Community-dwelling adults versus older adults: testing the continuum hypothesis of psychopathology

Little empirical evidence is available on older adults regarding the existence of a continuum between "normal" personality traits and DSM-IV-TR Axes I and II disorders (American Psychiatric Association, 2000). Given the typical complexity of clinical presentations in advanced age, it is feasible to expect a dimensional conceptualization of psychopathology to apply to older adults. In this pilot investigation, we first tested age differences in psychopathology, upholding the view that older adults should be considered separately from younger individuals in research on psychopathology. Then, in support of the dimensional approach, we tested the hypothesized continuity between normality and psychopathology by verifying the fulfillment of two operational criteria of continuity. A non-clinical sample of 100 Italian respondents was divided into two groups (50 people per group, 25 women and 25 men), aged 25-64 and 65-84, respectively. The instruments used were a measure of normal personality, SFERAS (Boncori & Barruffi, 2004) and one of Axes I and II psychopathology, TALEIA-400A (Boncori, 2007). MANOVA analyses demonstrated a significant effect on both measures, with older adults achieving higher Axis I scores and higher scores on normal personality traits connected to anxiety. The continuum hypothesis was confirmed on older and younger adults through correlational analyses that verified the fulfillment of both continuity criteria. Our results show that Italian older adults differ significantly in psychopathology from younger individuals; however, contrary to findings from other countries, in a negative direction. The continuity results (although in need of replication with larger samples, utilizing statistical methods better suited for these analyses, such as taxometric procedures) offer preliminary support for the notion that the dimensional approach to psychopathology could work well in older age.