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The Longitudinal Study of Personality Disorders

Mark F. Lenzenweger, PhD

Arch Gen Psychiatry. 1999;56:1009-1015.

Background  There exists no empirical literature documenting the long-term longitudinal stability of personality pathology comparable to that available for normal personality. A number of test-retest studies have usefully established the short-term reliability of Axis II measures. However, the test-retest design is methodologically inadequate for resolving issues related to the long-term stability of personality disorder (PD). This prospective longitudinal study evaluated the stability of PD features in multiwave perspective.

Methods  Subjects (N=250) drawn from a nonclinical university population were examined for PD features at 3 different time points using the International Personality Disorders Examination (IPDE) and the Millon Clinical Multiaxial Inventory II (MCMI-II) during a study period of 4 years.

Results  Features of PD displayed considerable evidence of stability for individual differences and group means, at the dimensional level of analysis, on both the IPDE and the MCMI-II. Both measures revealed modest declines in PD features over time; however, the observed changes were associated with relatively small effect sizes.

Conclusion  Features of PD, viewed from a dimensional perspective, seem to be relatively stable in terms of individual differences and group means based on both clinical interview and self-administered PD assessments.

From the Department of Psychology, Harvard University, Cambridge, Mass.