Health Care for Women International, 35:1305–1316, 2013 Copyright © Taylor & Francis Group, LLC ISSN: 0739-9332 print / 1096-4665 online DOI: 10.1080/07399332.2013.841697

Personality Traits and Personality Disorders in Older Women: An Explorative Study Between Normal Development and Psychopathology ´ JOANA HENRIQUES-CALADO, MARIA EUGENIA DUARTE-SILVA, ANA MARTA KEONG, CARLOTA SACOTO, and DIANA JUNQUEIRA Faculty of Psychology, University of Lisbon, Lisbon, Portugal

The relationships between Axis II personality disorders (DSM-IV) and the Five-Factor Model (FFM) were explored in older women. The sample consists of 90 participants (M = 72.29 years, SD = 7.10) who were administered the NEO-Five-Factor Inventory and the Personality Diagnostic Questionnaire. The highest prevalence of A and C clusters and obsessive–compulsive personality disorder was observed. Also, elevated neuroticism and decreased agreeableness and openness appear as valuable traits in the description of psychopathology. The study of maladaptive personality functioning within an aging population can be described with the same traits that underlie normal personality functioning, extending the range of psychopathology to a dimensional approach. The interplay of personality and psychopathology has been of substantial interest, but the relationship of personality to mental health and psychopathology within aging populations remains a topic of great interest in research, because less attention has been paid to the needs of an elderly population (Malatesta, 2007; Widiger & Seidlitz, 2002). The research on maladaptive personality functioning within an aging population continues to provide compelling support for the contribution of personality to mental health and compared specific traits and personality disorders assigned by the Axis II of DSM (Lynam & Widiger, 2001; Samuel & Widiger, 2004; Schroeder, Received 28 August 2012; accepted 30 August 2013. The authors thank all of the study participants. This work was supported by a doctoral grant from the Portuguese Foundation for Science and Technology (ref. SFRH/BD/ 44515/2008) awarded to the first author. Address correspondence to Joana Henriques-Calado, Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisbon, Portugal. E-mail: [email protected] 1305

1306

J. Henriques-Calado et al.

Wormworth, & Livesley, 2002; Tackett, Balsis, Oltmanns, & Krueger, 2009; Widiger, 2005; Widiger & Seidlitz, 2002). Abrams and Horowitz (1996) conducted a meta-analysis revision and suggested an overall prevalence rate for late life personality disorders of 20%, suggesting a higher rate of maladaptive personality functioning within the aging community than in the rest of the population. Across studies, as Kenan and colleagues (2000), Kunik and colleagues (1994), Morse and Lynch (2004), and Vine and Steingart (1994) researched, the most frequently diagnosed disorders in the elderly were paranoid, self-defeating, and schizoid. Other researchers report that the highest prevalence may be in clusters A, C, or both disorders, the most commonly diagnosed in late life, as data of Morse and Lynch (2004) suggested. The DSM-IV states that some types of personality disorder (e.g., antisocial and borderline personality disorders) tend to become less evident or to remit with age, whereas this appears to be less true for some other types (e.g., obsessive–compulsive; Morse & Lynch, 2004; Weissman & dLevine, 2007). Further complicating estimates of the prevalence of personality disorders in late life is the high comorbidity between depressive disorders and personality disorders in elderly samples (Kunik et al., 1994; Molinari & Marmion, 1993; Thompson, Futterman, & Gallagher, 1988). Also, Dolan-Sewell, Krueger, and Shea (2001) stated that personality disorders might provide a risk factor for late-life major depression, consistent with the findings obtained in mixed-age samples. A greater percentage of elderly major depressives with personality disorders than patients with other mental disorders are also reported (Kunik et al., 1994). Elderly people with a diagnosis of major depression have more personality disorders than “normal” elderly people, especially in cluster C (Abrams, Alexopoulos, & Young, 1987; Oltmanns & Balsis, 2011). For Widiger and Seidlitz (2002) the study of the importance of personality on psychopathology and aging must then include the study of DSM-IV personality disorders. The DSM-IV personality disorders reflect the categorical perspective that personality disorders are qualitatively distinct clinical syndromes. An alternative approach to studying personality and psychopathology is considering maladaptive personality traits in a dimensional perspective, and studying maladaptive traits within the general population, including the aged population, which is of considerable social and clinical significance (Blatt & Luyten, 2009; Widiger & Seidlitz, 2002). Arguably the most commonly used model of normal-range personality traits is the Five-Factor Model (FFM) (Widiger, Trull, Clarkin, Sanderson, & Costa, 2002). The FFM describes five broad domains that capture individual differences in personality: neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness. Personality traits, considered within the systems of the DSM, and general personality functioning could be quite useful in developing a more integrative understanding of the processes by which personality dispositions lead to either a resilience or vulnerability to

