1985). MMPI scales for DSM-III personality disorders: Their derivation and correlates. Journal of Personality Assessment, 49 245–256.
Morey, L. C., & Le Vine, D. J. (1988). A multi-trait, multimethod examination of Minnesota Multi-phasic Personality Inventory (MMPI) and Millon Clinical Multiaxial Inventory (MCMI). Journal of Psychopathology and Behavioral Assessment, 10 333–344.
Nürnberg, H. G., Raskin, M., Levine, P. E., Pollack, S., Siegel, O., & Prince, R. (1991). The comorbidity of borderline personality disorder and other DSM-III-R Axis II personality disorders. American Journal of Psychiatry, 148 1371–1377.
O’Brien, M. M., Trestman, R. L., & Siever, L. J. (1993). Cluster A personality disorders. In D. L. Dunner (Ed.), Current psychiatric therapy (pp. 399–404). Philadelphia: Saunders.
Oldham, J. M., Skodol, A. E., Rellman, A. D., Hyler, S. E., Rosnick, L., & Davis, M. (1992). Diagnosis of DSM-III-R personality disorders by two structured interviews: Patterns of co-morbidity. American Journal of Psychiatry, 149 213–220.
Patrick, J. (1988). Concordance of the MCMI and the MMPI in the diagnosis of three DSM-III Axis I disorders. Journal of Clinical Psychology, 44 186–190.
Patterson, G. R. (1982). Coercive family process. Eugene, OR: Castalia.
Pennington, B. H., Peterson, L. P., & Barber, H. R. (1979). The diagnostic use of the MMPI in organic brain dysfunction. Journal of Clinical Psychology, 35 484–492.
Perry, J. C. (1993). Longitudinal studies of personality disorders. Journal of Personality Disorders, 7 63–85.
Peterson, C. (1996). Personality (2nd ed.). San Diego, CA: Harcourt Brace Jovanovich.
Pfohl, B., Stangl, D., & Zimmerman, M. (1983). Structured Interview for DSM-III Personality (SIDP) (2nd ed.). Iowa City: University of Iowa.
Pfohl, B., Blum, N., & Zimmerman, M. (1995). Structured Interview for DSM-IV Personality SIDP IV. Iowa City: University of Iowa.
Pincus, H. A., Frances, A., Davis, W. W., First, M. B., & Widiger, T. A. (1992). DSM-IV and new diagnostic categories: Holding the line on proliferation. American Journal of Psychiatry, 149 112–117.
Quality Assurance Project. (1991). Treatment outlines for paranoid, schizotypal, and schizoid personality disorders. Australian and New Zealand Journal of Psychiatry, 24 339–350.
Reich, J. H., & Green, A. I. (1991). Effect of personality disorders on outcome of treatment. Journal of Nervous and Mental Disease, 179 74–82.
Renneberg, B., Goldstein, A. J., Phillips, D., & Chambless, D. L. (1990). Intensive behavioral group treatment of avoidant personality disorder. Behavior Therapy, 21 363–377.
Ricciardi, J. N., Baer, L., Jenike, M. A., Fischer, S. C., Sholtz, D., & Buttolph, M. L. (1992). Changes in DSM-III-R Axis II diagnoses following treatment of obsessive-compulsive disorder. American Journal of Psychiatry, 149 829–831.
Rose, M. K., Soares, H. H., & Joseph, C. (1993). Frail elderly clients with personality disorders: A challenge for social work. Journal of Gerontological Social Work, 19 153–165.
Rosowsky, E., & Gurian, B. (1991). Borderline personality disorder in late life. International Psychogeriatrics, 3 39–52.
Rusk, R., Hyerstay, B.J., Calsyn, D. A., & Freeman, C. W. (1979). Comparison of the utility of two abbreviated forms of the MMPI for psychiatric screening of the elderly. Journal of Clinical Psychology, 35 104–107.
Schneider, L. S., Zemansky, M. R., Bender, M., & Sloane, R. B. (1992). Personality in recovered depressed elderly. International Psychogeriatrics, 4 177–185.
