Development and Psychopathology 21 (2009), 1211–1231

Copyright # Cambridge University Press, 2009

doi:10.1017/S0954579409990125

Does change in temperament predict

change in schizoid personality disorder?
A methodological framework and illustration
from the Longitudinal Study of Personality
Disorders

MARK F. LENZENWEGERa AND JOHN B. WILLETT b

a
State University of New York at Binghamton; and b Harvard University

Abstract
Personality disorders (PDs) have been thought historically to be enduring, inflexible, and set in psychological stone
relatively firmly; however, empirical findings from recent prospective multiwave longitudinal studies establish otherwise.
Nearly all modern longitudinal studies of personality disorder have documented considerable change in PDs over time,
suggesting considerable flexibility and plasticity in this realm of psychopathology. The factors and mechanisms of change
in the PDs remain essentially opaque, and this area of PD research is just beginning to be probed using candidate predictors
of change, such as personality systems. In this report, we investigate whether change in temperament dimensions
(emotionality, activity, and sociability) predicts change in schizoid personality disorder. We present a latent growth
framework for addressing this question and provide an illustration of the approach using data from the Longitudinal Study
of Personality Disorders. Schizoid personality disorder was assessed using two different methodologies (structured
psychiatric interview and self-report) and temperament was assessed using a well-known psychometric measure of
temperament. All constructs were measured at three time points over a 4-year time period. To analyze these panel data, we
fitted a covariance structure model that hypothesized simultaneous relationships between initial levels and rates of change
in temperament and initial levels and rates of change in schizoid personality disorder. We found that rates of change in the
core temperament dimensions studied do not predict rates of change in schizoid personality over time. We discuss the
methodological advantages of the latent growth approach and the substantive meaning of the findings for change in
schizoid personality disorder.

It has long been assumed that personality disor-
der (PDs) features remain stable over time,
This research was supported in part by Grant MH-45448
from the National Institute of Mental Health (to M.F.L.).
We thank Armand W. Loranger for providing training
and consultation on the use of the International Personal-
ity Disorder Examination and Theodore Millon for pro-
viding consultation on the use of the Millon Clinical
Multiaxial Inventory—II. We are grateful to Lauren
Korfine for project coordination in the early phase of
the study.
Address correspondence and reprint requests to: Mark
F. Lenzenweger, Department of Psychology, State Univer-
sity of New York at Binghamton, Science IV, Binghamton,
NY 13902-6000; E-mail: mlenzen@binghamton.edu.
within the individual. For years the prevailing
diagnostic nomenclature (Diagnostic and Sta-
tistical Manual of Mental Disorders [DSM];
American Psychiatric Association [APA],
1980, 1987, 1994) has embraced this assump-
tion in asserting that PDs, which are relatively
prevalent disorders affecting about 10% of the
population (Lenzenweger, Loranger, Korfine,
& Neff, 1997; Lenzenweger, Lane, Loranger,
& Kessler, 2007), are “enduring patterns” of
individual behavior that are “inflexible” and
“stable over time” (APA, 1994, pp. 629–639).
However, an emerging corpus of data from
modern prospective longitudinal studies reveals
that there is considerable individual change in

