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Am J Psychiatry 1996; 153:907-913
Copyright © 1996 by American Psychiatric Association
Childhood antecedents of adolescent personality disorders
DP Bernstein, P Cohen, A Skodol, S Bezirganian and JS Brook
Bronx Veterans Affairs Medical Center, Psychiatry Service, NY 10468, USA.
OBJECTIVE: The purpose of this study was to investigate the childhood
antecedents of personality disorders that are diagnosed in adolescence.
METHOD: A randomly selected community sample of 641 youths was assessed
initially in childhood and followed longitudinally over 10 years. Childhood
behavior ratings were based on maternal report; diagnoses of adolescent
personality disorders were based on data obtained from both maternal and
youth informants. Four composite measures of childhood behavior problems
were used: conduct problems, depressive symptoms, anxiety/fear, and
immaturity. Adolescent personality disorders were considered present only
if the disorders persisted over a 2-year period. For all analyses,
personality disorders were grouped into the three clusters (A, B, and C) of
DSM-III-R. RESULTS: Logistic regression analyses indicated that all four of
the putative childhood antecedents were associated with greater odds of an
adolescent personality disorder 10 years later. Childhood conduct problems
remained an independent predictor of personality disorders in all three
clusters, even when other childhood problems were included in the same
regression model. Additionally, depressive symptoms emerged as an
independent predictor of cluster A personality disorders in boys, while
immaturity was an independent predictor of cluster B personality disorders
in girls. No moderating effects of age at time of childhood assessment were
found. CONCLUSIONS: These results support the view that personality
disorders can be traced to childhood emotional and behavioral disturbances
and suggest that these problems have both general and specific
relationships to adolescent personality functioning.
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