International Personality Disorder Examination Research Articles

Personality Traits as Predictors of Inpatient Aggression in a High-Security Forensic Psychiatric Setting: Prospective Evaluation of the PCL-R and IPDE Dimension Ratings

The Dangerous and Severe Personality Disorder (DSPD) initiative in England and Wales provides specialized care to high-risk offenders with mental disorders. This study investigated the predictive utility of personality traits, assessed using the Psychopathy Checklist-Revised (PCL-R) and the International Personality Disorder Examination, with 44 consecutive admissions to the DSPD unit at a high-security forensic psychiatric hospital. Incidents of interpersonal physical aggression (IPA) were observed for 39% of the sample over an average 1.5-year period following admission. Histrionic personality disorder (PD) predicted IPA, and Histrionic, Borderline, and Antisocial PDs all predicted repetitive (2+ incidents of) IPA. PCL-R Factor 1 and Facets 1 and 2 were also significant predictors of IPA. PCL-R Factor 1 and Histrionic PD scores were significantly associated with imminence of IPA. Results were discussed in terms of the utility of personality traits in risk assessment and treatment of specially selected high-risk forensic psychiatric patients in secure settings.

Estudio sobre aspectos etiológicos de la patología dual

It is important to assess the interaction between family psychopathologic history (FH), family dynamics (FD), behavior disorders, substance-use disorders and personality disorders (PD). Cross-sectional design. The sample was made up of 350 subjects with substance-use disorders who were assessed for FH including alcoholism and substance-use disorders through an interview; for substance use via a questionnaire; for FD; for PD using the International Personality Disorder Examination (IPDE); for behavior problems in adolescence; and for disocial disorder. Correlated variables were included in logistic regression models. Early age of onset for substance use is related to FH of substance use disorders and poorer FD. FH of alcoholism, substance-use disorders and psychiatric disorders are related to poorer FD. Early age of onset for substance use, FH and a disruptive FD are related to behavior problems and disocial disorder. Early age of onset for substance use, FH, disruptive FD, behavior problems and disocial disorder are related to presence of PD. Logistic regression predicted the presence of PD by age of onset for use of methadone (CI(95):1.005/3.222; p=0.048) and of other opiates (CI(95):0.864/0.992;p=0.028). FH score in alcoholism predicted Borderline Personality Disorder (CI(95):1.137- 2.942; p=0.013), and age of onset of cocaine use predicted Antisocial Personality Disorder (CI(95):0.864/0.992; p=0.028). FH of substance use and own use predict the presence of some PDs.

Familial aggregation of personality disorder: epidemiological evidence from high school students 18 years and older in Beijing, China

Background There has been evidence from Western countries of the familial aggregation of personality disorder (PD) in clinical populations. Nonetheless, it is not clear if the results apply to nonclinical population or non-Western countries. The aim of this study is to provide evidence about the familial aggregation of PD using an epidemiological sample of high school students and their parents in Beijing, China. Method A sample of high school students (at least 18 years old) and their parents was drawn by stratified cluster sampling. Personality disorder in students was assessed via a two-stage approach, Personality Diagnostic Questionnaire (PDQ) as a screening tool and International Personality Disorder Examination as the diagnostic tool. Parents completed the PDQ. Univariate and multivariate analyses were used to address the familial aggregation of PD. Results Students' PDQ scores were correlated with parents' PDQ scores. Parents of PD students scored higher in PDQ and were more likely to be PD cases than controls' parents (adjusted odds ratio, 6.4-18.8). Limitations Student controls and parents are only assessed by PDQ-4. Conclusion Obvious familial aggregation of PD was observed in this study. Psychiatrists may consider asking about family history when diagnosing PD.

P01-225 - Hospital admissions and personality pathology in adolescents with psychiatric disorders

The use of psychiatric services has been associated with a wide range of clinical variables. However, information about the impact of adolescent personality pathology related to hospital admissions is limited.ObjectiveTo analyze the different combination of personality pathology associated to variables of psychiatric hospital admissions (number of admissions, total of days spent as psychiatric inpatient, average of days for admission, and number of admissions in a day care hospital).MethodThe ICD-10 and DSM-IV modules of the semi-structured interview IPDE (International Personality Disorders Examination) were administered, in a sample of 107 adolescent psychiatric patients (M=15.8, SD=0.8 years old; age rank 15-17; 79% female).ResultsPersonality pathology group identified by the IPDE showed significantly higher number (p< .001) of psychiatric admissions (M=1.48) than no personality pathology group (M=0.57), but not significant higher number of admissions in a day care hospital. Psychotic patients showed the highest rate of admissions (M=2.88). In present sample, between 30% and 38% of all hospital admitted patients showed a Cluster B personality disorder (PD).The users of psychiatric inpatient services with a complex PD (two o more PD from different clusters) presents in average: 2-2.5 admissions, 34-53 total days spent as psychiatric inpatient, and 11-16 days on each admission.ConclusionPatients with psychotic disorders or complex PD were the highest users of inpatients services, but not of day care hospital admissions.

