Personality Disorders in Later Life
- S.P.J. van AlphenS.P.J. van AlphenFaculty of Psychology and Educational Sciences, Vrije Universiteit Brussel; Clinical Center of Excellence for Older Adults with Personality Disorders, Mondriaan Hospital
- and S.M.J. Heijnen-KohlS.M.J. Heijnen-KohlDepartment of Old Age Psychiatry, Mondriaan Hospital
Personality disorders severely impact a person’s functioning in many ways. Although a person may have found ways to cope throughout life, at an older age underlying dysfunctional patterns can emerge and cause much distress both for the person and those around them. Why normal personality traits shift to abnormality is not easily understood. In literature there are many theories with different definitions. In this chapter a few of the prominent theories on the description of personality will be discussed. For example, some psychologists have described personality as a complex pattern that is deeply tied to psychological characteristics that are largely unaware, hard to wipe out, and expressed in all aspects of functioning. Other psychologists define personality as individual differences in the tendency to display consistent patterns of thoughts, feelings, and behaviors. The American Psychiatric Association (2013) defines personality traits as enduring patterns in the way someone perceives, relates to, and thinks about the environment and oneself and that these patterns are exhibited in a wide range of social and personal context. These definitions of personality are all concerned with unique and stable characteristics in different situations. These theories are not age-specific, but age-related changes and differences in manifestations do occur. This complicates diagnosis as measurements for older adults have barely been developed or validated. The feasibility of measurements and various information sources will be addressed. Descriptions and diagnosis have the ability to enhance treatment for patients with personality disorders. Known treatment forms have successfully been applied to older adults as well and differing treatment levels will be distinguished. Treatment of first choice can be aimed at changing personality characteristics or enhancing adaptation, but in some cases supportive treatment is the best fit. In clinical practice a variety of possible interventions is needed to provide the best care for different manifestations of personality disorders.