Traits and Personality Disorders in Older Women

1307

psychopathology (Widiger & Seidlitz, 2002). There is also a considerable amount of research to indicate that the DSM-IV personality disorders can be readily understood as maladaptive variants of the personality traits included within the FFM (Widiger, 2005). In general terms, Terracianno, McCrae, Brant, and Costa (2005) summarize that a decline in neuroticism exists up to the age of 80, a stability and subsequent decline in extraversion, a decline in openness to experience, elevation in agreeableness, and elevation in conscientiousness up to age 70. Also Weiss and colleagues (2005) demonstrated that age was negatively related to neuroticism and openness to experience, and positively related to agreeableness; women had significantly higher neuroticism, openness to experience, and agreeableness scores. Also, personality traits have been shown to play a significant and meaningful role in the development of a variety of medical disorders (Contrada, Gather, & O’Leary, 1999). Elevated neuroticism appears to be characteristic of most personality disorders and is the primary marker for a degree of a personality dysfunction (McCrae & Costa, 1986; Widiger & Trull, 1992; Widiger, Verheul, & van den Brink, 1999). Moreover, in older age, neuroticism is associated with the recurrence of depression, and efforts to prevent recurrence of late-life depression should focus on those with high levels of neuroticism (Steunenberg, Braam, Beekman, Deeg, & Kerkhof, 2009). Widiger and Costa (1994) and Widiger and colleagues (2002) indicate that neuroticism plays a prominent role in the explanation of several aspects of personality disorder, as it relates positively to most, if not all, personality disorders (with the exception of antisocial). By contrast, openness appears to have lesser importance (Schroeder, Wormworth, & Livesley, 2002; Trull, Widiger, & Burr, 2001). Many studies have verified that FFM agreeableness is associated with dependent personality disorder, and conscientiousness is associated with obsessive–compulsive disorder (Blais, 1997; Costa & McCrae, 1990; Dyce & O’Connor, 1998; Wiggins & Pincus, 1989). The results provide support for the perspective that personality psychopathology can be captured by general personality dimensions. The FFM has the potential to provide a valid and scientifically sound framework in a way that covers most of the domains conceptualized in DSM (Bagby, Sellbom, Costa, & Widiger, 2008). Thus the aim of researchers in this study was to explore the relationship between the FFM domains and Axis II personality disorders (DSM-IV ) in a sample of aging women, considering the differences between normal development and psychopathology.

METHOD Participants An urban convenience nonclinical sample of 90 aging women, ranging in age from 60 to 89 years (M = 72.29 years, SD = 7.10), participated in the

1308

J. Henriques-Calado et al.

study. All the participants were of Caucasian ethnicity and their education level ranged from 4 to 19 years of schooling (M = 10.56 years, SD = 5.03). They had an average of two children. With regard to marital status, 10% were single, 48.9% married, 33.3% widowed, and 7.8% divorced.

Measures The NEO-Five Factor Inventory (NEO-FFI). The NEO-FFI (Costa & McCrae, 1992) is a self-report version of the NEO Personality Inventory (NEO PI-R), which operationalizes the FFM. The NEO-FFI contains 60 statements that participants were asked to respond to on a 5-point Likert scale ranging from 0 (strongly disagree) to 4 (strongly agree). The NEO-FFI yields scores for the following personality constructs: neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness. Each scale consists of 12 items, which were all scaled in such a way so that higher scores indicate higher values in the direction consistent with the construct label. In the present study the Cronbach alphas were .69 for neuroticism, .58 for extraversion, .63 for openness to experience, .51 for agreeableness, and .80 for conscientiousness. The Personality Diagnostic Questionnaire (PDQ–4+). The PDQ–4+ (Hyler, 1994) is a 99-item self-report measure of DSM-IV , Axis II Personality Disorders criteria, on which items are answered using a yes/no response format. Personality disorder (PD) symptom counts are computed by summing the items endorsed for each PD. Widiger and Coker (2002) suggest that the PDQ–4+ is one of the most commonly used self-report measures of PD symptoms. It is the measure that is most directly coordinated with the DSM-IV personality disorder diagnostic criteria (Widiger & Coker, 2002). The PDQ–4+ also appears to serve reasonably well as a screening instrument in that it does not miss many valid PD diagnoses, despite the fact that it has a high false positive rate (Davison, Leese, & Taylor, 2001; Hyler, 1994). Ten personality disorders are included in DSM-IV (American Psychiatric Association [APA], 2000) organized within three clusters of similar symptomatology: (a) odd or eccentric cluster (paranoid, schizoid, schizotypal); (b) dramatic or emotional (antisocial, borderline, narcissistic, histrionic); and (c) anxious or fearful (avoidant, dependent, obsessive–compulsive). In the present study, the Cronbach alphas have an average of approximately .60, which is in convergence with the general data about this instrument (Bagby & Farvolden, 2004). The factorial validity also replicated the DSM-IV three clusters.

