Developmentally sensitive markers of personality functioning in adolescents: Age-specific and age-neutral expressions.

Abstract

Criterion D of the (5th ed.;; American Psychiatric Association [APA], 2013) refers to a possible onset of personality disorders (PDs) in adolescence and in Section II the development/course in adolescence is described by some typical characteristics for several PDs. Yet, age-specific expressions of PDs are lacking in Section III. We urgently need a developmentally sensitive assessment instrument that differentiates developmental and contextual changes on the one hand from expressions of personality pathology on the other hand. Therefore we investigated which items of the Severity Indices for Personality Problems-118 (SIPP-118) were developmentally sensitive throughout adolescence and adulthood and which could be considered more age-specific markers requiring other content or thresholds over age groups. Applying item response theory (IRT) we detected differential item functioning (DIF) in 36% of the items in matched samples of 639 adolescents versus 639 adults. The DIF across age groups mainly reflected a different degree of symptom expressions for the same underlying level of functioning. The threshold for exhibiting symptoms given a certain degree of personality dysfunction was lower in adolescence for areas of personality functioning related to the Self and Interpersonal domains. Some items also measured a latent construct of personality functioning differently across adolescents and adults. This suggests that several facets of the SIPP-118 do not solely measure aspects of personality pathology in adolescents, but likely include more developmental issues. (PsycINFO Database Record

Empirical typology of adolescent personality organization

“…However, future research is needed to empirically translate the relevance of this model in useful assessment instruments that are adapted to adolescents, and further testing of the IPO‐A's relevance in adolescence is needed. As Debast, Rossi, Feenstra, and Hutsebaut (2017) have recently suggested, a developmentally sensitive assessment instrument that is able to differentiate between adolescent normative changes and expressions of personality pathology, would be ideal. The IPO‐A may therefore require a closer examination and potential addition of items in the near future that would encompass a wider (and more specific) range of personality functioning in adolescents.…”

Managing borderline personality disorder from a life course perspective: Clinical staging and health management.

“…Furthermore, although normative “borderline-like” phenomena such as impulsive behaviors, identity issues, and mood swings seem to diminish throughout adolescence in healthy youth, the symptoms of BPD youngsters increase over time, leading to a more pronounced differentiation between healthy and disordered young people throughout adolescence (De Fruyt & De Clercq, 2014). There is evidence that BPD will increasingly affect social relationships, which might lead to reduced social learning and opportunities to benefit from a healthy peer environment (salutogenesis; Debast, Rossi, Feenstra, & Hutsebaut, 2017; Fonagy & Allison, 2014). BPD in young people is not only prevalent but also associated with higher levels of distress compared to adult BPD (Becker et al, 1999), leading Chanen and McCutcheon (2013) to argue that BPD is particularly a disorder of young people.…”

Assessing Criterion A in adolescents using the Semistructured Interview for Personality Functioning DSM–5.

“…Similarly, Criterion 1 of borderline PD (BPD) referring to “frantic efforts to avoid real or imagined abandonment” may typically apply to a late-adolescent- or adult-like expression of fear of abandonment. There is empirical evidence to suggest that current PD criteria are not completely age neutral, such that symptoms in the areas of affect dysregulation and impulse dyscontrol seem to manifest early in the course of the disorder, whereas symptoms of interpersonal disturbance only seem to be expressed later on (Debast, Rossi, Feenstra, & Hutsebaut, 2017; Sharp et al, 2015). These conjectures and observations call into question the validity of the current diagnostic criteria to detect PD expressions across the life span.…”