An overview of Indian research in personality disorders

Personality disorders have significant, but often unrealized, public health importance. The present review summarizes the published work on personality disorders in the Indian population or by Indian researchers residing in the country. Researchers who have worked on assessment methodology in India have demonstrated that clinical diagnosis has a low reliability when compared with semi-structured interviews; and have attempted to increase the feasibility of the standardized use of International Personality Disorder Examination, a semi-structured interview developed by the World Health Organization (WHO). Studies on epidemiology demonstrate that none of the general population studies have employed standardized interviews, and hence, they grossly underestimate the prevalence of personality disorders in the community. The clinical epidemiology studies have employed questionnaires and interviews developed in the West, mostly without local adaptations, with discrepant results. However, these studies show that personality disorders are common in the clinical population and that rates vary across sub populations. While, there are a few reports attesting the theoretical importance of the role of culture in the formation and expression of personality disorders, empirical literature from India in this area is scanty. Similarly, there are few reports on the treatment of personality disorders, while, important areas such as service delivery, etiology, and validity of personality disorders, are unaddressed. The study of personality disorder in India is maturing, with researchers showing increased familiarity with the methodological nuances of this complex area of research.

A comparison of borderline personality disorder with and without eating disorders

This study examines the degree to which an eating disorder (ED) is associated with the recurrence and severity of suicide attempts, non-suicidal self-injury, rates of co-occurring Axis I and II disorders, and psychosocial functioning among Borderline Personality Disorder (BPD) outpatients. A group of 135 treatment-seeking women with BPD were assessed using structured clinical interviews. BPD was assessed using the International Personality Disorders Examination, confirmed by the Structured Clinical Interview for DSM-IV (SCID)-II, and Axis I disorders were assessed with the SCID I. A total of 17.8% of the sample met criteria for a current ED, with 6.7% meeting criteria for Anorexia Nervosa (AN), 5.9% for Bulimia Nervosa (BN), and 5.2% for Binge-Eating Disorder (BED). In this BPD sample, in the last year, current BN was associated with a significantly greater risk of recurrent suicide attempts while current AN was associated with increased risk of recurrent non-suicidal self-injury. BPD with current AN or BED was associated with a greater number of non-ED current Axis I disorders. Further replication of these results is needed. Women with BPD must be assessed for AN and BN as these diagnoses may confer greater risk for suicidal and self-injurious behavior and may have to be prioritized in treatment.

Screening for personality disorders among adults seeking speech treatment for stuttering

Stuttering is frequently associated with negative consequences which typically begin in early childhood. Despite this, no previous studies have investigated the presence of personality disorders among adults who stutter. Therefore, the aims of the present study were to screen for personality disorders among adults who stutter, and to compare these screening estimates with matched controls from a national population sample. Using a matched case–control design, participants were 94 adults seeking treatment for stuttering, 92 of whom completed the International Personality Disorders Examination Questionnaire (IPDEQ) as a first-stage screener, and 920 age- and gender-matched controls from the Australian National Survey of Mental Health and Well-Being (ANSMHWB). A conditional logistic regression model was used to estimate odds ratios for the primary outcome: first-stage presence of any personality disorder; as well as specific personality disorders. Based on first-stage screening, the presence of any personality disorder was significantly higher for adults in the stuttering group than matched controls, demonstrating almost threefold increased odds. This difference between groups remained significant for all specific personality disorders, with four- to sevenfold increased odds found for Dissocial, Anxious, Borderline, Dependent and Paranoid personality disorders, and two- to threefold increased odds found for Histrionic, Impulsive, Schizoid and Anankastic personality disorders. In conclusion, stuttering appears to be associated with a heightened risk for the development of personality disorders. These results highlight the need for research regarding the assessment and treatment of personality disorders among adults who stutter. Educational objectives : The reader will be able to: (1) describe the nature of personality disorders, including factors thought to contribute to their development; (2) identify some of the negative consequences associated with stuttering which may contribute to the development of personality disorders among adults who stutter; (3) describe the process involved in screening for personality disorders, including various methods of scoring; and (4) summarize findings regarding the first-stage presence of personality disorders among adults seeking speech treatment for stuttering in the present sample in comparison with age- and gender-matched controls from a national population sample.

