Personality disorders and aging: a cross-sectional MCMI-III study

The assumption that personality disorders have an early onset and are enduring is subject of considerable debate (Clark, 2007). As early as 1988 hypotheses have been advanced that the histrionic, narcissistic, antisocial, and passive-aggressive/negativistic PDs (immature disorders) are more common in younger adults and tend to remit with age, whereas schizoid, compulsive, schizotypal, and paranoid PDs (mature disorders) have a later onset and vary little over time (Tyrer, 1988; Vaillant & Perry, 1990). The current cross-sectional study examined the course of PDs in a Belgian sample, consisting of 890 men and 521 women (N=1411), with ages ranging from 18 to 75 years old (mean= 36.9, SD = 11.5). The MCMI-III Axis II scales were used to detect differences between three age groups: 18-29, 30-49, and 50-75 (respectively 30, 55, and 15% of the sample). Except for the schizotypal and paranoid scales, all MCMI-III PD measures showed significant age-group differences, and all hypotheses were confirmed: Younger individuals showed higher mean scores on the histrionic, narcissistic, antisocial, and negativistic scales, whereas older individuals showed higher scores on the schizoid and compulsive scales. Most patterns across the three age groups were linear. As a means of understanding the nature of age changes at the trait domain level, Grossman facet scales were examined for each PD measure that demonstrated significant age-group differences. Results showed that age-related PD scale score changes could be accounted for by changes within specific trait domains; for example, increased schizoid scale scores for older persons were linked to increased scores on the facet scale measuring interpersonal detachment, but not the facet scales measuring apathetic temperament and impassive expressiveness. Findings suggest avenues for future research examining specific areas of personality functioning that may contribute to the softening of maladaptive traits and habits over the adult lifespan.