Stability of personality disorders across the life span and the contributing psychological factors of personality disorders in older adults with mental health problems
View/ Open
Reid2015.docx (1.035Mb)
Date
27/11/2015Author
Reid, Shonagh
Metadata
Abstract
Personality disorders (PD) are among the most complex aspects of human behaviour
to understand and manage. Stability is thought to be one of the major distinguishing
features between PD’s and other forms of psychopathology, however, recent studies
have challenged this notion. Borderline personality disorder (BPD) is the focus of
this review and is characterised by interpersonal and emotion regulation difficulties.
This thesis aimed to first examine the naturalistic course of BPD, through systematic
review of the current literature. Following screening, 12 studies, that met all
inclusion/exclusion criteria, were critically evaluated. The results, from studies rated
as methodologically sound, suggested that the categorical diagnosis of BPD has poor
stability over time, with only 3%-35% of participants retaining a diagnosis of BPD
over time. However, the studies reviewed were limited by the population they
examined: mainly working age adults with mental health problems. Therefore,
studies need to be continued and replicated to increase our understanding of the lifespan
course of BPD.
PD’s within older adults with mental health problems is a highly debated topic.
Clinicians have highlighted the presence of PD symptoms within this group and the
need for appropriate therapies. Schema therapy is one intervention that has shown to
be effective in the treatment of PD symptoms within a working adult population. A
recent Delphi-study led to the consensus that existing therapies for PD, such as
schema therapy, that have shown to be effective in working aged adults are
applicable to older adults. Therefore, the empirical project focused on exploring the
theoretical underpinnings of schema therapy in older adults with mental health
problems. 3 self-report questionnaires were administered to 62 participants (aged 65-
85 years); Young’s Schema Questionnaire – Short Form (YSQ-S3), Coolidge Axis-II
Inventory (Short) (SCATI-II) and The Regulation of Emotions Questionnaire (REQ-
2). Analysis highlighted that YSQ-S3 and REQ-2 scores significantly predicted 69%
of the variance in SCATI-II scores. To the author’s knowledge, this study is the first
of its kind to find support for the relationships between early maladaptive schemas
(EMS), PD symptoms and the use of dysfunctional emotion regulation (ER)
strategies, consistent with the schema therapy model, in older adults with mental
health problems.