Do Personality Disorders Change over the Lifetime?

This video answers the question: “Do personality disorders improve, worsen, or stay the same as people age?” When we talk about personality disorders and how they change over time, it's important to recognize that the prevalence of personality disorders in the general population is around 10-15%. This prevalence rate is stable across all of the age categories. We conceptualize personality disorders as extreme personality traits and we conceptualize personality traits as being relatively stable over time, so it would make sense to think of personality disorders as being stable over time. If an individual is diagnosed with a personality disorder in early adulthood, it wouldn't be surprising that they would still have symptoms when they are in middle age and older age. To understand the course of personality disorders, it's important to understand the onset of personality disorders as they're conceptualized in the Diagnostic and Statistical Manual (DSM). In the DSM there are ten personality disorders and for each of these ten personality disorders the symptoms would have had to been present before or during early adulthood. This means there is no such thing as a late onset personality disorder if we're going strictly by what's in the DSM. Then ten personality disorders are divided into three clusters: A, B, and C. Cluster A contains the odd, eccentric personality disorders: paranoid, schizoid, and schizotypal. Cluster B contains the dramatic, emotional, and erratic personality disorders: antisocial, borderline, narcissistic, and histrionic personality disorder. Cluster C is the anxious, fearful cluster: avoidant, dependent, and obsessive-compulsive personality disorder. When we look at the research that is available and we look at the progression of personality disorders over time, we know that for Cluster A personality disorders the prevalence tends to increase with age and the severity, frequency, and duration of the symptoms also tends to increase by a small amount. With Cluster B personality disorders the prevalence decreases with age and the symptom severity, frequency, and duration also decrease. With cluster C personality disorders, we see an increased prevalence with age and we see an increase and severity, frequency, and duration with age.