Author's School

Graduate School of Arts & Sciences

Author's Department/Program



English (en)

Date of Award

Summer 8-15-2013

Degree Type


Degree Name

Doctor of Philosophy (PhD)

Chair and Committee

Thomas F Oltmanns


Personality disorders: PDs) are associated with many negative health outcomes, including overutilization of health care resources, increased risk for chronic health problems, and poor adherence to medical recommendations. It is unclear, however, how significantly personality pathology affects an individual's daily health and functioning when health problems have already occurred. The purpose of this dissertation was to determine whether the presence of PD features moderate individual change over time in physical, emotional, and social functioning among individuals with significant health problems. The sample included 1,630 community-dwelling participants, ages 55-64. PD features were measured at baseline; health problems and all outcome variables were measured at baseline and four follow-up assessments. Multilevel modeling analyses were used to test the interactions between number of health problems, time, and personality disorder features in predicting physical, psychological, and social functioning. The results showed that PD features had a significant effect on functioning above and beyond the effects of health problems alone. Borderline, avoidant, and dependent PD features, in particular, showed significant main effects for all three functional outcome domains. Interaction effects with personality pathology were significant for medication use, medical resource utilization, and depressed mood. Individuals with borderline pathology showed significantly more medication use over the 2.5 years when health problems were not present. Individuals with avoidant features used more medical resources over time when health problems were present. Furthermore, individuals with antisocial or histrionic PD features and a higher number of health problems showed increased depressive mood scores over time.


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