Procedure Participants were informally contacted by trained undergraduate and graduate research assistants and volunteered to participate and gave informed

Traits and Personality Disorders in Older Women

1309

consent. Participants were asked to complete a package of questionnaires that included the NEO-FFI, PDQ–4+, and a sociodemographic questionnaire. All protocols were self-administered, and instructions were presented in written form.

RESULTS In Table 1 we report zero-order Pearson correlations between NEO-FFI domains, PDQ–4+ scales, age and education. The correlations between NEOFFI domains were as expected and referred by Costa and McCrae (1992), and the correlations between PDQ–4+ scales were in accordance with Davison and colleagues (2001) and Hyler (1994). Age was significantly correlated with paranoid and dependent scales, and negatively with openness to experience. Education was significantly correlated with openness to experience and negatively correlated with all PDQ–4+ scales, with the exception of the obsessive–compulsive scale. Age and education correlated negatively. In Table 2 is shown the prevalence of personality disorders in the 90 participants. One may see a higher rate of maladaptive personality functioning in this aging community, a high comorbidity between diagnoses, and the highest prevalence of A and C personality disorder clusters, especially of obsessive–compulsive personality disorder. The personality traits characterizing the group with personality disorders were analyzed to the detriment of the group that did not evidence psychopathological diagnoses. In Table 3 the results obtained by the Mann-Whitney U statistic are presented, testing differences between the personality disorder group (PDG) and the nonpersonality disorder group (NPDG). Some personality disorders, such paranoid, schizoid, schizotypal, avoidant, and narcissistic, show a differentiated pattern of FFM domains. Also, elevated neuroticism, decreased agreeableness, and decreased openness to experience appear as valuable traits in the description of personality disorders.

DISCUSSION The study of maladaptive personality functioning within an aging population can be described with the same traits that underlie normal personality functioning (Tackett et al., 2009; Widiger, 2005; Widiger & Seidlitz, 2002). Some of the personality disorders scales show a differentiated pattern of the FFM domains, with the exception of histrionic (high neuroticism), borderline, and obsessive–compulsive (high neuroticism, low agreeableness), and Dependent (high neuroticism, low openness to experience) personality disorder scales. A high prevalence of obsessive–compulsive, paranoid, avoidant, schizotypal, and Schizoid personality disorders were observed in the sample of these women. Similarly, high comorbidity was observed among

1310

Note: ∗ p < .05.

∗∗ p

∗∗∗ p

1.00 −.33∗∗∗ −.22∗ −.24∗ −.30∗∗ .28∗∗ .23∗ .16 .40∗∗∗ .32∗∗∗ .60∗∗∗ .07 .53∗∗∗ .46∗∗∗ .32∗∗∗ .05 −.15

1

< .01.

1. Neuroticism 2. Extraversion 3. Openness 4. Agreeableness 5.Conscientiousness 6. Paranoid 7. Schizoid 8. Schizotypal 9. Histrionic 10. Narcissistic 11. Borderline 12. Antisocial 13. Avoidant 14. Dependent 15. Obsessive 16. Age 17. Education

Variables

< .001.

