Coordinating Author Information: Lisa E. Stone, MA | University of Colorado- Colorado Springs
Session Abstract: Introduction: The Alternative Model of Personality Disorders (AMPD) was included in Section III of DSM-5 with the intention of promoting research on a novel dimensional approach to PD conceptualization. Research on the AMPD among older adults is limited, but preliminary evidence suggests that the unique biopsychosocial context of later life may lead to unique patterns of presentation under the AMPD (Stone & Segal, 2021). Additional research is needed to determine specific later life contexts that lead to such unique patterns. Changes in perceived health status may be one such context that affects presentation according to the AMPD. This study examined overlap between perceived health status and the AMPD’s two constructs (personality functioning and pathological personality traits) among older adults.
Method: Older adults (N = 222; M age = 66.6 years) completed the Levels of Personality Functioning Scale-Self-Report (LPFS-SR), Personality Inventory for DSM-5-Brief Form (PID-5-BF), and Short Form-36 Questionnaire (SF-36) with its eight domains of perceived health status: Physical Functioning, Role Limitations due to Physical Health, Role Limitations due to Emotional Health, Energy/Fatigue, Emotional Well-Being, Social Functioning, Pain, and General Health.
Results: Pearson correlations were computed between the eight SF-36 health scales with the LPFS-SR domains (Identity, Self-Direction, Empathy, and Intimacy) and PID-5-BF domains (Negative Affect, Detachment, Antagonism, Disinhibition, and Psychoticism). All eight health scales were significantly and negatively correlated with all four LPFS-SR domains (ranging from r = -.36 to -.69) and with all five PID-5-BF domains (ranging from -.23 to -.68). Next, to control for the interrelated nature of the health scales, multiple regressions were computed with the SF-36 scales predicting each of the LPFS-SR and PID-5 domains. The SF-36 scales accounted for significant variance in the LPFS-SR domains, with R2 ranging from .53 to .59. General Health, Social Functioning, and Role Limitations due to Emotional Health were significant negative predictors across all four LPFS-SR domains. The SF-36 scales also accounted for significant variance in the PID-5-BF domains, with R2 ranging from .49 to .55. General Health, Social Functioning, Role Limitations due to Emotional Health, and Emotional Well-Being were significant negative predictors of all five PID-5-BF domains.
Discussion: Overall, there was significant overlap between older adults’ perceived health status and the AMPD’s two diagnostic constructs, with worse perceived health associated with increased PD pathology. Greater correlational overlap was detected among this sample of older adults than in previous research among younger adults (Nelson et al., 2018). Regression analyses indicate that older adults’ sense of their general physical health and their perceived affective distress had the strongest negative associations with the AMPD’s constructs. Findings could indicate: 1) personality pathology conceptualized by the AMPD leads to poorer health outcomes in later life, similar to prior literature among the categorical PDs (Cruitt & Oltmanns, 2018); or 2) health status could create artificial elevations in PD pathology under the AMPD. For example, changes in older adults’ identity related to changes in physical health could artificially lead to elevations in Identity in personality functioning. Additional research is needed to clarify possible explanations.
Lisa E. Stone, MA | University of Colorado- Colorado Springs
Daniel L. Segal, PhD | University of Colorado- Colorado Springs