1211
1212
personality pathology over time and, in addi-
tion, that these changes differ across indi-
viduals, whether PDs are conceptualized as di-
mensions or diagnostic entities (Johnson,
Cohen, Kasen, Skodol, Hamagami, & Brooks,
2000; Lenzenweger, 1999; Lenzenweger,
Johnson, & Willett, 2004; Shea et al., 2002; Za-
narini, Frankenburg, Hennen, & Silk, 2003; Za-
narini, Frankenburg, Hennen, Reich, & Silk,
2005). In short, PDs do not appear to be set
like plaster or carved in granite. Rather, the con-
temporary picture of the PDs is one character-
ized by plasticity, individual change, and inter-
individual heterogeneity in change over time.
The reasons for this plasticity, change, and het-
erogeneity over time, nonetheless, remain fun-
damentally opaque.
We have been pursuing a program of re-
search designed to illuminate and uncover vari-
ables that may be responsible for both interindi-
vidual and intraindividual growth and change
in the PDs (Lenzenweger & Castro, 2005; Len-
zenweger, Clarkin, Fertuck, & Kernberg, 2004;
Lenzenweger & Willett, 2007). Our program
has been facilitated by the availability of pro-
spective, multiwave PD and personality data
from the Longitudinal Study of Personality Dis-
orders (LSPD; for an overview, see Lenzenwe-
ger, 2006) as well as contemporary develop-
ments in quantitative methods suited for the
study of growth and change (Singer & Willett,
2003), especially those inspired by the individ-
ual growth curve framework for the study of
change over time (Rogosa & Willett, 1985).
In this report, we seek to provide a window
on this methodological and quantitative ap-
proach by adopting a longitudinal focus on
schizoid personality disorder (SZDPD).
SZDPD has long been described in the clinical
literature as a diagnostic entity of considerable
interest (Bernstein, Arntz, & Travaglini,
2009), yet still very little is known about its
long-term longitudinal course within the indi-
vidual over time and the determinants of differ-
ences in change across individuals (if any).
According to the DSM-IV (APA, 1994), “the
essential feature of schizoid personality disor-
der is a pervasive pattern of detachment from
social relationships and a restricted range
of expression of emotion in interpersonal
settings (p. 638).” SZDPD individuals may be
M. F. Lenzenweger and J. B. Willett
described as “loners” or “recluses” by the lay
observer. The lack of desire for contact of any
sort (including sexual contact) with other hu-
man beings in SZDPD is profound. The nearly
complete absence of any expression of emotion
creates the impression of coldness, detachment,
and almost complete affective flattening (for an
excellent review, see Bernstein et al., 2009).
Affecting roughly 1–2% of the general pop-
ulation (Lenzenweger, 2008),1 SZDPD resides
in the “odd/eccentric” Cluster A section of the
DSM system Axis II taxonomy with both
schizotypal personality disorder and paranoid
personality disorder. However, whereas schizo-
typal and paranoid personality disorder have
come to be considered alternative expressions
of schizophrenia liability (Lenzenweger, 1998,
2009), SZDPD appears to be considerably less
related to schizophrenia liability. SZDPD af-
fected individuals rarely come to the attention of
treating clinicians, as most do not appear in
either inpatient or outpatient settings; rather,
they live and function in the community. Those
SZDPD individuals that present to clinical
services are more likely than not to present in
some form of crisis (e.g., drug abuse, suicidal
behavior, depressive episode). A recent study
of the prevalence of PDs in a large series
of outpatients found relatively few (1.4%) to
have SZDPD (Zimmerman, Rothschild, &
Chelminski, 2005). Moreover, in contrast to
schizotypal and paranoid PDs (as well as most
other PDs), SZDPD represents more of a mono-
thetic disorder, phenotypically manifesting it-
self as a profound disruption in sociability.
This disruption may perhaps be reflective of a
massive impairment in the underlying affilia-
tion system (see Depue & Lenzenweger,
2001, 2005). Finally, the disorder seems to
1. In the National Comorbidity Survey—Replication
(NCS-R) study of Axis II psychopathology in the United
States population, a prevalence of 4.9% was found for
schizoid personality disorder in the clinical reappraisal
sample of the study (Lenzenweger, Lane, Loranger, &
Kessler, 2007). This figure is most likely biased upward
compared with the estimates generated for the full NCS-R
study sample, which served to generate the population prev-
alence estimates for Axis II PDs. In the full NCS-R sample a
population prevalence estimate was generated only for “any
Cluster A” disorder, not for individual Cluster A disorders.
Change in schizoid personality disorder and temperament
appear with comparable frequency in men and
women (Bernstein et al., 2009).
Not unlike the general picture of plasticity
and change over time emerging for nearly all
of the other PDs in the DSM taxonomy, SZDPD
is also characterized by change over time rather
than immutable stability. For example, in the
LSPD, the study from which we drew the data
for the current exercise, although individuals
maintained their position in the overall rank or-
dering of SZDPD features across assessment
waves, we observed statistically significant
changes in the mean levels (declines) of
SZDPD features in both interview and self-re-
port assessments (Lenzenweger, 1999). Len-
zenweger, Johnson, et al. (2004) used the
more sensitive and fine-grained analytic ap-
proach of individual growth curve analysis
and found that SZDPD features showed a statis-
tically significant (rate of change ¼ 20.07, p ,
.004) rate of change (toward decreasing symp-
tomatology) over time, consistent with a small
to medium effect size. Clearly, SZDPD was
found to show evidence of growth/change
over a 4-year study period in the LSPD. The re-
sults of the Children in the Community Study
(CIC), under the direction of Patricia Cohen,
also reported that levels of SZDPD features de-
clined over time, showing a 47% drop in mag-
nitude from the 9- to 12-year-old period to the
25- to 28-year-old period (Johnson et al.,
2000). Of interest, unlike the LSPD results, rel-
atively low levels of stability in individual dif-
ferences (rank order stability) were found for
SZDPD, and therefore, SZDPD features in ado-
lescence did not predict SZDPD in adulthood
successfully. Thus, contemporary prospective
multiwave studies suggest not only a lessening
of SZDPD features over time, on average, but
also the presence of interindividual heterogene-
ity in the emergence of the disorder over time
(in the CIC).2
In contrast to the findings of the LSPD and
CIC, Durbin and Klein (2006) did not find a
2. There are two other prospective, multiwave studies un-
derway in the personality disorder area, namely, the Col-
laborative Longitudinal Personality Disorders Study
(Shea et al., 2002) and the McLean Study of Adult De-
velopment (Zanarini et al., 2005). However, neither of
these studies includes SZDPD as a research focus.
1213
statistically significant decrease in SZDPD fea-
tures from baseline assessment to a 10-year fol-
low-up in outpatient psychiatric patients who
had concurrent mood disorders. However, it is
somewhat difficult to discern whether some of
the residual impairment and affective phenom-
enology present in individuals who are affec-
tively ill could impact the presentation and,
perhaps, assessment of SZDPD features.
Fortunately, Durbin and Klein used a well-con-
structed semistructured psychiatric interview
(the International Personality Disorder Exami-
nation [IPDE]; Loranger, 1999), which has
been shown to be robust for Axis II assessments
even in the face of mood and mental state dis-
turbances (Loranger et al., 1991). Finally, the
results of a study in the United Kingdom found