1.00 .15 .15 .33∗∗ −.01 −.14 −.05 −.07 .06 −.15 .20 −.31∗∗ −.22∗ −.12 −.11 .05

2

1.00 −.05 .24∗∗ .02 −.25∗∗ −.06 −.19 −.12 −.05 −.01 −.22∗ −.30∗∗∗ −.13 −.26∗∗ .40∗∗∗

3

1.00 .30∗∗∗ −.28∗∗ −.22∗ −.31∗∗∗ −.35∗∗∗ −.36∗∗ −.24∗∗ −.25∗∗ −.17 −.22∗ −.31∗∗∗ −.04 .03

4

6

7

8

9

10

11

12

13

14

15

16

17

1.00 .24∗∗ 1.00 .03 .36∗∗∗ 1.00 .24∗ .54∗∗∗ .60∗∗∗ 1.00 .01 .36∗∗∗ .25∗∗ .23∗ 1.00 −.19 .46∗∗∗ .42∗∗ 56∗∗∗ .48∗∗∗ 1.00 .06 .49∗∗∗ .29∗∗ .40∗∗∗ .49∗∗∗ .54∗∗∗ 1.00 .01 .40∗∗∗ .25∗∗ .52∗∗∗ .30∗∗ .53∗∗∗ .44∗∗∗ 1.00 −.15 .30∗∗∗ .29∗∗ .23∗∗ .46∗∗∗ .50∗∗∗ .61∗∗∗ −.26∗∗ 1.00 −.27∗∗ .26∗∗ .23∗ .12 .48∗∗∗ .39∗∗∗ .38∗∗∗ .20 .52∗∗∗ 1.00 .15 .40∗∗∗ .56∗∗∗ .48∗∗∗ .40∗∗∗ .34∗∗∗ .26∗∗ .26∗∗ .40∗∗∗ −.26∗∗ 1.00 −.19 .08 .21∗ .02 .15 .13 .15 .05 .11 .22∗ .16 1.00 −.06 −.21∗ −.23∗ −.24∗∗ −.26∗∗ −.39∗∗∗ −.30∗∗∗ −.21∗ −.29∗∗∗ −.25∗∗ −.06 −.28∗∗ 1.00

5

TABLE 1 Pearson Correlations (Z-Scored) Among Study Variables

Traits and Personality Disorders in Older Women

1311

TABLE 2 Descriptive Statistics and Prevalence of Personality Disorders Variables

f

%

M

Cluster A Cluster B Cluster C Paranoid Schizoid Schizotypal Histrionic Narcissistic Borderline Antisocial Avoidant Dependent Obsessive

– – – 33 23 27 5 8 13 3 33 8 43

42.34 14.80 42.86 36.70 25.60 30.00 5.60 8.90 14.40 3.30 36.70 8.90 47.80

– – – 4.94 4.96 5.78 5.00 3.50 6.00 3.00 5.06 5.38 4.80

SD – – –

.90 .77 .80

– 1.78 1.16 – 1.06 .74 1.10

TABLE 3 Results of Mann–Whitney U-Test With p-Values Variables Paranoid N A C Schizoid N O A Schizotypal A Borderline N A Histrionic N Narcissistic C Avoidant N E Dependent N O Obsessive N A

PDG Mean rank

NPDG Mean rank

U

Z

58.45 36.79 52.82

38.00 54.54 41.26

513.00∗∗∗ 653.00∗∗ 699.00∗

−3.58 −2.42 −2.03

59.26 36.20 35.24

40.78 48.69 49.02

454.00∗∗∗ 556.50∗ 534.50∗∗

−2.93 −1.98 −2.19

33.13

50.80

516.50∗∗∗

−2.95

76.29 32.13

40.76 47.56

98.50∗∗∗ 307.50∗

−4.39 −1.91

69.10

44.11

94.50∗

−2.08

64.25

43.67

178.00∗

−2.13

58.58 35.94

38.28 50.78

509.50∗∗∗ 622.00∗∗

−3.53 −2.59

69.63 20.44

43.15 47.95

135.00∗∗∗ 127.50∗∗∗

−2.74 −2.85

52.51 39.07

39.09 51.38

709.00∗∗ 734.00∗∗

−2.44 −2.24

Note. ∗ p < .05. ∗∗ p < .01. ∗∗∗ p < .001. N = Neuroticism, E = Extraversion, O = Openness to Experience, A = Agreeableness, C = Conscientiousness.