Schneier, F. R., Spitzer, R. L. Gibbon, M., Fyer, A. J., & Leibowitz, M. R. (1991). The relationship of social phobia subtypes to avoidant personality disorder. Comprehensive Psychiatry, 32 496–502.
Segal, D. L., Hersen, M., Van Hasselt, V. B., Silberman, C. S., & Roth, L. (1996). Diagnosis and assessment of personality disorders in older adults: A critical review. Journal of Personality Disorders.
Shea, M. T., Pilkonis, P. A., Bechman, E., Collins, J. F., Elkin, I., Sotsky, S. M., & Docherty, J. P. (1990). Personality disorders and treatment outcome in the NIMH treatment of depression: Collaborative Research Program. American Journal of Psychiatry, 147 711–718.
Siegel, D. J., & Small, G. W. (1986). Borderline personality disorder in the elderly: A case study. Canadian Journal of Psychiatry, 31 859–860.
Silberman, C. S., Roth, L., Segal, D. L., & Burns, W. (1997). Relationship between the Millon Clinical Multiaxial Inventory-II and Collidge Axis II Inventory in chronically mentally ill older adults: A pilot study. Journal of Clinical Psychology, 53 559–566.
Snyder, S., Pitts, W. M., & Gustin, Q. (1983). Absence of borderline personality disorder in later years. American Journal of Psychiatry, 140 271–272.
Spar, J. E., & La Rue, A. (1990). Concise guide to geriatric psychiatry Washington, DC: American Psychiatric Press.
Steketee, G., Foa, E. B., & Grayson, J. B. (1982). Recent advances in the behavioral treatment of obsessive-compulsives. Archives of General Psychiatry, 39 1365–1371.
Stravynski, A., Lesage, A., Marcouiller, M., & Elie, R. (1989). A test of the therapeutic mechanism in social skill training with avoidant personality disorder. Journal of Nervous and Mental Disease, 177 739–744.
Streiner, D. L., & Miller, H. R. (1988). Validity of the MMPI scales for DSM-III personality disorders: What are they measuring? Journal of Personality Disorders, 2 238–242.
Task Force on Nomenclature and Statistics, American Psychiatric Association. (1976). DSM-III in midstream: Conference publication. Missouri Institute of Psychiatry.
Taylor, J. R., Strassberg, D. S., & Turner, C. W. (1989). Utility of the MMPI in geriatric populations. Journal of Personality Assessment, 53 665–676.
Thompson, L. W., Gallagher, D., & Czirr, R. (1989). Personality disorder and outcome treatment of late life depression. Journal of Geriatric Psychiatry, 21 133–146.
Turkat, I. D., & Carlson, C. R. (1984). Data-based versus symptomatic formulation of treatment: The case of a dependent personality. Journal of Behavior Therapy and Experimental Psychiatry, 15 153–160.
Tyrer, P. (1988). What’s wrong with the DSM-III personality disorders? Journal of Personality Disorders, 2 289–291.
Weiss, J. M. (1973). The natural history of antisocial attitudes: What happens to psychopaths? Journal of Geriatric Psychology, 2 236–242.
Westin, D. (1991). Cognitive-behavioral interventions in the psychoanalytic psychotherapy of borderline personality disorders. Clinical Psychology Review, 11 211–230.
Widiger, T. A., & Trull, T. J. (1993). Personality and psychopathology: An application of the five-factor model. Journal of Personality, 60 363–393.
Widiger, T. A., Williams, J. B., Spitzer, R. F., & Francis, A. (1985). The MCMI as a measure of DSM III. Journal of Personality Assessment, 49 366–378.
Zimmerman, M. (1994). Diagnosis of personality disorders. Archives of General Psychiatry, 51 225–244.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1998 Springer Science+Business Media New York
About this chapter
Cite this chapter
Falk, B., Segal, D.L. (1998). Personality Disorders. In: Hersen, M., Van Hasselt, V.B. (eds) Handbook of Clinical Geropsychology. The Springer Series in Adult Development and Aging. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-0130-9_14
Download citation
DOI: https://doi.org/10.1007/978-1-4899-0130-9_14
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4899-0132-3
Online ISBN: 978-1-4899-0130-9
eBook Packages: Springer Book Archive