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Abstract
Previous research suggests that personality disorders, particularly in clusters A and C, persist into late life, are particularly prevalent in late-life depressed samples, and negatively impact treatment of late-life depression. The present study examined the self-reported personality disorder traits of a sample of 65 depressed elders using the Wisconsin Personality Disorder Inventory IV (WISPI IV). As expected, clusters A and C were most prevalent and the presence of a personality disorder predicted the maintenance or re-emergence of depressive symptoms, as did hopelessness and ambivalence regarding emotional expression. No specific personality disorder traits were associated with clinical features of late-life depression (age of onset, number of previous episodes) while some personality disorder traits were associated with psychological correlates of depression (hopelessness, ambivalence regarding emotional expression, thought suppression). A theoretical explanation for the cluster prevalence based on self-verification is discussed along with a profile of elderly patients who may have poor depression treatment course if they exhibit personality disorder traits, particularly interpersonal rigidity or avoidance, chronic hopelessness, and emotional inhibition.
Acknowledgements
This research was supported by the Duke Mental Health Clinical Research Center, which was performed pursuant to NIMH grant P50 MH60451 and RO1 MH54846 and manuscript preparation was supported by grant NIMH K23 MH01614 to Thomas R. Lynch. Manuscript preparation by Dr. Morse was supported by a postdoctoral training fellowship from NIMH grant T32 MH 18269, Clinical Research Training for Psychologists (PI: Paul A. Pilkonis, PhD). We would like to thank Paul Pilkonis for his helpful comments on earlier drafts of this manuscript and Mai El-Khoury and David Rak for their invaluable help in data collection.