Table Of ContentRELATIONSHIPS BETWEEN PERSONALITY DISORDER BELIEFS AND
PERSONALITY DISORDER FEATURES AMONG YOUNG AND OLDER
ADULTS
by
GABRIELLE C. KRUS
B.A., Valparaiso University, 2013
A thesis submitted to the Graduate Faculty of the
University of Colorado Colorado Springs
in partial fulfillment of the
requirements for the degree of
Master of Arts
Department of Psychology
2015
This thesis for Master of Arts degree by
Gabrielle C. Krus
Has been approved for the
Department of Psychology
By
Daniel Segal
Fred Coolidge
Leilani Feliciano
Date
Krus, Gabrielle C. (M.A., Psychology)
Relationships Between Personality Disorder Beliefs and Personality Disorder Features
Among Young and Older Adults
Thesis directed by Professor Daniel Segal
The purpose of the present study was to compare personality disorder (PD) beliefs
and PD features among young and older adults. PDs are commonly conceptualized as a
constellation of pathological variations of normal personality traits. A popular
explanation for their onset and perpetuation is the interplay between environmental
stressors and personality dispositions. Beck’s cognitive theory offers a thorough
conceptualization of PDs. Cognitive theory promulgates that particular beliefs explain the
underlying nature of PDs and guides the treatment process. Beck and Beck (1995) created
the Personality Belief Questionnaire (PBQ) to identify the underlying causes (assuming
the causes are beliefs) responsible for maladaptive behavior(s). In the present study,
community dwelling young adults (n=203; M age = 71.8 years) and older adults (n=125;
M age = 20.4 years) completed the PBQ, the Coolidge Axis Two Inventory-Revised
(CATI+), and the Personality Inventory for the DSM-5 (PID-5). The main findings were
that as young and older adults’ PBQ scale scores increased, so did their CATI+PD scale
and PID-5 trait domain scores. Cross-sectional results (t-tests) showed that older adults
scored lower on all PBQ scales compared to young adults. Finally, PBQ scale scores
predicted CATI+PD scale scores and PID-5 trait domain scores fairly well. In conclusion,
PD beliefs appear to correlate with PD features, but other factors are likely to contribute
to the variance of features seen in PDs.
Key words: personality disorder, PD, Personality Beliefs Questionnaire, Beck,
cognitive theory, older adults, young adults
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TABLE OF CONTENTS
CHAPTER
1. INTRODUCTION ...............................................................................................1
a. Nature of Personality Disorders ...............................................................2
i. Describing Personality .................................................................4
ii. Personality Pathology Versus Personality Disorders ...................6
iii. History of Conceptualizing Personality Disorders ......................7
iv. A Modern Description of Personality Disorders .........................8
v. Challenges within the Current Model ..........................................23
b. Cognitive Theory .....................................................................................31
i. Cognitive Theory and Older Adults .............................................34
ii. Cognitive Theory and Personality Disorders ...............................35
c. Beliefs as the Foundation of Personality Disorders .................................39
d. Measuring Beliefs to Assess Personality Disorders.................................43
i. Personality Belief Questionnaire (PBQ) ......................................43
ii. Personality Disorder Belief Questionnaire (PDBQ) ....................48
iii. Missing Pieces within the Literature on Assessing PB Beliefs ...49
iv. The Present Study ........................................................................50
2. METHOD ............................................................................................................53
i. Participants ...................................................................................53
CHAPTER
ii. Procedure .....................................................................................55
iii. Measures ......................................................................................56
b. Statistical Analyses ..................................................................................61
3. RESULTS ............................................................................................................72
i. Equivalency of Age Groups .........................................................72
ii. Hypothesis 1.................................................................................75
iii. Hypothesis 2.................................................................................80
iv. Hypothesis 3.................................................................................88
v. Exploratory Analysis 1 ................................................................91
vi. Exploratory Analysis 2 ................................................................94
4. DISCUSSION ......................................................................................................103
i. Hypothesis 1.................................................................................103
ii. Hypothesis 2.................................................................................106
iii. Hypothesis 3.................................................................................109
iv. Hypothesis 4.................................................................................111
v. Limitations and Recommendations..............................................112
5. CONCLUSION ....................................................................................................116
REFERENCES ................................................................................................................119
APPENDIX ......................................................................................................................126
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TABLES
TABLE
1. Participant Demographic Information for Full, Young Adult, and
Older Adult Samples ............................................................................................54
2. Correlation Matrix between PBQ and CATI+PD Scales for the Full
Sample (N = 328) .................................................................................................61
3. Correlation Matrix between PBQ and CATI+PD Scales for the Young
Adult Sample (N = 203) .......................................................................................62
4. Correlation Matrix between PBQ and CATI+PD Scales for the Older
Adult Sample (N = 125) .......................................................................................62
5. Fisher’s Z Scores for Young and Older Adult PBQ and Corresponding
CATI+PD Scale Score Correlations (N = 328) ...................................................63
