The authors examine DSM-III personality disorders in a longitudinally
followed community sample of middle-aged inner city men. Eighty-six (23%)
of the subjects received an axis II diagnosis of personality disorder.
Although these men received relatively little psychiatric attention, they
were severely impaired in terms of how they felt about themselves, how
others saw their global mental health, and their ability to work and to
love. When the strong overlap with alcoholism was controlled for,
personality disorder was clearly related to adaptive problems that
manifested by early adolescence. The evidence suggests that early
deficiencies of biology, environmental support, and ego strength contribute
to the development of personality disorder.