[Instability of personality characteristics and personality disorders during the lifespan: effects for assessment in older adults].

The instability of personality characteristics and personality disorders during the lifespan is the topic of this literature search. It concerns the effects of this instability for personality assessment in older adults. Five longitudinal studies, based on the Big Five model of Costa & McCrae, support the hypothesis that personality characteristics change during the lifespan. Neuroticism, extraversion and openness decrease with age. In contrast, altruism and conscientiousness increase with age. One longitudinal and three cross-sectional studies of personality pathology indicate age-specific changes in the expression of (mal) adaptive personality characteristics. Besides that, nearly one third of the DSM criteria for Axis II personality disorders are insufficiently applicable to older people, based on a large cross sectional study. Therefore the temporal instability of personality characteristics and the limited validity of the Axis II criteria complicate personality assessment in older adults. Improvements could be found in major standardization studies of personality questionnaires in elderly patients in mental health care and nursing home care. Significant changes in the DSM, such as the development of an age specific and multidimensional approach to personality disorders is also recommended.