The alternative model of personality disorders, trauma, and aging: Relationships with post-traumatic stress symptoms and the effect of cumulative trauma exposure

Experiencing traumatic events across the lifespan has long been identified as an etiologic factor in the development or worsening of personality disorder (PD) symptoms. However, knowledge about relationships between trauma and PDs among older adults is limited. In particular, no research has been conducted examining these relationships in later life according to alternative, dimensional models of PDs (i.e., Alternative Model of Personality Disorders; AMPD). The purpose of the study was to examine relationships between the AMPD's two diagnostic constructs (Criterion A: personality functioning and Criterion B: pathological personality traits) with post-traumatic stress (PTS) symptoms, the developmental timing of first experiencing trauma, and cumulative trauma exposure among an older adult sample. Older adults aged 65 years and older (n ​= ​185) completed questionnaires assessing trauma history, PTS symptoms, and the AMPD's two diagnostic constructs. Correlations, hierarchical regressions, and MANCOVA models were computed. Overall, correlational and MANCOVA results suggest that cumulative trauma exposure was more strongly related to AMPD personality pathology than the developmental timing of first experiencing trauma. Further, correlations and regressions suggest that Criterion A's Identity construct was most related to PTS symptoms, with more limited relationships with cumulative trauma exposure and the developmental timing of trauma. Criterion B's Psychoticism and Detachment domains were most strongly related to both PTS symptoms and cumulative trauma exposure. These findings represent the intrapersonally and interpersonally disruptive nature of experiencing trauma and demonstrate that relationships with personality pathology meaningfully persist into older adulthood.