A validity study of axis II of DSM-III

The authors examine DSM-III personality disorders in a longitudinally followed community sample of middle-aged inner city men. Eighty-six (23%) of the subjects received an axis II diagnosis of personality disorder. Although these men received relatively little psychiatric attention, they were severely impaired in terms of how they felt about themselves, how others saw their global mental health, and their ability to work and to love. When the strong overlap with alcoholism was controlled for, personality disorder was clearly related to adaptive problems that manifested by early adolescence. The evidence suggests that early deficiencies of biology, environmental support, and ego strength contribute to the development of personality disorder.