1312

J. Henriques-Calado et al.

those diagnosed. These results are in agreement with Abrams and Horowitz (1996), Molinari and Marmion (1993), and Thompson and colleagues (1988), suggesting a higher rate of maladaptive personality functioning within the aging community. These findings are also congruent with those of Morse and Lynch (2004), Kenan and colleagues (2000), Kunik and colleagues (1994) and Vine and Steingart (1994), concerning the highest prevalence in A, C, or both personality disorder clusters, such as those most commonly diagnosed in late life. Otherwise, some types of personality disorders (e.g., antisocial, histrionic, narcissistic, and borderline) that tend to become less evident or diminish with age were observed, whereas this appears to be less true for some other types (e.g., obsessive–compulsive, paranoid, avoidant; Abrams et al., 1987; Morse & Lynch, 2004; Oltmanns & Balsis, 2011). In this study, paranoid personality disorder was characterized by high neuroticism and low agreeableness, as expected by Widiger and colleagues (2002) and was also related to schizoid, borderline, and obsessive–compulsive disorders. Decreased agreeableness characterized schizotypal disorder, and high neuroticism characterized histrionic, avoidant, and dependent personality disorders. It is known that high neuroticism appears to be characteristic of most personality disorders, and it is more inherently related to dysfunction than any of the other four factors (McCrae & Costa, 1986). Neuroticism may itself prove to be the primary marker for a degree of personality dysfunction, indicating the vulnerability that is inherent to a personality disorder, in this study this being the case perhaps with both narcissistic and antisocial, but also with schizotypal disorder. These findings are in accordance with the Widiger and Trull (1992) research. Other researchers, such as Finch and Graziano (2001), however, had suggested that neuroticism is a risk factor rather than an invariant predictor of such psychopathological experiences. It has been advocated that higher levels of agreeableness might mitigate some of these negative symptoms and outcomes (Ode & Robinson, 2009; Ode, Robinson, & Wilkowski, 2008). agreeableness is another trait of the FFM that may be important in understanding symptoms characteristic of emotional disorders; it may be that high levels of Agreeableness are generally protective among individuals otherwise predisposed to negative emotions and outcomes. Agreeableness moderates neuroticism-linked tendencies toward depressive symptoms, showing that the relationship between neuroticism and depressive symptoms were stronger among individuals low in agreeableness, and tendencies toward negative affective priming were especially pronounced among individuals high in neuroticism and low in agreeableness. According to Ode and Robinson (2009), agreeableness is associated with intrapsychic abilities for regulating negative affective states, and this suggestion is consistent with prior data and developmental literature. Agreeableness may be an important trait to assess within clinical contexts, but also in relation to high levels of neuroticism in personality disorders (Widiger et al., 1999). It appears that

Traits and Personality Disorders in Older Women

1313

in this sample of aging women, the neuroticism (high) trait and, the neuroticism (high)/agreeableness (low) domains play an important role, also keeping consistent with anterior data. In this study, the conscientiousness (high) trait characterizes the paranoid disorder, the openness to experience (low) relates to schizoid, dependent, and obsessive–compulsive disorders, and the extraversion (low) trait relates to avoidant disorder. Research data on the expectations in normal development within the domains of the FFM in an aging population must be kept in mind, however, recalling Tackett and colleagues (2009) and, Widiger and Seidlitz (2002). A decline in neuroticism exists up to the age of 80, together with stability and a posterior decline in extraversion, a decline in Openness to experience, elevation in agreeableness, and elevation in conscientiousness up to age 70 (Terraccianno et al., 2005). Also Weiss and colleagues (2005) have demonstrated that age is negatively related to neuroticism and openness to experience, and it is positively related to agreeableness. This study presents some convergent results: age is negatively related with openness to experience and positively related to schizoid and dependent personality disorders. Education is also related to positive openness to experience, which should mitigate or act as a protective factor in the expression of personality disorders (see Table 1). We suggest that some elevations or decreases in some traits are to be expected from a developmental and social perspective. These personality traits must be viewed not as maladaptive traits, per se, but as normal/expected traits that perhaps may improve the specificity of the relationship with maladaptive traits. It must be noted that this aging women sample, even with personality disorders, revealed some adaptive traits, education having, probably, played an important role. In this way, this maladaptive personality functioning, within an aging population, must have some kind of link between personality development in mental health and disorder. As an orientation to further research on aging and mental health, we suggest that personality traits should be considered as important elements of vulnerability in personality disorders functioning. Age and education should be taken as covariates as they may have clinical implications as far as prevention is concerned.

REFERENCES Abrams, R. C., Alexopoulos, G. S., & Young, R. C. (1987). Geriatric depression and DSM-III-R personality disorder criteria. Journal of the American Geriatrics Society, 35, 383–386. Abrams, R. C., & Horowitz, S. V. (1996). Personality disorders after age 50: A metaanalysis. Journal of Personality Disorders, 10, 271–281.

