Medication Use and Quality of Life in Older Adults with Personality Disorders.

Background: Medication use is increasing in psychiatric populations, particularly those with personality disorders (PDs). Older adults with PDs are at higher risk for adverse drug reactions (ADRs), which may interfere with daily functioning.

Objectives: This study aimed to describe medication use and health-related quality of life (HR-QOL) in older adults with PDs compared with control groups and to evaluate predictors of medication use and HR-QOL.

Integrating Positive Schemas in Schema Therapy for Cluster C Personality Disorders in Older Adults: A Multiple Baseline Study.

Schema therapy (ST) is an effective psychotherapy for personality disorders in (older) adults. There is an increasing awareness of the imbalance in the ST community because of the emphasis on negative schemas versus attention to positive schemas. This study aimed to evaluate the effectiveness of an adapted ST approach that integrates positive schemas.

Comparing the Utility of a Clinical Staging Approach and the DSM-5 in Diagnosing Personality Disorders Among Older Adults.

Clinical staging may provide a valuable alternative to the limitations of categorical diagnostic models like the DSM-5 for mental disorders. However, research on the clinical utility of staging models on mental disorders is limited, particularly in comparison to the DSM-5, which hinders the implementation of staging models in clinical practice. The limitations of categorical models are even more pronounced in older adults, as personality disorders (PDs) may manifest differently later in life, potentially leading to over- or underdiagnosis when relying on the DSM-5.

Psychometric Properties of the Scale for Subjective Somatic and Cognitive Complaints of Psychotropic Medication Adult-Aged-Spectrum (SCOPA).

Objective: Patient-reported side-effect questionnaires contribute to balanced decisions regarding treatment strategy among patients with mental health disorders. However, current side-effect questionnaires are less suitable for older adults because they often lack age-specific side effects. Therefore, the Scale for Subjective Somatic and Cognitive Complaints of Psychotropic Medication Adult-Aged-Spectrum (SCOPA) was developed to quantify psychotropic side effects across the full adult age spectrum.

Sensitivity, Specificity and Interrater Reliability of a Clinical Staging Model for Personality Disorders in Older Adults: A Case Series Study.

A recent Delphi study found expert-consensus that clinical staging (CS) could provide a valid framework in the assessment of personality disorders (PDs) in older adults (Conjaerts et al., 2025). The categorical models used currently to assess PDs are poorly suited for treatment selection, in older adults even more so as age-specific factors were not considered in the development.

STEPPS for Over-Controlled and Under-Controlled Emotional Dysregulation in Older Adults with Personality Disorders: A Case Study.

Objectives: This paper aims to present a clinical illustration of under-controlled and over-controlled emotional dysregulation behaviors in older adults with personality disorders (PD). Furthermore, another aim is to explore how Systems Training for Emotional Predictability and Problem Solving for Older Adults (STEPPS-OA) can be useful for both types of emotional dysregulation.

Methods: A 65-year-old woman with emotional under-control and a 67-year-old woman with emotional over-control participated in STEPPS-OA.

The progress in the field of clinical staging for mental disorders within the last decade: an updated systematic review.

Introduction: Clinical staging aims to refine psychiatric diagnosis by describing mental disorders on a continuum of disorder progression, with the pragmatic goal of improved treatment planning and outcome prediction. The first systematic review on this topic, published a decade ago, included 78 papers, and identified separate staging models for schizophrenia, unipolar depression, bipolar disorder, panic disorder, substance use disorder, anorexia, and bulimia nervosa. The current review updates this review by including new proposals for staging models and by systematically reviewing research based upon full or partial staging models since 2012.

Psychometric Properties of the Dutch Version of the Young Positive Schema Questionnaire (YPSQ-NL).

In schema therapy early adaptive schemas (EASs) and early maladaptive schemas (EMSs) have been found to be independent but related constructs. The Young Positive Schema Questionnaire (YPSQ) was developed and validated in English to measure EASs. The present study investigated psychometric properties of the Dutch translation in a representative sample of 650 non-clinical Dutch individuals.

Clinical Staging for Personality Disorders in Older Adults.

Objective: This scientific research aimed to investigate the feasibility of implementing a clinical staging (CS) model for personality disorders (PDs) in older adults. The CS model could provide valuable insights into the life course of personality pathology, prognosis, and treatment decisions for PDs in older adults.

Methods/design: The study employed an international Delphi methodology with three rounds and involved 21 experts.

Feasibility of EMDR toward Personality Functioning in Older Adults with PTSD.

Objectives: Severe posttraumatic stress disorder (PTSD) in older adults (≥60 years) has been found to be associated with maladaptive personality functioning and personality disorders (PD). Emerging evidence in adults supports that reprocessing adverse events with Eye Movement Desensitization and Reprocessing (EMDR) could improve personality functioning and reduce full PDdiagnosis.

Methods: A multicenterfeasibilitystudy in 24 older PTSD-patients receiving weekly EMDR-sessions for either 3, 6 or 9 months.

Can personality disorder be accurately assessed in older age? A differential item functioning analysis of ICD-11 inventories.

Objectives: The contested categorical personality disorder (PD) criteria are not well suited to inform PD diagnoses in older adults. Yet, the classification of PDs is undergoing a critical transition phase with a paradigm shift to a dimensional approach for diagnosing PDs. No special attention was given to the expression of PDs in older age when the dimensional ICD-11 model was developed.

A First Exploration: Can Eye Movement Desensitization and Reprocessing Improve Cognition in Older Adults With Posttraumatic Stress Disorder?

