شخصیت، آسیب شناسی روانی، و پیری

The interplay of personality and psychopathology has been of substantial interest since the beginning of medicine and continues to be a clinically significant yet highly challenging focus of investigation. There is considerable empirical support for the important contributions that personality traits provide to the development of and resilience to psychopathology within mixed-age populations. However, the relationship of personality to mental health and psychopathology within the aging population is only just beginning to be studied. The purpose of this paper is to stimulate and to hopefully further the development of informative research on the interaction of personality and psychopathology within the aging community.

The interaction of personality and psychopathology has been of substantial interest since the beginning of medicine (Maher & Maher, 1994) and continues to be a clinically significant yet highly challenging domain of study (Watson & Clark, 1994; Widiger, Verheul, & van den Brink, 1999). However, the relationship of personality to mental health and psychopathology within the aging community is only just beginning to be studied (Abrams & Horowitz, 1996; Agronin, 1998 and Agronin, 2000; Rosowsky, Abrams, & Zweig, 1999; Sadavoy & Fogel, 1992; Segal, Hersen, Van Hasselt, Silberman, & Roth, 1996). The purpose of this paper is to stimulate and hopefully to further the development of a broader life span perspective. We begin with a brief overview of maladaptive personality functioning, followed by illustrative aging research and a discussion of conceptual and methodological issues.

One basic observation of the research on the relationship of personality and psychopathology is its vitality. The relationship between personality and psychopathology has been of clinical and scientific interest since the beginning of medicine (Maher & Maher, 1994), an interest proven to be justifiable as personality traits have been shown to be of considerable importance for the development of, resistance to, and treatment of anxiety, depression, substance, and other forms of psychopathology (Basic Behavioral Science Task Force of the National Advisory Mental Health Council, 1996). Much of this research has been confined to studies of mixed-age adults within the community and clinical settings but interest is now being extended to more elderly and aged populations. Lessons learned in the study of personality and psychopathology within mixed-age populations will hopefully inform the study of personality and psychopathology within older populations. For example, the failure to adequately differentiate between pathoplastic and etiological relationships has been problematic in general personality research due in part to the reliance on cross-sectional studies and prospective studies of convenience. Cross-sectional studies can provide quite informative results but “the most important facts about traits have come from longitudinal studies” (Costa & McCrae, 1998, p. 110), particularly the studies of persons with a theoretically relevant personality disposition, beginning at the time of the onset of the disposition, prior to the occurrence of psychopathology and followed for a sufficient period of time across the life span for the vulnerability to become evident. Entrance into the causal sequence after a significant amount of interaction between personality, psychopathology, and life events has already occurred has complicated substantially the meaning and implication of findings, especially if the participants have already had a history of suffering from the pathologies of research interest. Studies beginning late in life could have some difficulty differentiating between pathoplastic and causal relationships, as they might be unable to sample persons with a particular personality disposition who lacked any prior history of a respective mental disorder without eliminating the very persons who would be of most interest and relevance to the study. Yet, if these persons are included, researchers would need to address the concern that the current personality traits were a result of the prior mental disorder history or were subsyndromal or characterologic expressions of a common psychopathology. Research on the study of personality and psychopathology within elderly populations should also go beyond existing research within mixed-age populations by including the consideration of the mechanisms through which personality traits result in psychopathology and by addressing issues of particular importance to older populations as well as issues that are of relevance throughout the life span. Research is needed to embed personality disorders and traits in a larger theoretical network of psychological and physiological processes. Studies are needed to establish the cognitive, emotional, and neurobiological processes that are associated with specific personality disorders in older adults as these studies could suggest psychotherapeutic and pharmacologic interventions that might lead to an amelioration or prevention of psychopathology. Future research on personality and psychopathology should also address the potential limitations of existing personality constructs and instruments for the study of elderly populations. Existing constructs and measures may not be ideally suited for older persons. In addition, the existing methodologies used to address the contributions of personality to vulnerability and resilience to stress throughout the life span should be applied to concerns and issues that are of particular clinical or social importance within an aging community (e.g., deterioration in physical health and functioning, loss of close friendships and social support, the demands and stress placed on elderly caregivers, and matters concerning one's one mortality), as well as considering the increasing psychological resources with age that may ameliorate some pathologies.