evidence for change in SZDPD features over
time, on average, but in contrast to all other
studies, these investigators reported an increase
in SZDPD features with the passage of time
(Seivewright, Tyrer, & Johnson, 2002). Thus,
it seems reasonable to claim, informed by em-
pirical data (as opposed to clinical impression
or traditional psychiatric lore), that SZDPD dis-
plays a degree of plasticity over time.3 The de-
velopmental psychopathology task at hand,
therefore, is to discern those variables responsi-
ble for this plasticity (i.e., the individual
changes) in the SZDPD as a psychopathologi-
cal entity. Moreover, we should seek to illumi-
nate the mechanism by which these changes,
and the interindividual differences among
them, in SZDPD occur over time.
What could a set of candidate variables that
were responsible for change in SZDPD over
time look like? One could consider any number
of potential predictors of change in SZDPD
symptomatology over time. However, one im-
mediate research vector presents itself, namely,
temperament and those processes subserving
temperament. Thus, we hypothesize that one
possible mechanism that might account for
the change in SZDPD over time could be
those underlying temperament processes that
show themselves some plasticity over time.
3. We note that the short-term (e.g., 2 months), test–retest
reliability of SZDPD features as assessed by the IPDE
is relatively high for both level and rank order analyses
(Loranger et al., 1991).
1214
Temperament denotes a collection of con-
structs, and the overarching concept of tempera-
ment core to many developmental approaches
to psychopathology. However, why would tem-
perament be of relevance to the development of
personality disorders in general, and SZDPD in
particular? In many models, temperament is
conceptualized as being the foundation that un-
derlies personality and therefore, presumably,
personality disorders. Temperament is often
conjectured as being grounded in genetically
influenced neurobehavioral systems and, more-
over, it is thought to maintain its influence on
the development of interindividual differences
over time through childhood (e.g., Putnam,
Rothbart, & Gartstein, 2008) on in to adoles-
cence and adulthood (e.g., Schwartz, Wright,
Shin, Kagan, & Rauch, 2003). Several major
theoretical positions/frameworks regarding the
nature of temperament have been advanced
over the years (e.g., Buss & Plomin, 1984; Der-
ryberry & Rothbart, 1988; Kagan, Reznick, &
Snidman, 1988; Thomas & Chess, 1977; see
also Shiner, 1998)4 and, in many respects, the
similarities among them are greater than their
differences. For the purposes of the LSPD, a
measure of temperament was needed that could
be completed by individuals who were young
adults at the time of assessment, yet as a mea-
sure it would presumably be sensitive to the
central constructs of temperament known to
be prominent in childhood and, by implication,
their phenotypic expression in adulthood. Thus,
Buss and Plomin’s (1984) Emotionality–Activ-
ity–Sociability (EAS) Adult Temperament
Scale was administered in the LSPD to assess
the primary temperamental constructs of emo-
tionality, activity, and sociability in the study
participants.
4. We note the Cloninger model (Cloninger et al., 1993) of
temperament and character in this context; however, we
view the primary “temperament” components of the
Cloninger model as representing heterogenous blends
of underlying personality dimensions (see Waller, Li-
lienfeld, Tellegen, & Lykken, 1991). Moreover, Clonin-
ger et al. (1993) view the character dimensions of their
taxonomy (e.g., transcendence) as having primary
causal influence on the development of personality pa-
thology. As such, this model mixes both personality con-
structs and more ethereal constructs in a hybrid system.
M. F. Lenzenweger and J. B. Willett
A necessary and logical precursor to ad-
dressing the question of whether change in tem-
perament over time predicts change in SZDPD
over time is to specify and fit statistical models
that represent simultaneously, in a thoughtful
and fine-grained manner, individual growth
over time in measures of both temperament
(emotionality, sociability, and activity) and
SZDPD features. In this paper, we use longitu-
dinal data on both SZDPD symptomatology
and the three major temperament dimensions
to test our hypotheses about how individual
change in emotionality, activity, and sociability
impact individual change in SZDPD features
over time. As our hypotheses concern potential
relationships among individual change over
time in both our outcome and our predictors,
in our analyses we must simultaneously model
change over time in personality disorders and
in the interactive temperament systems (emo-
tionality, activity, and sociability) that we be-
lieve could impact that change in SZDPD. We
do this by applying latent growth modeling, a
recently developed analytic approach that has
mapped the methods of individual growth mod-
eling onto the general covariance structure
model (Willett & Bub, 2005; Willett & Keiley,
2000; e.g., Lenzenweger & Willett, 2007).
Our application of latent growth modeling is
relatively new in developmental psychopathol-
ogy research, and builds directly on more tradi-
tional methods of analyzing longitudinal data.
It is an extension of our earlier work on the
analysis of individual growth, in which we
used multilevel modeling to investigate sys-
tematic interindividual differences in growth
by examining the relationships between time-
invariant predictors, such as a subject’s gender,
and an individual’s change in an outcome, like
personality disorders, over time (Lenzenweger,
Johnson, et al., 2004).
Under the standard individual growth mod-
eling approach, individual change in the per-
sonality disorder outcome is described as a
function of time by specifying a “Level 1” indi-
vidual growth model (Singer & Willett, 2003).
The strength of the growth modeling approach
is that it is possible to specify a variety of linear
and nonlinear functional forms for representing
individual change over time, seeking the most
meaningful, well-fitting, and substantively ap-
Change in schizoid personality disorder and temperament
pealing representation. However, when there
limited numbers of waves of longitudinal data
available for analysis, the functional form of
the latter Level 1 growth model must necessar-
ily be simple. With three waves of data on each
individual, for instance, as in the current exam-
ple, one can only adopt an individual growth
model that has, at most, two parameters. This
typically means that individual change is de-
scribed as a linear function of time. Such a
model contains two individual growth parame-
ters: (a) an intercept parameter that represents
the individual’s “true initial status” (providing
that the first occasion of measurement is chosen
as the origin of time: a process known as “cen-
tering”), and (b) a slope parameter that repre-
sents the individual’s “true rate of change
over time.”
Once the Level 1 model has been defined,
the two individual growth parameters can then
stand in place of the individual change trajec-
tory in subsequent analyses of interindividual
differences in change. These latter analyses
are achieved by specifying a “Level 2” statisti-
cal model in which the interindividual hetero-
geneity in the Level 1 parameters; that is, the
differences across people in individual true in-
itial status and rate of change are hypothesized
to depend upon selected time-invariant predic-
tors of change, such as subject gender.
The Level 1 and Level 2 models can be fitted
simultaneously to longitudinal data, usually by
maximum-likelihood methods. By testing and
interpreting the obtained Level 2 parameter es-
timates, we can detect and assess any systematic