Objectives: In older adults, PTSD is associated with decreased verbal learning and executive dysfunction. Therefore, feasibility of EMDR-treatment to improve cognitive performance in older adults with PTSD was examined. Additionally, we investigated pre-treatment correlation with often co-occurring risk factors for cognitive decline (sleep problems, depressive disorder, physical inactivity, childhood traumatic events).

Personality disorders in older adults: Differences in self-informant ratings.

Previous research on self-informant reports in assessing personality disorders (PDs) has been mainly focused on adults, leaving older adults under-studied. We examined self-informant agreement in PD screening among older adults (≥60 years) using the Gerontological Personality disorders Scale (GPS). Potential differences such as who reports more personality pathology on a PD screener (i.

The effectiveness of individual schema therapy in older adults with borderline personality disorder: A multiple-baseline case series design.

Objective: The aim of this study was to explore the effectiveness of schema therapy (ST) in older adults with borderline personality disorder (BPD).

Methods: Multiple baseline case series design with five BPD patients, with a mean age of 66. After a baseline phase with random length, patients received weekly ST sessions for a year, followed by follow-up sessions during 6 months.

The role of maladaptive personality in behavioural and psychological symptoms in dementia.

Background: Although research demonstrated a significant link between premorbid normative personality traits and the severity of behavioural and psychological symptoms in dementia (BPSD) and associated emotional distress of the caregiver, little is known about the relationship of BPSD symptoms and associated distress with maladaptive traits.

Method: Informants (N = 182) of Dutch nursing home residents with dementia aged 65+, completed the Neuropsychiatric Inventory Questionnaire to assess the severity of BPSD and associated emotional distress. Premorbid maladaptive personality traits were evaluated using informant versions of a brief version of the Personality Inventory for Diagnostic and Statistical manual of Mental Disorders-5 (PID-5-BF), and two age-specific personality measures, the Informant Personality Questionnaire (HAP), and Gerontological Personality disorder Scale.

[Integration of the DSM-5 and ICD-11 Maladaptive Traits in Older Adults: Construct Validity of the PID-5-BF+M].

Background: The Personality Inventory for DSM-5 Brief Form + Modified (PID-5-BF+M) is a self-report questionnaire measuring maladaptive personality traits, as defined by the dimensional classifications of personality disorders in DSM-5 Section 3 and ICD-11. The instrument combines both classifications to capture six personality domains and 18 underlying personality facets, operationalized by two items each. This study examined the construct validity of this questionnaire in older adults, by examining the factor structure and the reliability of the domains and facets.

A Systematic Review of the Heterogeneity of Schema Therapy.

We aimed to explore the heterogeneity of schema therapy regarding (a) patient characteristics, (b) content, and (c) way of delivering schema therapy. A search was conducted of the electronic databases EMBASE, PsycINFO, Web of Science, MEDLINE, and COCHRANE up to June 15, 2022. Treatment studies were eligible if they (a) used schema therapy as (component of) the intervention examined, and (b) reported an outcome measure quantitatively.

The feasibility of eye movement desensitization and reprocessing (EMDR) for older adults with posttraumatic stress disorder (PTSD) and comorbid psychiatric and somatic disorders.

Objective: The aim of this study is to investigate the feasibility of eye movement desensitization and reprocessing (EMDR) therapy in older adults with posttraumatic stress disorder (PTSD), and to explicitly include information about presence of the comorbid psychiatric and somatic disorders as well as a history of traumatic events at treatment start.

Method: A nonrandomized feasibility study in a multicenter design was conducted with 25 older PTSD patients (60-84 years). Treatment consisted of weekly 1-hour EMDR sessions for PTSD during 3, 6, or maximum 9 months.

Systems training for emotional predictability and problem solving in older adults with personality disorders: a pilot study.

Background: Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a cognitive behavioural therapy-based group treatment programme for patients with borderline personality disorder (BPD). STEPPS has demonstrated its effectiveness for (younger) adults. However, there are no studies into the effects of STEPPS for older adults.

Feasibility of EMDR in Older Adults with PTSD to Reduce Frailty and Improve Quality of Life.

Objectives: Posttraumatic stress disorder (PTSD) after exposure to multiple (childhood) trauma's is strongly associated with accelerated aging and high psychiatric and somatic comorbidity, influencing frailty and Quality of Life (QoL) in older adults. Eye Movement Desensitization therapy (EMDR) addresses psychological and physiologic symptoms stemming from adverse life events and therefore could influence frailty and QoL in older adults.

Methods: We conducted a multi-center feasibility study (two psychiatric hospitals) in Dutch older outpatients (N = 24; ≥60 years) with PTSD.

Age-neutrality of the SCID-II: Differential Item Functioning in Younger Outpatients (Aged 20-45) and Older Outpatients (Aged 65+).

Objectives: Measurements are often developed for the assessment of personality disorders (PDs) in younger adults and seldom evaluated on the applicability in older adults. Remarkably, research has not yet been conducted into age-group appropriateness of the gold standard for the assessment of PDs, known as Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II). Therefore, the current study empirically investigated the age-neutrality of the PDs assessed by the SCID-II.

A Feasibility Study of Group Schema Therapy with Psychomotor Therapy for Older Adults with a Cluster B or C Personality Disorder.

Objectives: Schema group therapy is an effective treatment for personality disorders, but its focus on cognitive techniques may be a limitation for older adults. This article describes the rationale and initial evaluation of a group schema therapy protocol enriched with psychomotor therapy (GST+PMT) for older adults in geriatric mental health care.

Methods: Within an observational feasibility study, we evaluated the effect of a 26-week GST+PMT program in 19 outpatients aged 60-70 years with a cluster B or C personality disorder on the Young Schema Questionnaire, Schema Mode Inventory and Manchester Short Assessment of Quality of Life.