Personality Disorders in Older Adults
Emerging Issues in Diagnosis and Treatment
Edited by Erlene Rosowsky, Robert C. Abrams, Richard A. Zweig
Routledge – 1999 – 330 pages
As the average age of the population rises, mental health professionals have become increasingly aware of the critical importance of personality in mediating successful adaptation in later life. Personality disorders were once thought to "age out," and accordingly to have an inconsequential impact on the lives of the elderly. But recent clinical experience and studies underscore not only the prevalence of personality disorders in older people, but the pivotal roles they play in the onset, course, and treatment outcomes of other emotional and cognitive problems and physical problems as well. Clearly, mental health professionals must further develop research methods, assessment techniques, and intervention strategies targeting these disorders; and they must more effectively integrate what is being learned from advances in research and theory into clinical practice.
Inspired by these needs, the editors have brought together a distinguished group of behavioral scientists and clinicians dedicated to understanding the interaction of personality and aging. Offering a rich array of theoretical perspectives (intrapsychic, interpersonal, neuropsychological, and systems), they summarize the empirical literature, present phenomenological case reports, and review psychodynamic, cognitive-behavioral, and pharmacological treatment approaches. This comprehensive state-of-the-art guide will be welcomed by all those who must confront the complexity and the challenge of working with this population.
"The editors have assembled excellent articles on research and assessment, outcome measurements, clinical diagnostic and treatment issues and methods, and case examples….This is a book that can be highly recommended."
—READINGS: A Journal of Reviews and Commentary in Mental Health
"Personality disorders in later life have received too little attention. Now, finally, Rosowsky, Abrams, and Zweig and their contributors shed new light. Expanding our understanding of the breadth of these problems and putting them in perspective, this book improves our ability to assess and treat older people."
—Gene D. Cohen, M.D., Ph.D.
George Washington University
"Personality Disorders in Older Adults is a gem for clinicians as well as researchers. It clearly heralds the importance of personality in understanding and treating older persons. I enjoy the clinical richness and reflections from a psychotherapist writing as an older person, and appreciate the comprehensive conceptual attention to dimensional models and measures of personality and personality disorders. The consistent focus on the clinical implications in each chapter makes this a valuable resource."
—Paul Costa, Ph.D.
Laboratory of Personality and Cognition, Intramural Research Program, NIA/NIH
Contents: Preface. L. Siever, Foreword. Part I: Conceptual Background. J.F. Clarkin, L.A. Spielman, E. Klausner, Conceptual Overview of Personality Disorders in the Elderly. L. Havens, Personality and Aging: A Psychotherapist Reflects Late in His Own Life. Part II: Research and Assessment: Overview and Outcome Measures. R.A. Zweig, J. Hillman, Personality Disorders in Adults: A Review. R.C. Abrams, S.V. Horowitz, Personality Disorders After Age 50: A Meta-Analytic Review of the Literature. T.J. Gradman, L.W. Thompson, D. Gallagher-Thompson, Personality Disorders and Treatment Outcome. P.R. Duberstein, L. Seidlitz, J.M. Lyness, Y. Conwell, Dimensional Measures and the Five-Factor Model: Clinical Implications and Research Directions. L.M. Dougherty, Determining Personality Disorders in Older Adults Through Self-Identification and Clinician Assessment. D.K. Mroczek, S.W. Hurt, W.H. Berman, Conceptual and Methodological Issues in the Assessment of Personality Disorders in Older Adults. Part III: Clinical Issues: Diagnosis and Treatment. E. Rosowsky, The Patient-Therapist Relationship and the Psychotherapy of the Older Adult With Personality Disorder. M. Viederman, The Influence of Personality on Reactions of Older Adults to Physical Illness. J.H. Miner, Neuropsychological Contributions to Differential Diagnosis of Personality Disorder in Old Age. W.A. Myers, Personality Disorders in Older Adults: Some Issues in Psychodynamic Treatment. R.M. Goisman, Cognitive-Behavioral Therapy, Personality Disorders, and the Elderly: Clinical and Theoretical Considerations. M. Agronin, Pharmacologic Treatment of Personality Disorders in Late Life. Part IV: Systems and Social Issues. E. Rosowsky, M.A. Smyer, Personality Disorders and the Difficult Nursing Home Resident. V. Molinari, Ethical Issues in the Clinical Management of Older Adults With Personality Disorder. B.G. Knight, Afterword: Personality Disorders in Late Life and Public Policy: Implications of the Contextual, Cohort-Based, Maturity, Specific Challenge Model.