interindividual differences in change that are
present. As a consequence, we may conclude
that the true initial status and rate of change in
personality disorder differ for men and women,
and consequently, that the entire personality
growth trajectory differs by gender, on average,
in the population (Singer & Willett, 2003, pro-
vide an extensive description of the approach).
The individual growth model approach has
many important advantages for the serious
analysis of longitudinal data. It is not limited
by the number of waves of data that can be in-
corporated into the analysis. In fact, the more
waves of data that are collected and analyzed,
the more statistical power accrues to the analy-
sis, the greater the reliability with which change
1215
can be measured, and the more complex the in-
dividual trajectories that can be fit. This often
opens up a richer arena of more interesting re-
search questions that can be addressed, and
with increasing precision. For instance, with
more waves of data designed into the data col-
lection, the investigator is no longer limited to
a simple assessment of what predicts heteroge-
neity in the initial status and rate of change of
the individual trajectories, but it may also be
able to examine more complex curvilinear
growth. For instance, one could track individual
logistic and negative exponential trajectories
over time, say, testing for interindividual differ-
ences in their asymptotes, half-lives, and instan-
taneous slopes at entry. Furthermore, in addi-
tion to suffering no limits on the number of
waves of data that can be incorporated into
any analysis, the individual growth modeling
approach allows different individuals to con-
tribute different numbers of waves of data,
each obtained on a unique schedule, to the
same analysis: something that more traditional
approaches to analyzing panel data, such as re-
peated-measures analysis of variance, cannot
entertain. Finally, where appropriate, it is also
straightforward to hypothesize individual
growth trajectories that are discontinuous, and
that exhibit their discontinuities at important
transitions in an individual’s life. This permits
the investigator to extend the research to assess-
ing the impact of experimental treatments and
disrupive life events, such as divorce, on indi-
vidual growth over time.
Our current work is a direct extension of the
individual growth modeling framework to a
multivariate context, with growth in several
constructs being modeled simultaneously. To
achieve this, we use the methods of covariance
structure analysis to model growth over time
simultaneously in multiple domains, such as
SZDPD and temperament. This “latent growth
modeling” approach differs only in that it per-
mits the concurrent specification of several Level
1 individual growth models to describe change
in both the outcome and the predictors simul-
taneously. Consequently, at Level 2, we can ex-
amine potential relationships among the multiple
trajectories of change, rather than simply seeking
time-invariant predictors of those changes (al-
though the latter can be incorporated also).
1216
Our approach is concerned fundamentally
with understanding of both stability and change
(growth) in psychopathology over time. A num-
ber of other statistical approaches have been
brought to bear on questions of stability and
change in psychopathology over time, of
course, in longitudinal data like ours. One ap-
proach, for example, treats the dimensions of
temperament as time-varying predictors of
change in SZDPD symptomatology and incor-
porates measures of temperament directly into
the Level 1 individual growth model itself,
along with the time predictor. Although this is
a feasible analytic approach for handing time-
varying covariates, it addresses an entirely dif-
ferent research question from ours, asking in-
stead whether there is a concurrent relationship
between time-varying levels of symptomatol-
ogy and temperament while both are changing
over occasions (thereby asking, “Is SZDPD
symptomatology related to measures of tem-
perament, controlling for time?”), rather than
the relationship that we have examined here be-
tween concurrent changes in both outcome and
predictor. A second popular approach has been
to use path analysis and structural equation
modeling to investigate simultaneous set of
lagged pairwise relationships, between levels
of the time-varying predictors on one occasion
and the level of the outcome on a subsequent
occasion, over multiple waves of data (this is
a path-analytic extension of the now mostly dis-
used and largely discredited cross-lagged corre-
lation approach). Again, although this kind of
analysis can certainly succeed in detecting the
presence of multiple simultaneous pairwise re-
lationships, and examine and compare the mag-
nitudes of their effects over time, it cannot ad-
dress a research question about change over
time nor one about hypothesized links between
simultaneous changes in both outcome and pre-
dictor, as does the approach we have imple-
mented here.
In the present study, therefore, we sought to
investigate, using prospective multiwave data
from the LSPD (Lenzenweger, 1999, 2006;
Lenzenweger et al., 1997; Lenzenweger, John-
son, et al., 2004; Lenzenweger & Willett,
2007), whether individual change in emotion-
ality, activity, and sociability predicted individ-
ual change in SZDPD features over time. For
M. F. Lenzenweger and J. B. Willett
the purposes of our work, we defined our out-
come as the total number of SZDPD features
evidenced by each subject at each wave. Fortu-
nately, we had two independent measures of
SZDPD available for all of our participants:
one based on a structured interview and the
other based on self-report (see below). Both
of these clinical measures are well-validated
from the standpoint of psychopathology assess-
ment. The use of two measures that are based on
two different methodologies (interview vs. self-
report) provides useful alternative vantage
points from which to view change in SZDPD.
Therefore, to address our research questions,
we modeled individual change simultaneously
in emotionality, activity, and sociability and
SZDPD features using latent growth modeling,
and examined the prediction of individual
change in the latter outcome variable by the in-
dividual changes in emotionality, activity, and
sociability. We present and describe our statis-
tical models in greater detail, below.
Finally, in this context we note that our focus
on the participants in the LSPD data set neces-
sarily begins with the longitudinal study of per-
sons that entered the study at age 18 as they
were selected initially from a university sample.
Moreover, the DSM approach to the diagnosis
of personality disorders demarcates age 18 as
the minimum age for the diagnosis of personal-
ity disorders. Although the LSPD began with
subjects at age 18, there is no reason to believe
that the development of personality pathology
began at age 18. In fact, although the DSM ap-
proach to personality disorders has selected age
18 as a formal cutoff, in the LSPD we actually
had to evaluate the history of the participants as
it related to personality disorders back to the
age 13. This was so because our primary diag-
nostic interview necessitated knowledge of the
PD-relevant history for each participant for
the current year as well as for the prior 5 years.
Insofar as schizoid PD is concerned, or any PD
for that matter, it is our view that the develop-
ment and emergence of personality pathology
essentially begins at conception. By this we
mean to emphasize that all PDs are emergent
phenomena that develop from the complex in-
teraction of genetically influenced brain-based
neurobehavioral systems (Depue & Lenzenwe-
ger, 2001, 2005, 2006) with environmental
Change in schizoid personality disorder and temperament 1217