A comparison of women who continue and discontinue treatment for borderline personality disorder

AbstractBackground Treatment non‐completion is a significant problem for personality disorder treatment services.Aims We investigated differences between treatment continuers and treatment discontinuers of a tertiary specialist service for people with borderline personality disorder. The two groups were compared on: (1) personality disorder severity; (2) motivation for therapy; (3) mood; and (4) social problem solving.Method Patients' personality disorders were examined using the International Personality Disorder Examination. Three self‐report questionnaires were administered at the start of treatment: the Treatment Motivation Questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the Social Problem Solving Inventory‐Revised.Results Of 14 outpatients recruited to the service during 2005 to 2007, seven continued and seven discontinued treatment. Those who did not continue with therapy had more complex personality disorder profiles, were more externally motivated for treatment and were less internally motivated for treatment. All patients scored high on the HADS. Problem‐solving abilities were apparently intact, but adversely affected by a negative problem orientation. Treatment discontinuers spent, on average, three times longer in hospital than continuers.Conclusion Engaging people with complex personality disorders, low internal motivation for therapy and negative problem orientation is a challenge for services. Non‐completion of treatment is associated with more days in hospital and higher service costs. Copyright © 2009 John Wiley & Sons, Ltd.

Personality Disorders Among Alcohol-Dependent Patients Manifesting or not Manifesting Cocaine Abuse: A Comparative Pilot Study

This study assessed personality disorders (PDs) in 158 alcohol-dependent outpatients (62 manifesting cocaine abuse and 96 without cocaine abuse) with the International Personality Disorders Examination interview between 2003 and 2006. Thirty-nine alcohol-dependent/cocaine abusers (62.9% of this group) and 51 only alcohol-dependent patients (53.1% of this group) manifested at least one PD. There were no statistically significant differences between groups in the overall prevalence rate of PDs. The most prevalent PDs, among the alcohol-dependent/cocaine abusers, were antisocial (21%), narcissistic (14.5%), and borderline (11.3%) PDs. The most frequently diagnosed PDs among the only alcohol-dependent patients were obsessive–compulsive (20.8%), paranoid (10.4%), and dependent (9.4%) PDs. There were significant differences between the groups. The study limitations are discussed.

Normal and pathological personality characteristics in subtypes of drug addicts undergoing treatment

This study examines the differences in normal and pathological personality that appear in a sample of drug addicts empirically classified into two types of consumers, called Type A (functional) and Type B (chronic). An assessment protocol that comprised the European Addiction Severity Index (EuropASI), the NEO-Five-Factor Inventory, reduced (NEO-FFI), and the International Personality Disorder Examination was administered to 533 drug addicts of both sexes, aged between 17 and 60 years. The results showed that the functional consumers (Type A) had higher scores in extraversion and agreeableness than the chronic consumers (Type B), and the latter had higher scores in schizoid and dysocial personality disorder traits. Based on the differences in normal and pathological personality traits of both typologies, we determined some aspects about the diagnosis, treatment choice, and therapeutic prognosis that allow a better approach to the problem of drug addiction.

Dysfunctional beliefs and antisocial personality disorder

Beck identified dysfunctional beliefs associated with personality disorders and these form the basis of the Personality Belief Questionnaire (PBQ). The PBQ has not yet been empirically examined in relation to antisocial personality disorder (ASPD); here, we examined the associations between PBQ antisocial beliefs and ASPD diagnosis, identified using the International Personality Disorder Examination (IPDE). Adult male prisoners were grouped as ASPD only (n = 17), ASPD plus another personality disorder (n = 14), and no personality disorder (n = 18). Our hypotheses were: the ASPD only group would score higher on the PBQ antisocial scale than other scales; the ASPD only group would score higher on the PBQ antisocial scale than would those with no personality disorder; and the PBQ antisocial scale would best predict group membership. Men with ASPD only did not score highest on the PBQ antisocial scale, and, although they held more antisocial beliefs than men with no personality disorder, they also held significantly more dysfunctional beliefs on most other scales. Hence, antisocial beliefs are not a distinguishing feature. The PBQ antisocial scale did not discriminate groups, but the avoidant and paranoid scales did. The PBQ antisocial scale does not relate to antisocial personality disorder, although it may relate to primary psychopathy.