6. Correlation between PID-5 Negative Affect, Detachment, Antagonism,
Disinhibition, and Psychoticism Trait Domains and PBQ Scales for Full
Sample (N = 328) .................................................................................................64
7. Correlations between PID-5 Negative Affect, Detachment, Antagonism,
Disinhibition, and Psychoticism Trait Domains and PBQ Scales for Young
Adult Sample (N = 203) .......................................................................................64
8. Correlations between PID-5 Negative Affect, Detachment, Antagonism,
Disinhibition, and Psychoticism Trait Domains and PBQ Scales for Older
Adult Sample (N = 125) .......................................................................................65
9. Descriptive Statistics for All Measures by Sample Group ..................................66
10. Correlations between Age and PBQ Scales for Full Sample (N = 328) ..............67
11. Multiple Regression Analysis with Young Adult Sample for PBQ Scales
Predicting PID-5 Trait Domains ..........................................................................68
TABLE
12. Standardized Beta (B) in Multiple Regression Analysis with Young Adult
Sample for PBQ Scales Predicting PID-5 Trait Domains ...................................68
13. Multiple Regression Analysis with Older Adult Sample for PBQ Scales
Predicting PID-5 Trait Domains ..........................................................................68
14. Standardized Beta (B) in Multiple Regression Analysis with Older Adult
Sample for PBQ Scales Predicting PID-5 Trait Domains ...................................69
15. Multiple Regression Analysis with Young Adult Sample for PBQ Scales
Predicting CATI+PD Scales ................................................................................69
16. Standardized Beta (B) in Multiple Regression Analysis with Young Adult
Sample for PBQ Scales Predicting CATI+PD Scales..........................................70
17. Multiple Regression Analysis with Older Adult Sample for PBQ Scales
Predicting CATI+PD Scales ................................................................................70
18. Standardized Beta (B) in Multiple Regression Analysis with Older Adult
Sample for PBQ Scales Predicting CATI+PD Scales..........................................71
19. Correlations between Years of Education and Major Variables in Young
and Older Adult Samples .....................................................................................74
20. Inter-correlation Matrix between PBQ Scales for the Full Sample (N = 328) ....76
21. Inter-correlation Matrix between CATI+PD Scales for the Full Sample
(N = 328) ..............................................................................................................76
22. Inter-correlation Matrix between PBQ Scales for the Young Adult Sample
(N = 203) ..............................................................................................................77
23. Inter-correlation Matrix between CATI+PD Scales for the Young Adult
Sample (N = 203) .................................................................................................77
24. Inter-correlation Matrix between PBQ Scales for the Older Adult Sample
(N = 125) ..............................................................................................................78
25. Inter-correlation Matrix between CATI+PD Scales for the Older Adult
Sample (N = 125) .................................................................................................78
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CHAPTER 1
INTRODUCTION
Personality disorders (PDs) are infamous for the difficulty clinicians and
researchers have with describing and treating them. Scientists, theorists, and practitioners
have argued about their nature, onset, prevalence, and treatability since their initial
conceptualization. To better understand PDs, researchers have developed measurements
to define, detect, and assess them. One method in which this has been attempted is
through identifying pathological beliefs that describe the nature of PDs (Butler, Brown,
Beck, & Grisham, 2002). These beliefs have been found to assist in the detection and
treatment of PDs (Beck et al., 2001). The purpose of the present study was to examine if
these proposed PD beliefs correlate with their corresponding PD features as classified
within the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5)
(American Psychiatric Association, 2013) within a young adult and an older adult
sample. If a correlation exists, it is possible that PD beliefs might predict their
corresponding PD features, providing direction for future research. The following
literature review provides a conceptual foundation for the current study. An explanation
of how PDs are currently conceptualized is given first, followed by a description of
cognitive theory, which is a prominent model explaining how PDs manifest in
individuals. A discussion follows regarding how specific beliefs mediate the course of
PD development, using cognitive theory as its premise.
2
Nature of Personality Disorders
PDs are highly complex, involving a deeper analysis beyond each PD’s salient
behaviors. Their complexity has led to a history of debate over their precise description,
difficulty in treatment, and challenge to detect within the general community. One in 10
people are affected by personality pathology, making it a significant public health
concern (Lenzenweger, Loranger, Korfine, & Neff, 1997; Sansone & Sansone, 2011).
Through a community sample tracking teenagers at the ages of 14, 16, 22 and 33, the
Children in the Community (CIC) study found that 32.7% of 642 New York teenagers
had a PD. By the age of approximately 22, this decreased to 14.7% within 611 of the
individuals sampled (Skodol, Johnson, Cohen, Sneed, & Crawford, 2007). Researchers
have estimated the prevalence of older adults having at least one PD to be approximately
11% in the general community (see review by Segal, Coolidge, & Rosowsky, 2006). The
PD prevalence rate in older adults varies tremendously across mental health settings,
ranging from 7-63% depending on the demographics of the sample and the assessment
method (Segal et al., 2006).
Within the general population of the United States, prevalence rates vary for each
PD contingent upon the study. For instance, the National Epidemiologic Survey on
Alcohol and Related Conditions found point prevalence estimates of the following PDs
for American adult population using DSM-IV criteria: paranoid = 4.41%, schizoid =
3.13%, schizotypal = 3.9%, histrionic = 1.84%, antisocial = 3.6%, avoidant = 2.36%,
dependent = 0.49%, and obsessive-compulsive = 7.88% (see American Psychiatric
Association, 2013, pp. 651-681; Grant, et al., 2004). Also using DSM-IV criteria, the
National Comorbidity Survey Replication found period prevalence rates of PDs within