inputs (e.g., parenting, peer relations, specific Table 1. Descriptive statistics and selected
contextual enrichments, trauma, and so on). demographic characteristics of participants
To this end, we present our analyses and results in the Longitudinal Study of Personality
as a dynamic snapshot of the developmental pe- Disorders sample (N ¼ 250)
riod from roughly 18 to 21 in the LSPD sub-
jects; however, we emphasize that we see the Father Mother
development and emergence of SZDPD as hav-
Parental education
ing roots well before this period. Furthermore,
1–8 years 1.6% 0.8%
we note that additional study of the subjects 9–11 years 2.4% 2.8%
in the LSPD will provide important long-term 12 years 8.4% 15.2%
data on the life span development of SZDPD 13–15 years 16.0% 20.4%
on into the later life course. 16þ years 68.8% 58.8%
Not available 2.8% 2.0%
Parental occupation
Method Laborer/service 2.0% 2.4%
Operatives (machine) 2.8% 1.2%
Craftsman/foreman 3.2% 1.6%
Data set: LSPD Clerical/sales 4.0% 16.8%
Management/official 26.8% 12.8%
The LSPD (Lenzenweger, 1999, 2006; Lenzen-
Professional/technical 52.4% 42.0%
weger, Johnson, et al., 2004), which was begun Not available or
in 1991 as the first National Institutes of Mental homemaker 8.8% 23.2%
Health-sponsored longitudinal study of PDs, has Race
a prospective multiwave longitudinal design African American 3.6%
Latin Hispanic 4.8%
with participants evaluated at three points in
Caucasian Anglo 72.0%
time, corresponding to their first, second, and Asian Pacific Islander 17.2%
fourth years in college. Interview assessments Native American 0.8%
for PD (i.e., Axis II) and Axis I disorders were Other 1.6%
conducted by PhD or advanced Master Social
Worker clinicians with extensive Axis II diagnos-
tic experience, at each of the three assessment helped to ensure diversity across sociodemo-
waves (Lenzenweger et al., 1997). All participants graphic background variables. All participants
in the LSPD also completed a self-report inven- gave voluntary written informed consent and
tory for personality pathology at all three assess- received an honorarium of $50.00 at each
ment waves. Finally, as the LSPD is a naturalistic wave of data collection. Extensive detail con-
prospective study, participants were free to seek cerning the initial subject selection procedure
psychological treatment of their own accord. Ex- and sampling is given elsewhere (Lenzenwe-
tensive detail regarding the LSPD, including reli- ger, 1999; Lenzenweger et al., 1997). Of
ability assessments and other technical matters, is the initial 258 participants, 250 completed
given in prior publications and the interested all three assessment waves and are included
reader is referred to those papers (Lenzenweger, in our current analysis. We summarize a se-
1999, 2006; Lenzenweger et al., 1997). lection of their individual characteristics in
Table 1.
Participants
Initial screening measure
The 258 participants in the LSPD were drawn
initially from a population consisting of 2,000 IPDE DSM-III-R Screen (IPDE-S). The IPDE-
first-year undergraduate students (Lenzenwe- S is a 250-item self-administered true–false
ger, 1999; Lenzenweger et al., 1997; Lenzen- PD screening inventory developed by A. W.
weger, Johnson, et al., 2004). The participants Loranger. The diagnostic efficiency and psycho-
were recruited from both the private and public metric properties of the IPDE-S, in a two-stage
(State University of New York) colleges at Cor- screen application, were generally excellent and
nell University in Ithaca, New York, which have been described previously (Lenzenweger
1218 M. F. Lenzenweger and J. B. Willett