Suicidal thoughts and behavior among adults with self-reported pain conditions in the national comorbidity survey replication.

We sought to examine whether the presence of a noncancer pain condition is independently associated with an increased risk for suicidal ideation, plan, or attempt after adjusting for sociodemographic and psychiatric risk factors for suicide and whether risk differs by specific type of pain. We analyzed data from the National Comorbidity Survey Replication, a household survey of U.S. civilian adults age 18 years and older (n = 5692 respondents). Pain conditions, nonpain medical conditions, and suicidal history were obtained by self-report. DSM-IV mood, anxiety, and substance use disorders were assessed using the World Health Organization's Composite International Diagnostic Interview. Antisocial and borderline personality traits were assessed with the International Personality Disorder Examination screening questionnaire. In unadjusted logistic regression analyses, the presence of any pain condition was associated with lifetime and 12-month suicidal ideation, plan, and attempt. After controlling for demographic, medical, and mental health covariates, the presence of any pain condition remained significantly associated with lifetime suicidal ideation (odds ratio, 1.4; 95% confidence interval, 1.1-1.8) and plan. Among pain subtypes, severe or frequent headaches and "other" chronic pain remained significantly associated with lifetime suicidal ideation and plan; "other" chronic pain was also associated with attempt. The risk for suicidal thoughts and behaviors that may accompany back, neck, and joint pain can be accounted for by comorbid mental health disorders. There may be additional risk accompanying frequent headaches and "other" chronic pain that is secondary to psychosocial processes not captured by the mental disorders assessed.

Structural brain abnormalities in borderline personality disorder: A voxel-based morphometry study

Imaging studies using region-of-interest morphometry and positron emission tomography have contributed to our understanding of structural and functional abnormalities in borderline personality disorder (BPD); however, both methods have practical limitations to their usefulness for exploratory studies of brain–behavior relationships. We used voxel-based morphometry (VBM) in 34 subjects with BPD and 30 healthy control (HC) subjects to study effects of diagnosis, gender, childhood sexual abuse, depressed mood, impulsivity and aggression on group differences. VBM is a computer-based method for whole brain analysis that combines the advantages of a functional study with a structural method. The BPD subjects, diagnosed with the Diagnostic Interview for Borderline Patients and the International Personality Disorders Examination, were compared with 30 HC subjects, with age and gender covaried. Analyses were repeated separately by gender and, in women, by histories of childhood sexual abuse. Depressed mood, impulsivity, and aggression were covaried in separate analyses. Compared with HC, BPD subjects had significant bilateral reductions in gray matter concentrations in ventral cingulate gyrus and several regions of the medial temporal lobe, including the hippocampus, amygdala, parahippocampal gyrus, and uncus. BPD women (and abused BPD women), but not BPD men, had significant reductions in medial temporal lobe, including the amygdala. BPD men, but not BPD women, showed diminished gray matter concentrations in the anterior cingulate gyrus compared with findings in HC subjects. Covarying for depressed mood rendered group differences non-significant in the ventral cingulate but had little effect on differences in medial temporal cortex. Covarying for aggression (LHA) had relatively little effect on group differences, while covarying for impulsivity, as determined by the Barratt Impulsiveness Scale, rendered all previously noted voxel-level group differences non-significant. Diminished gray matter in the prefrontal cortex and the medial temporal cortex may mediate the dysregulation of impulse and affect in BPD. Group differences varied greatly by gender, levels of depression, and impulsivity. VBM is an efficient method for exploratory study of brain–behavior relationships.

