A trait based perspective on personality and personality pathology in older adults

Student thesis: Doctoral Thesis


An age-neutral measurement system is one of the basic conditions to study the course of personality across the lifespan, both longitudinally and cross-sectionally. To our knowledge, only two personality measures were created with the goal of age neutrality: the Revised NEO Personality Inventory (NEO-PI-R; Costa & McCrae, 1992), one of the most widely used personality measures, and the Personality Assessment Inventory (PAI; Morey, 1991). During the development of the latter, item response theory was applied to identify and eliminate those items that contained measurement bias across two broad age groups (Oltmanns & Balsis, 2010). In the construction of the NEO-PI-R the later life context was theoretically considered during the item generation and selection phase. However, its age-neutrality has not been empirically investigated. In afirst study (Chapter 2) we address this issue and investigate the age-neutrality of the NEO-PI-R items, exploring possible age-related measurement invariance across a younger and an older sample by conducting Differential Item Functioning (DIF) analyses.
In a second study (Chapter 3) we aim to evaluate the NEO-PI-R as a possible screening instrument to assess DSM-IV personality disorders from a Five-Factor Model perspective. This was done using the so-called "FFM PD count" technique, which was developed by Miller and colleagues (2005), and previously validated in younger (and middle-aged) adult samples. Five alternative FFM PD counts based upon the NEO-PI-R were computed and evaluated with the Assessment of DSM-IV Personality Disorders Questionnaire (ADP-IV; Schotte et al., 2004), both in terms of convergent and divergent validity. The best working count for each personality disorder was selected, and normative data was gathered, from which cut-off scores were derived. The validity of these cut-off scores and their usefulness as a screening tool was than tested against both a categorical and a dimensional measure of personality pathology (i.e., the DSM-IV and the DAPP-BQ, respectively).
One of the major proposed changes in the fifth edition of the DSM to the conceptualization of personality disorders includes the replacement of current personality disorder categories on Axis II with a taxonomy of dimensional maladaptive personality traits (Tackett et al., 2009). Unfortunately, this dimensional focus detracted attention from another important issue, namely the suitability of the criteria for measuring personality in later life (Oltmanns & Balsis, 2011). Apparently and regrettably, the later life context was not explicitly considered during the development of this new classification system either (Tackett et al., 2009). Analogous to study 1, we therefore set out to empirically investigate the age-neutrality of the Personality Inventory for DSM-5 (PID-5; Krueger et al., 2012), the operationalization of the proposed DSM-5 traits (Chapter 4). Subsequently, we investigate its convergent validity by examining the joint hierarchical structure of the 25 proposed DSM-5
personality traits with the 18 dimensions of the Dimensional Assessment of Personality Pathology (DAPP; Livesley et al., 1992) model, a widely recognized and researched model that also focuses on pathological features of personality (Chapter 5).
In Chapter 6 we aim to unravel the specific value of personality questionnaires in clinical geropsychology and geriatric psychiatry from a more contemplative perspective. The role of personality questionnaires is discussed within the broader context of personality assessment in older adults, and some critical reflections are made regarding the use of self versus informant reports, and the choice for an age-neutral versus an age-specific measurement system. Also, some recommendations are provided that should help psychiatrists, clinical geropsychologists, geriatricians and researchers in their search towards a better understanding of personality disorders in later life. Finally, the major findings of the abovementioned studies will be summarized and discussed from a broader perspective in the final chapter (Chapter 7), along with recommendations for further research and general conclusions.
Date of Award2013
Original languageEnglish
SupervisorGina Rossi (Promotor), Eva Dierckx (Co-promotor), Sebastiaan van Alphen (Jury), Liesbeth De Donder (Jury), Martinus Josephus Maria Kardol (Jury), Esther Hoogenhout (Jury), An Haekens (Jury) & Barbara Declercq (Co-promotor)


  • traits
  • assessment
  • personality
  • personality pathology
  • older adults

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