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Sex differences in personality dysfunction in help-seeking adolescents.

Marialuisa Cavelti1, Jana Schenk1, Silvano Sele1

  • 1University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, Bern 60, 3000, Switzerland.

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Summary

Female adolescents seeking help show greater personality dysfunction than males, particularly in self-functioning. This highlights the need for sex-sensitive approaches to personality disorders (PDs).

Keywords:
DSM-5 Alternative Model of Personality Disorders (AMPD)DimensionalGenderPersonality disorderSex

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Area of Science:

  • Psychiatry
  • Developmental Psychology
  • Clinical Psychology

Background:

  • Understanding sex differences in personality disorders (PDs) is critical for effective diagnosis and treatment.
  • The DSM-5 Alternative Model of Personality Disorders (AMPD) provides a framework for assessing personality dysfunction.
  • Adolescent help-seeking populations represent a key group for studying PDs.

Purpose of the Study:

  • To investigate sex differences in personality dysfunction among help-seeking adolescents using the DSM-5 AMPD Criterion A.
  • To identify specific domains of personality functioning where sex differences are most pronounced.

Main Methods:

  • A sample of 706 adolescent patients (mean age 15.4 years, 80.88% female) was assessed.
  • Personality dysfunction was evaluated using the Semi-Structured Interview for Personality Functioning DSM-5 (STiP 5.1).

Main Results:

  • Females exhibited significantly higher overall personality dysfunction (Cohen's d=0.36) compared to males.
  • Greater impairments in females were noted in self-functioning domains, including identity (d=0.52) and self-direction (d=0.38).
  • While not statistically significant, females showed greater impairments in intimacy (d=0.23) compared to males; empathy differences were not significant. Higher dysfunction correlated with increased alcohol use disorder likelihood and psychosocial impairments in females.

Conclusions:

  • Female adolescents seeking treatment display more significant personality functioning impairments than males, especially in self-functioning.
  • These findings underscore the necessity of exploring biological, psychological, and social factors contributing to these sex differences.
  • The study calls for the development of sex-sensitive diagnostic tools and interventions for personality disorders.