et al., 1997). The grouping variable for the study 175-item, true–false, self-administered inven-
participants described below was based on this tory of personality pathology designed to coor-
measure and is, thus, retained as a control vari- dinate with the DSM-III-R Axis II PDs. The
able in the analyses we report; specific scores MCMI-II possesses excellent psychometric
from the IPDE-S are not used in the analyses. properties and yields separate dimensional
scores for each of the 11 Axis II PDs (Millon,
1987). We defined our other SZDPD outcome
Outcome measures
variable as the scale score for the disorder de-
Personality disorder assessments. rived from the MCMI-II, specifically the
SZDPD base rate corrected score (BR; for tech-
IPDE. The IPDE is the well-known semi-
nical detail on BR scores, see Millon, 1987).
structured interview procedure that assesses
both DSM and ICD-10 PD features (Loranger,
1999; Loranger et al., 1994; Loranger, Sartor- Axis I diagnostic measure
ious, & Janca, 1996), and was used in the World
Structured Clinical Interview for DSM-III-R
Health Organization/Alcohol, Drug Abuse, and
Disorders: Nonpatient Version (SCID-NP).
Mental Health Administration sponsored Inter-
The SCID-NP (Spitzer, Williams, Gibbon, &
national Pilot Study of Personality Disorders
First, 1990) is a semistructured DSM-III-R
(Loranger et al., 1994, 1996). The IPDE has ex-
Axis I clinical interview for use with nonpa-
cellent psychometric properties, and it has been
tients. The clinical interviewers were trained
shown to be robust as a diagnostic assessment
on the use of the SCID-NP using the video-
tool for PDs even in the face of mental state
tape-based training system provided with the
(anxiety, depression) changes. The DSM-III-R
SCID-NP. All interviewers achieved high reli-
criteria were assessed in this study because
ability with criterial cases (intraclass correlation
these were the criteria in effect at the time the
coefficients . .80 for symptom assessments).
LSPD was undertaken. We note the DSM-III-
The SCID interview was done first followed
R and the later DSM-IV criteria bear consider-
by the IPDE as is customary practice for thor-
able resemblance to one another and the funda-
ough Axis II assessments. The Axis I diagnostic
mental PD constructs are the same in both
information generated by the SCID is not a pri-
nomenclatures. Clinically experienced inter-
mary focus of this report, although we do note
viewers received intensive training in IPDE
the results of some sensitivity analyses that in-
administration and scoring by Armand W.
corporate data from the SCID later in this report.
Loranger, and were supervised throughout the
project by the first author, who was blind to
the participants’ identity, putative PD status, Predictors
and all prior assessment information. The inter-
Because our questions focus on change, time is
rater reliability for IPDE assessments (based on
the principal “Level 1” predictor in our analy-
intraclass correlation coefficients) was excel-
ses. It was measured in years from a subject’s
lent at all three waves, ranging between .84
entry into the study. Although all participants
and .92 for all PD dimensions. The interviewers
contributed three waves of data, each being as-
were (a) blind to the putative PD group status of
sessed repeatedly on the same schedule, the
the participants, (b) blind to all prior LSPD PD
time between assessments varied marginally
assessment data, and (c) the same interviewer
from subject to subject because of the practical
never assessed the same subject more than
constraints of data collection. For instance, the
once. We defined one of our SZDPD outcome
average age of participants at each was therefore
variables as the dimensional score total for the
18.78 years (SD ¼ 0.51) at the first wave, 19.83
disorder derived from the IPDE.
years (SD ¼ 0.54) at the second wave, and
21.70 years (SD ¼ 0.56) at the third wave. To
Millon Clinical Multiaxial Inventory—II implement the latent growth analysis, which
(MCMI-II). The MCMI-II (Choca & Van Den- buys some of its analytic sophistication at the
berg, 1997; Millon, 1987) is the well-known expense of the flexibility of the individual
Change in schizoid personality disorder and temperament
growth modeling approach, we needed to as-
sume a common measurement schedule across
all participants, and so we set the times of mea-
surement for each person equal to their be-
tween-person averages, at each wave. Declaring
the origin of time as entry into the study, then,
in our analyses time takes on the values of 0,
0.95 and 2.82 years at the first, second, and
third waves, respectively. In our analyses, we
then took the natural logarithm of its values
(i.e., time value þ 1) before incorporating
time into out Level 1 models to linearize the in-
dividual growth trajectories and promote effi-
ciency in the estimation in the latent growth
models (Singer & Willett, 2003). Thus, the
transformed time values (see Appendix A)
were 0.00, 0.67, and 1.34.
Temperament. The EAS Adult Temperament
Scale (Buss & Plomin, 1984), is a 20-item
self-report measure, for use with adults, of the
three major temperament constructs, emotion-
ality (E) (which breaks down further to “fear,”
“distress,” and “anger” subdimensions), activ-
ity (A), and sociability (S), which are thought
to underlie personality processes in children
and adults. The EAS requires a subject to read
20 statements and decide how characteristic or
typical each statement is of him/herself on a
5-point scale. Factor analysis of the childhood
and adult versions of the EAS has revealed a
consistent structure that supports the basic three
temperaments model of Buss and Plomin
(1984; see also Mathieson & Tambs, 1999;
Nærde, Røysamb, & Tambs, 2004) and test–
retest reliability of the Adult EAS is acceptable.
Covariates
Although none of their effects are a principal
focus of the findings we report here, we also in-
cluded three important covariates to control for
intrinsic features of the study’s sampling and re-
search design, in all of our analyses. These were
(a) the subject’s age at entry into the study, (b)
the subject’s assignment to putative PD risk
group prior to study onset, and (c) the subject’s
sex. Age-at-entry was measured in years and
was included to account for marginal heteroge-
neity in the ages of participants at the beginning
of the study. The group variable described par-
1219
ticipants’ initial assignment (established prior
to IPDE and MCMI-II data collection) to either
a “possible personality disorder” (PPD) or “no
personality disorder” (NPD) group according to
the IPDE-Screen (IPDE-S; Lenzenweger,
1999; Lenzenweger et al., 1997). As detailed
in Lenzenweger at al. (1997), PPD participants
met the diagnostic threshold on the IPDE-S for
at least one specific DSM-III-R PD, whereas
NPD participants: (a) did not meet the DSM-
III-R defined threshold for diagnosis, and (b)
had fewer than 10 PD features across all disor-
ders on the screener (see Lenzenweger, 2006,
for greater detail). Five PPD and three NPD
participants did not complete all three waves
of data collection; two of these noncompleting
participants died during the course of the study,
one in each subject group. Control predictor
male identified the subject as either male or fe-
male: the sample contained 121 males (47%)
and 137 females (53%). We also included a
two-way interaction of the group and sex pre-
dictors as a covariate in our analyses.
Statistical analysis
As noted above, to evaluate the simultaneous
impact of individual change in emotionality, ac-
tivity, and sociability on individual change in
the SZDPD features on the IPDE and MCMI-
II over time, we adopted a latent growth model-
ing approach (Willett & Bub, 2005; Willett &
Keiley, 2000). Under this approach, we used
the Y and X measurement submodels present
within the general covariance structure model
to specify individual growth models for our
time-varying outcome and for all three (emo-
tionality, activity, and sociability) of our time-
varying predictors simultaneously. With only
three waves of data on both outcome and pre-
dictors for each subject, we were limited in
the complexity of our growth specification.
Consequently, after preliminary graphical ex-
ploration, we specified linear trajectories to
represent change over time in each of the mea-
sures. Thus, individual trajectories of change
in the outcome and each of the predictors are
implicitly represented, in each case, by a “true
initial status” and a “true rate of change”
parameter for each participant. Then, in the
standard structural component of the general
1220 M. F. Lenzenweger and J. B. Willett

