OBJECTIVE: Personality disorders are a major mental health problem, but
little information about their etiology and natural history is available.
This study examined continuities between axis I disorders in adolescents
and personality disorders in young adults. METHOD: The authors interviewed
145 young adults (mean age, 19.6 years) who had been diagnosed with a
variety of DSM-III emotional and disruptive disorders during adolescence
(mean age, 13.7 years). The Personality Disorder Examination was used to
establish whether the subjects currently suffered from personality
disorders. RESULTS: Subjects who had had disruptive disorders during
adolescence showed high rates of all types of personality disorders (40%
had a personality disorder at follow-up), while subjects who had had
emotional disorders had a lower rate of personality disorders (12%). Men
were more likely to have cluster A personality disorders, and women were
more likely to have cluster C personality disorders. Disruptive diagnoses
were associated with cluster B personality disorders, but emotional
disorders did not show an association with cluster C personality disorders.
Oppositional disorder did not increase the likelihood of passive-aggressive
personality disorder. There was an association between attention deficit
disorder with hyperactivity and borderline personality disorder.
CONCLUSIONS: The rate of personality disorders was lower among young adults
who had had emotional disorders during adolescence than among those who had
had disruptive disorders, suggesting either that treatment for emotional
disorders is more effective or that the personality psychopathology in
these adolescents is not as severe as that in adolescents with disruptive