Revisiting the structure of mental disorders: Borderline personality disorder and the internalizing/externalizing spectra

Researchers have turned to dimensional models of psychopathology as a means of explaining robust patterns of comorbidity. A hierarchical model consisting of internalizing and externalizing dimensions has been a useful approach to understanding comorbidity among some mental disorders, although a limited number of disorders have been examined within this framework. The objective of the present study is to determine how borderline personality disorder fits into this framework. Dimensional measures of nine psychiatric disorders were used in a confirmatory factors analysis to compare five models of comorbidity in 1,197 members (N=541 women) of a population-based sample. Symptom composites were derived from the Michigan Composite International Diagnostic Interview and the International Personality Disorders Examination Questionnaire. Five models were fit to dimensional indicators of nine disorders. A model in which borderline personality disorder served as a multidimensional indicator of the externalizing factor and the anxious-misery subfactor of internalizing disorders provided the best fit to the data in the whole sample and in men. For women, this model also fit well but an alternative model in which borderline personality disorder served only as an indicator of the anxious-misery subfactor of internalizing disorders fit equally well. The present study demonstrates the utility of the internalizing/externalizing framework for characterizing personality disorders as well as Axis I disorders. Future work should explore how other personality disorders fit into this framework.

DSM-IV personality disorders in Mexico: results from a general population survey

OBJECTIVE: This paper reports the first population estimates of prevalence and correlates of personality disorders in the Mexican population. METHOD: Personality disorders screening questions from the International Personality Disorder Examination were administered to a representative sample of the Mexican urban adult population (n = 2,362) as part of the Mexican National Comorbidity Survey, validated with clinical evaluations conducted in the United States. A multiple imputation method was then implemented to estimate prevalence and correlates of personality disorder in the Mexican sample. RESULTS: Multiple imputation method prevalence estimates were 4.6% Cluster A, 1.6% Cluster B, 2.4% Cluster C, and 6.1% any personality disorder. All personality disorders clusters were significantly comorbid with DSM-IV Axis I disorders. One in every five persons with an Axis I disorder in Mexico is likely to have a comorbid personality disorder, and almost half of those with a personality disorder are likely to have an Axis I disorder. CONCLUSIONS: Modest associations of personality disorders with impairment and strong associations with treatment utilization were largely accounted for by Axis I comorbidity suggesting that the public health significance of personality disorders lies in their comorbidity with, and perhaps effects upon, Axis I disorders rather than their direct effects on functioning and help seeking.

Screening for Borderline Personality Disorder in Outpatient Youth

Young people with borderline personality disorder (BPD) commonly seek help but often go unrecognized. Screening offers a means of identifying individuals for more detailed assessment for early intervention and for research. This study compared the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD), Borderline Personality Questionnaire (BPQ), the BPD items from the International Personality Disorder Examination Screening Questionnaire and the BPD items from the Structured Clinical Interview for DSM-IV Axis II disorders (SCID-II) Personality Questionnaire. 101 outpatient youth (aged 15-25 years) completed the screening measures and were interviewed, blind to screening status, with the SCID-II BPD module. The screening measures were readministered two weeks later to assess test-retest reliability. All four instruments performed similarly but the BPQ had the best mix of characteristics, with moderate sensitivity (0.68), the highest specificity (0.90), high negative predictive value (0.91) and moderate positive predictive value (0.65). Compared to the other three instruments, the BPQ had the highest overall diagnostic accuracy (0.85), a substantially higher kappa (0.57) with the criterion diagnosis, the highest test-retest reliability (ICC = 0.92) and the highest internal consistency (alpha = 0.92). The only clear difference to emerge in the Receiver Operator Curve (ROC) analysis was that the BPQ significantly outperformed the MSI (p = 0.05). Screening for BPD in out-patient youth is feasible but is not a replacement for clinical diagnosis.

Personality Disorders and the Five-Factor Model among French Speakers in Africa and Europe

To describe the relation between personality disorders (PDs) and the Five-Factor Model (FFM)--a dimensional model describing normal personality traits known for its invariance across cultures--in 2 different cultural settings. Several authors have suggested that PDs may be more accurately described using a dimensional model instead of a categorical one. Subjects from 9 French-speaking African countries (n = 2014) and from Switzerland (n = 697) completed both the French version of the International Personality Disorder Examination screening questionnaire, assessing the 10 DSM-IV PDs, and the French version of the Revised NEO Personality Inventory, assessing the 5 domains and 30 facets of the FFM. Correlations between PDs and the 5 domains of the FFM were similar in both samples. For example, neuroticism was highly correlated with borderline, avoidant, and dependent PDs in both Africa and Switzerland. The total rank-order correlation (rho) between the 2 correlation matrices was very high (rho = 0.93) and significant (P < 0.001), as were the rhos for all domains of the FFM and all PDs, except paranoid and dependent PDs. However, the rhos for PDs across facet scales were all highly significant (P < 0.001). Moreover, 80% of Widiger and colleagues' predictions and 70% of Lynam and Widiger's prototypes, concerning the relation between PDs and the FFM, were confirmed in both samples. The relation between PDs and the FFM was stable in 2 samples separated by a great cultural distance. These results suggest that a dimensional approach and in particular the FFM may be useful for describing PDs in various cultural settings.