1314

J. Henriques-Calado et al.

American Psychiatric Association (APA). (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author. Bagby, R. M., & Farvolden, P. (2004). The Personality Diagnostic Questionnaire-4+ (PDQ-4+). In M. J. Hilsenroth, D. L. Segal, & M. Hersen (Eds.), Comprehensive handbook of psychological assessment, Volume 2. Personality assessment (pp. 122–133). New York: John Wiley. Bagby, R. M., Sellbom, M., Costa, P. R., & Widiger, T. A. (2008). Predicting diagnostic and statistical manual of mental disorders-IV personality disorders with the five-factor model of personality and the personality psychopathology five. Personality and Mental Health, 2(2), 55–69. Blais, M. A. (1997). Clinician ratings of the five-factor model of personality and the DSM-IV personality disorders. Journal of Nervous and Mental Disease, 185, 388–393. Blatt, S. J., & Luyten, P. (2009). A structural-developmental psychodynamic approach to psychopathology: Two polarities of experience across the life span. Development and Psychopathology, 21, 793–814. Contrada, R. J., Gather, C., & O’Leary, A. (1999). Personality and health: Dispositions and processes in disease susceptibility and adaptation to illness. In L. A. Pervin & O. P. John (Eds.), Handbook of personality: Theory and research (pp. 576–604). New York, NY: Guilford Press. Costa, P. T., & McCrae, R. R. (1990). Personality disorders and the five-factor model of personality. Journal of Personality Disorders, 4, 362–371. Costa, P. T., & McCrae, R. R. (1992). NEO PI-R professional manual. Odessa, FL: Psychological Assessment Resources. Davison, S., Leese, M., & Taylor, P. J. (2001). Examination of the screening properties of the personality diagnostic questionnaire 4+ (PDQ-4+) in a prison population. Journal of Personality Disorders, 15, 180–194. Dolan-Sewell, R. T., Krueger, R. F., & Shea, M. T. (2001). Co-occurrence with syndrome disorders. In W. J. Livesley (Ed.), Handbook of personality disorders: Theory, research and treatment (pp. 84–104). New York, NY: Guilford. Dyce, J. A., & O’Connor, B. P. (1998). Personality disorders and the five-factor model: A test of facet-level predictions. Journal of Personality Disorders, 12(1), 31–45. Finch, J. F., & Graziano, W. G. (2001). Predicting depression from temperament, personality, and patterns of social relations. Journal of Personality, 69(1), 27–55. Hyler, S. E. (1994). The personality diagnostic questionnaire. New York, NY: New York State Psychiatric Institute. Kenan, M. M., Kendjelic, E. M., Molinari, V. A., Williams, W., Norris, M., & Kunik, M. E. (2000). Age-related differences in the frequency of personality disorders among inpatient veterans. International Journal of Geriatric Psychiatry, 15, 831–837. Kunik, M. E., Mulsant, B. H., Rifai, A. H., Sweet, R. A., Pasternak, R., & Zubenko, G. S. (1994). Diagnostic rate of comorbid personality disorder in elderly psychiatric inpatients. American Journal of Psychiatry, 151, 603–605. Livesley, J. W. (2001). Handbook of personality disorders. New York, NY: Guilford. Lynam, D. R., & Widiger, T. A. (2001). Using the five-factor model to represent the DSM-IV personality disorders: An expert consensus approach. Journal of Abnormal Psychology, 110, 401–412.

