Longitudinal Trajectories of Personality Disorders: A Growth Mixture Modeling Analysis

Abstract

Among clinical and community samples, personality disorders (PDs) have been consistently reported to have negative effects throughout the lifespan. Although longitudinal studies have reported a general decline in PD symptoms, it is unclear whether there are subgroups of individuals with different PD trajectories from early adolescence to adulthood. This study aimed to examine this question in a large representative community sample and identify early childhood predictors of these varying trajectories. Longitudinal data collected across 20 years from participants in the Children in the Community (CIC) Study, a representative nonclinical cohort, were used. Trajectories of each PD cluster across four waves of assessments were estimated using growth mixture modeling. The extent to which early childhood risk factors were associated with latent class membership was examined. Two distinct trajectories were each identified for cluster A, B, and C PD symptoms from early adolescence into mid-adulthood. Most participants followed a trajectory of decreasing PD symptoms whereas a small proportion showed increases in PD symptoms over time. Individuals with depressive symptoms or a singleparent household in early childhood were more likely to be in the latent class with increasing PD symptoms across time. There is considerable heterogeneity in PD symptom trajectories over time among a large non-clinical sample in the community. Increases in PD symptoms in early adolescence may indicate elevated PD symptoms later in life. Findings highlight the need for early intervention and treatment to guide this subgroup of adolescents towards normative development and a reduction of PD symptoms.