Organization of co‐occurring Axis II features in borderline personality disorder

Considerable heterogeneity exists in the comorbid Axis II features that frequently accompany borderline personality disorder (BPD). These features have potential to be meaningfully organized, relate to specific BPD presentation, and have implications for treatment process and outcome. The present study explored patterns of Axis II comorbidity in order to identify subtypes of BPD. A well-defined sample of 90 patients diagnosed with BPD was recruited as part of an RCT study. Participants were administered the International Personality Disorder Examination (Loranger, 1999) to diagnose BPD and assess comorbid Axis II features. Other measures were also administered to assess aspects of current work and relationship functioning, symptomatology, and self-concept. Q-factoring was used to develop subtypes based on commonly occurring Axis II profiles, identifying three: Cluster A (elevated paranoid and schizotypal features), Cluster B (elevated narcissistic and histrionic features), and Cluster C (elevated avoidant and obsessive-compulsive features). An additional factor analysis revealed two dimensions underlying the comorbid features identifiable as: extraversion versus introversion and antagonism versus constraint. Validity of these two maps of comorbidity was explored in terms of the BPD criteria themselves, as well as on work and relationship functioning, identity diffusion, views of self and others, positive and negative affect, behavioural dyscontrol, and symptomatic distress. Clinically meaningful subtypes can be identified for BPD based on co-occurring Axis II features. Further research is needed to replicate and further establish base-rates of these subtypes as well as their differential implications for treatment.

Comparative study of personality disorder associated with deliberate self harm in two different age groups (15-24 years and 45-74 years)

Aims:To study the presence of personality disorder in cases of deliberate self harm (DSH) in young (15–24 years) and elderly (45–74 years) and compare.Materials and Methods:Deliberate self harm cases admitted in Medical and surgical departments and cases attending psychiatry department of R.G. Kar Medical College, Kolkata were studied. For diagnosis of personality disorder ICD 10 International Personality Disorder Examination (IPDE) questionnaire was used.Results:Percentage of elderly patients having personality disorder (64%) was higher compared to young DSH patients (58.5%). In young group, most common disorder was emotionally unstable personality disorder (28.6%) and in elderly group most common was anankastic type of personality disorder (36%). Schizoid, dissocial, histrionic, and anxious-avoidant personality disorders were found in small percentages of cases.Conclusion:Among DSH patients, the most common personality disorder found in young age was Emotionally unstable (Impulsive and Borderline) personality disorder, but most common personality disorder found in elderly patients was Anankastic personality disorder.

Predicting individual change in personality disorder features by simultaneous individual change in personality dimensions linked to neurobehavioral systems: The longitudinal study of personality disorders.

Personality disorders (PDs), long thought to be immutable over time, show considerable evidence of individual change and malleability in modern prospective longitudinal studies. The factors responsible for the evident individual change in PDs over time, however, remain essentially unknown. A neurobehavioral model that posits negative emotion (NEM), nonaffective constraint (CON), communal positive emotion (PEM-C), and agentic positive emotion (PEM-A) as important systems underlying PD provides a theoretical basis for investigating predictors of change in PD features over time. Thus, in this study, the authors investigated how individual change in NEM, CON, PEM-C, and PEM-A over time predicted individual change in PD features over time, using longitudinal data on PD assessed by the International Personality Disorders Examination (A. W. Loranger, 1999), as well as data on normal personality features gathered within a 4-year prospective multiwave longitudinal study (N = 250). The authors used the method of latent growth modeling to conduct their analyses. Lower initial levels of PEM-C predicted initial levels of the growth trajectories for those with elevated Cluster A PD features. Elevated NEM, lower CON, and elevated PEM-A initial levels were found to characterize the initial levels of growth trajectories for those with increased Cluster B PD features. Interestingly, subjects with higher initial levels of PEM-A revealed a more rapid rate of change (declining) in Cluster B PD features over time. Elevated NEM and decreased PEM-C initial levels were found to characterize the growth trajectories for subjects with increased Cluster C PD features. The substantive meaning of these results is discussed, and the methodological advantages offered by this statistical approach are also highlighted.