Figure 1. The hypothesized path model depicting the relationships among true initial status (elevation) and true
rate of change in four personality indicators of neurobehavioral systems and true initial status (elevation) and true
rate of change in personality disorder (PD) symptomatology over time (control predictors omitted for clarity, see
text for additional details). [A color version of this figure can be viewed online at journals.cambridge.org/dpp]

covariance structure model, we specified Level
2 relationships among the respective individual
growth parameters to articulate our hypotheses
about the prediction of change in SZDPD fea-
tures over time by changes in emotionality, ac-
tivity, and sociability.
In Figure 1, we present a simplified path dia-
gram that displays, for a generic SZDPD fea-
tures outcome (for either IPDE or MCMI-II
data), the several hypothesized measurement
models and structural model that underpin our
covariance structure analyses. As noted above,
the Y and X measurement models on the right
and left sides of the path model, respectively,
specify the hypothesized Level 1 change trajec-
tories in the outcome and the predictors, and the
structural model that occupies the center of the
path diagram defines the hypothesized Level 2
relationships among the individual growth pa-
rameters. Although we included additional con-
trol variables (as described above) in all of our
statistical models as predictors of change in
SZPD features, we have omitted them from
the path diagram in Figure 1 to avoid clutter.
It is easy to see how this kind of path model
could easily be extended to incorporate any
number of additional outcomes and predictors,
each changing over time, and each measured on
Change in schizoid personality disorder and temperament
its own schedule of data collection. It would
even be possible to generalize the latent growth
model to accommodate differing numbers of
waves of data for each outcome and predictor.
We fitted the complete path model to our
longitudinal data using the LISREL software
(Version 8.7; Jöreskog & Sörbom, 2004), sepa-
rately for each of the two SZPD outcome mea-
sures (IPDE—interview; MCMI-II—self-re-
port). Appendix A presents the LISREL VIII
program for fitting the basic latent growth
model discussed here.
As can be seen in Figure 1, having three
waves of longitudinal data available on each
outcome and predictor permitted us to specify
individual growth models in which predictors
describing participants’ emotionality, activity,
and sociability were hypothesized simultane-
ously to be linear functions of time. This im-
plied the presence, in the path model, of three
latent constructs representing the true initial
levels (or elevations, p EMOT
1 , p ACT
1 , p SOC
1 ) and
true slopes (or rates of change, p EMOT 2 , p ACT
2 ,
p SOC
2 ) of the growth trajectories for these neuro-
behavioral indicators. Growth in the total
SZDPD features (IPDE or MCMI-II), was sim-
ilarly specified in the latent growth model,
yielding another pair of latent constructs that
represented the true initial level ( p SZDPD1 ) and
true rate of change ( p SZDPD
2 ) of the PD features
growth trajectory in each of the clusters. Then,
the individual latent growth parameters repre-
senting change over time in emotionality, activ-
ity, and sociability were hypothesized to predict
the latent growth parameters that represented
change in SZDPD features in the structural
part of the path model, providing 12 structural
regression parameters (gammas) that were the
focus of our analytic attention and addressed
our research questions.
In an initial round of statistical analysis, we
fitted the “full” path model specified in Figure 1
(including all covariates) for each of our two
outcomes (IPDE SZDPD and MCMI-II
SZDPD features). Then, we tested sequential
nested hypotheses to ascertain a parsimonious
final fitted model in which we omitted several
of the originally hypothesized paths because
they were not required (for a description of
this approach, see Singer & Willett, 2003).
We provide parameter estimates and associated
1221
inferential statistics for both the “full” and the
“reduced” models later in the paper. A full tax-
onomy of fitted models is available from the
first author, on request. All hypothesized latent
growth models were fitted assuming that the
Level 1 measurement errors were homoscedas-
tic over time, within each growth process, be-
cause supplementary analyses in which the er-
rors were permitted to be heteroscedastic
confirmed that this was reasonable. Finally,
we also conducted sensitivity analysis in which
we fit models in which we included two addi-
tional predictors of true initial level and true
rate of change in the SZDPD dimensions,
namely, the presence or absence of any form
of Axis I disorder before or during the study pe-
riod as well as the presence or absence of any
form of psychological/psychiatric treatment be-
fore or during the study period, as predictors.
We detected no important differences in our
findings on inclusion of these covariates.
Results
Clinical characteristics of the sample
The lifetime DSM-III-R Axis I diagnoses for
study participants have been reported pre-
viously (Lenzenweger, 1999; Lenzenweger,
Johnson, et al., 2004). In overview, 81
(62.8%) of the PPD participants received a def-
inite or probable Axis I diagnosis compared to
32 (26.4%) NPD participants (x 2 ¼ 33.30, df ¼
1, p , .00001). Forty-one (31.8%) PPD partic-
ipants versus 21 (17.4%) NPD participants re-
ported a prior history of treatment by Wave III
(x 2 ¼ 6.97, df ¼ 1, p , .008). Finally, at
Wave I, 11% of the participants qualified for
an Axis II diagnosis of some sort. The raw rates
of diagnosed PDs in the LSPD sample as of
Wave I were as follows: 1.2% paranoid, 1.2%
schizoid, 1.6% schizotypal, 0.8% antisocial,
1.6% borderline, 3.5% histrionic, 3.1% narcis-
sistic, 1.6% obsessive–compulsive, 0.8% pas-
sive–aggressive, 1.2% avoidant, 0.8% depen-
dent, and 4.3% PD—not otherwise specified.
Moreover, as of the Wave III assessment (i.e.,
4 years, 16% of the sample received a probable
or definite diagnosis for at least one Axis II PD
(or PD—not otherwise specified). Thus, by
Wave III, approximately one in every six
1222
Table 2. Bivariate correlations among
temperament and schizoid personality
disorder (N ¼ 250) at baseline (Wave 1)
Temperament Dimensions
Emotionality Activity Distress
Schizoid PD
IPDE .01 2.14* 2.38**
MCMI-II .08 2.16* 2.54**
Note: Values are Pearson product-moment correlation co-
efficients with two-tailed p values. PD, personality disor-
der; IPDE, International Personality Disorder Examination
(Loranger et al., 1991); MCMI-II, Millon Clinical Multiax-
ial Inventory—II (Millon, 1987). Temperament dimensions
of emotionality, activity, and distress were assessed using
the Buss and Plomin (1984) EAS Adult Temperament
Scale.
*p , .05. **p , .01.
participants in the sample met formal DSM-III-
R thresholds for PD diagnoses based on the
highly conservative IPDE (Loranger, 1999).
When converted to weighted population preva-
lence rates (see Lenzenweger, 2006), the rates
of diagnosed PD accord well with estimates
for the general population of the United States
(Lenzenweger, Lane, et al., 2007).
Baseline (Wave I) associations among
temperament and SZDPD measures
Although the principal focus of this report is the
latent growth analysis that we report next, we
anticipate that some psychopathologists would
have an interest in the baseline (Wave I) asso-
ciations that were observed between the two
measures of SZDPD and the temperament vari-
ables. We present these statistics in Table 2. In-
spection of the table reveals that SZDPD has a
robust inverse relationship with sociability
(large effects) across both clinical measures
and activity has a modest, but statistically sig-
nificant, inverse relationship (small effects)
with activity across both clinical measures. At
baseline, SZDPD has very weak associations
with the emotionality temperament dimension.
Latent growth analyses
The variability in SZDPD growth across partic-
ipants that we sought to model as a function of
M. F. Lenzenweger and J. B. Willett
temperament in this approach is evident in Fig-
ure 2. In exploratory analyses, Figure 2 presents
individual ordinary least squares fitted growth
curves for each of the 250 participants in the
LSPD across the study period. The most striking
aspect of this collection of empirical individual
growth trajectories for both the IPDE and
MCMI-II SZDPD features scores is the large
heterogeneity that is evident in the observed
growth. Clearly, the participants did not all fol-
low the same trajectory, nor did their outcome
values remain completely consistent over time,
as would have been predicted by the DSM defi-
nition of PD. Indeed, although some partici-
pants’ SZDPD features scores did, in fact, re-
main largely unchanged over time, others lost
SZDPD features over time and yet others devel-
oped more SZDPD features over time. It was this
variability in SZDPD growth that we sought to
model as a function of change in temperament,
in our latent growth analyses.
Table 3 reports our full and reduced fitted la-
tent growth models for each of the two SZDPD
outcomes (IPDE and MCMI-II). We present pa-
rameter estimates, approximate p values and se-
lected goodness of fit statistics (goodness of fit
chi square, Akaike information criterion, root
mean square residual, standardized root mean
square residual) for all fitted models. We also re-
port a pseudo-R 2 statistic describing the success
of the prediction of variability in each SZDPD
growth parameter in each model. This latter sta-
tistic is akin to the adjusted R 2 statistic, more fa-
miliar in regular regression analyses, and esti-
mates the proportion of variance in the relevant
SZDPD growth parameter that has been ex-
plained simultaneously by all predictors in the
particular model. The overall average trend for
SZDPD growth over the study period was to-
ward a lessening of SZDPD features with the
passage of time; however, there were indeed a
nontrivial number of cases where SZDPD symp-
tomatology worsened (i.e., increased) with time.
We now discuss the results for the IPDE and
MCMI-II measures of SZDPD separately.
With respect to the IPDE SZDPD results, we
found that in the full model, which included the
full array of temperament dimensions as well as
all control variables (sex, group, Group  Sex
interaction, and age at study entry), the true in-
itial status of sociability was inversely related to
Change in schizoid personality disorder and temperament 1223