Traits and Personality Disorders in Older Women

1315

Malatesta, V. J. (2007). Introduction: The need to address older women’s mental health issues. Journal of Women & Aging, 19(1–2), 1–12. McCrae, R. R., & Costa, E T. (1986). Personality coping, and coping effectiveness in an adult sample. Journal of Personality, 54, 385–405. Molinari, V., & Marmion, J. (1993). Personality disorders in geropsychiatric outpatients. Psychological Reports, 73(1), 256–258. Morse, J. Q., & Lynch, T. R. (2004). A preliminary investigation of self-reported personality disorders in late life: Prevalence, predictors of depressive severity, and clinical correlates. Aging & Mental Health, 8, 307–315. Ode, S., & Robinson, M. D. (2009). Can agreeableness turn gray skies blue?: A role for agreeableness in moderating neuroticism-linked dysphoria. Journal of Social & Clinical Psychology, 28, 436–462. Ode, S., Robinson, M. D., & Wilkowski, B. M. (2008). Can one’s temper be cooled?: A role for agreeableness in moderating neuroticism’s influence on anger and aggression. Journal of Research in Personality, 42, 295–311. Oltmanns, T. F., & Balsis, S. (2011). Personality disorders in later life: Questions about the measurement, course, and impact of disorders. Annual Review of Clinical Psychology, 7, 321–349. Samuel, D. B., & Widiger, T. A. (2004). Clinicians’ personality descriptions of prototypic personality disorders. Journal of Personality Disorders, 18, 286–308. Schroeder, M. L., Wormworth, J. A., & Livesley, W. (2002). Dimensions of personality disorder and the five-factor model of personality. In P. R. Costa & T. A. Widiger (Eds.), Personality disorders and the five-factor model of personality (pp. 149–160). Washington, DC: American Psychological Association. Steunenberg, B., Braam, A. W., Beekman, A. F., Deeg, D. H., & Kerkhof, A. M. (2009). Evidence for an association of the big five personality factors with recurrence of depressive symptoms in later life. International Journal of Geriatric Psychiatry, 24, 1470–1477. Tackett, J. L., Balsis, S., Oltmanns, T. F., & Krueger, R. F. (2009). 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. Development & Psychopathology, 21, 687–713. Terracciano, A., McCrae, R. R., Brant, L. J., & Costa, P. T. (2005). Hierarchical linear modeling analyses of NEO-PI-R scales in the Baltimore longitudinal study of aging. Psychology and Aging, 20, 493–506. Thompson, L.W., Futterman, A., & Gallagher, D. (1988). Assessment of late life depression. Psychopharmacology Bulletin, 24, 577–587. Trull, T. J., Widiger, T. A., & Burr, R. (2001). A structured interview for the assessment of the five-factor model of personality: Facet-level relations to the axis II personality disorders. Journal of Personality, 69, 175–198. Vine, R. G., & Steingart, A. B. (1994). Personality disorder in the elderly depressed. Canadian Journal of Psychiatry, 39, 392–398. Weiss, A., Costa, P. T., Karuza, J., Duberstein, P. R., Friedman, B., & McCrae, R. R. (2005). Cross-sectional age differences in personality among medicare patients aged 65 to 100. Psychology and Aging, 20, 182–185. Weissman, J., & dLevine, S. (2007). Anxiety disorders and older women. Journal of Women & Aging, 19(1–2), 79–101.

1316

J. Henriques-Calado et al.

Widiger, T. A. (2005). A dimensional model of psychopathology. Psychopathology, 38, 211–214. Widiger, T. A., & Coker, L. (2002). Assessing personality disorders. In J. N. Butcher & J. N. Butcher (Eds.), Clinical personality assessment: Practical approaches (pp. 407–434). New York, NY: Oxford University Press. Widiger, T. A., & Costa, P. R. (1994). Personality and personality disorders. Journal of Abnormal Psychology, 103(1), 78–91. Widiger, T. A., & Seidlitz, L. (2002). Personality, psychopathology, and aging. Journal of Research in Personality, 36, 335–362. Widiger, T. A., & Trull, T. J. (1992). Personality and psychopathology: An application of the five-factor model. Journal of Personality, 60, 363–393. Widiger, T. A., Trull, T. J., Clarkin, J. F., Sanderson, C., & Costa, P. R. (2002). A description of the DSM-IV personality disorders with the five-factor model of personality. In P. R. Costa & T. A. Widiger (Eds.), Personality disorders and the five-factor model of personality (pp. 89–99). Washington, DC: American Psychological Association. Widiger, T. A., Verheul, R., & van den Brink, W. (1999). Personality and psychopathology. In L. A. Pervin, O. P. John, L. A. Pervin, & O. P. John (Eds.), Handbook of personality: Theory and research (2nd ed., pp. 347–366). New York, NY: Guilford. Wiggins, J. S., & Pincus, A. L. (1989). Conceptions of personality disorders and dimensions of personality. Psychological Assessment, 1, 305–316.

Copyright of Health Care for Women International is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.

Personality traits and personality disorders in older women: an explorative study between normal development and psychopathology.

The relationships between Axis II personality disorders (DSM-IV) and the Five-Factor Model (FFM) were explored in older women. The sample consists of ...
77KB Sizes 0 Downloads 0 Views