Figure 2. Individual ordinary least-squares fitted growth trajectories in schizoid personality disorder fea-
tures for 250 participants over the study period. Time is reported in years since the beginning of the study,
and it is centered for each subject using the subject’s age at entry into the study. (a) The International Per-
sonality Disorder Examination (IPDE; Loranger, 1999) assessments and (b) the Millon Clinical Multiaxial
Inventory—II (MCMI-II; Millon, 1987) assessments.
 Table 3. Predicting individual growth in schizoid personality disorder features (true initial status and true rate of change) by individual growth
in temperament dimensions of emotionality, activity, and sociability (N ¼ 250)

Growth in Schizoid Personality Disorder Features

IPDE MCMI-II

Full Model Reduced Model Full Model Reduced Model

p1 p2 p1 p2 p1 p2 p1 p2

Parameter Estimates and Approximate p Values

Intercept 7.232 23.916 5.035† 2.071 155.137† 224.754 163.868*** 64.710

EMOT
p1 0.012 0.079 — — 0.644 20.432 — —
p2 0.781 20.403 — — 2.564 26.529 — —
ACT
p1 20.185 0.089 — — 24.125 20.436 — —
p2 20.347 0.122 — — 26.875 5.137 — —
1224

SOC
p1 20.926*** 0.109 2.758*** — 222.975*** 21.599 223.92*** —
p2 20.266 21.670 — — 24.499 232.030 — —
Sex (male) 20.075 0.301 0.001 0.092 10.221* 21.259 9.68* 22.093
Group (PPD) 20.025 20.039 20.163 0.081 1.475 25.515 0.301 26.594*
Group by Sex 0.693 20.797 0.494 20.381† 26.654 1.394 25.994 9.992*
Age at entry 20.147 0.135 20.095 20.118 21.523 1.849 22.262 23.448

Goodness of Fit Statistics

x 2 statistic (df ) 81.84 (58) 108.79 (69) 88.09 (58) 118.39 (69)
Pseudo R2 33.2% 32.5% 24.6% 7.1% 53.3% 82.4% 52.4% 25.1%
AIC 324.25 339.84 255.53 336.18
RMSR 0.071 0.089 5.253 8.99
SRMSR 0.059 0.076 0.035 0.046

Note: The table contains parameter estimates and approximate p values from the structural portion of selected full and reduced (final) fitted latent growth models for the interview (IPDE) and
self-report (MCMI-II) data. IPDE, International Personality Disorder Examination (Loranger et al., 1991); MCMI-II, Millon Clinical Multiaxial Inventory—II (Millon, 1987); p1 , true initial
status; p2 , true rate of change; EMOT, emotionality temperament dimension; ACT, activity temperament dimension; SOC, sociability temperament dimension; AIC, Akaike information
criterion; RMSR, root mean square residual; SRMSR, standardized root mean square residual. Sex is coded 1 ¼ male, 0 ¼ female; Group (PPD) is coded 1 ¼ probable personality disorder,
0 ¼ normal control.
†p , .10. *p , .05. **p , .01. ***p , .001 (two tailed).
Change in schizoid personality disorder and temperament
true initial SZDPD status. No other tempera-
ment nor control variable predicted the true in-
itial status of SZDPD. In terms of rate of change
in the SZDPD features from the IPDE, no pre-
dictor among the temperament or control vari-
able set was statistically significantly related
to true rate of change. We fitted a reduced
model that included the true initial level of
sociability in the prediction of true initial status
of SZDPD as well as the control variables as
predictors of both true initial status and true
rate of change in SZDPD. Not unlike the results
for the full model, true initial status of sociabil-
ity was inversely related to true initial status
levels for SZDPD. No other predictors had a
statistically significant relationship with true
rate of change in SZDPD for the IPDE data,
in the reduced model.
With respect to the MCMI-II SZDPD results,
we found that in the full model, which also in-
cluded the full array of temperament dimensions
as well as the control variables (sex, group, Group
 Sex interaction, and age at study entry), again
true initial status of sociability was inversely re-
lated to the true initial SZDPD status of the partic-
ipants. In this analysis, subject sex was also asso-
ciated with true initial status of SZDPD, with
males exhibiting higher levels. No other tempera-
ment or control variables were related to true in-
itial status of SZDPD. In terms of rate of change
in the SZDPD features from the MCMI-II, no pre-
dictor in the temperament or control variable set
was statistically significantly related to true rate
of change in SZDPD features.
We again fitted a reduced model that included
the true initial level of sociability as a predictor of
true initial status of SZDPD as well as the control
variables as predictors of both true initial status
and true rate of change in SZDPD. Not unlike
the results for the full model, true initial status
of sociability was inversely related to true initial
status levels for SZDPD. In the reduced model,
as before, males exhibited higher levels of true
initial status of SZDPD features. With respect
to the rate of change in SZDPD features on the
MCMI-II, there were no statistically significant
predictors of the true rate of change in SZDPD
features in the full model. However, of interest,
in the reduced model, we found a statistically sig-
nificant relationship between the “Subject Group
[PPD vs. NC]Sex interaction” and true rate of
1225
change in SZPD such that male/PPD participants
exhibited a positive rate of change in SZDPD
(i.e., greater amount of symptomatology) over
time. There were no other predictors that were re-
lated to true rate of change in SZDPD for the
MCMI-II data in the reduced model.
Sensitivity analyses: Impact of treatment
and/or Axis I
In addition to our primary analyses of SZDPD
described above, we also conducted sensitivity
analyses to evaluate the impact of the presence
or absence of any Axis I disorder and/or the pre-
sence or absence of any form of psychiatric/
psychological treatment in the participants ei-
ther before, or during, the study period on the
growth observed for the SZDPD feature dimen-
sions on the IPDE and MCMI-II. We believed
that this was a reasonable set of analyses to
undertake given the possibility that comorbid
Axis I pathology might alter the growth trajec-
tories, as might the impact of any form of treat-
ment. We found that the presence of any form
of Axis I disorder either before or during the
study period was unrelated to true rate of
change for SZDPD features over time, and
that the presence of any form of psychiatric/
psychological treatment was also unrelated to
true change for SZDPD features over time.
Discussion
The emerging corpus of empirical results from
the longitudinal study of personality pathology
suggests that the disorders are considerably
more flexible and plastic than previously
thought. Indeed, the prevailing doctrine in psy-
chiatry and clinical psychology over the past
100 years held that PDs are stable, enduring,
and traitlike. Like the other PDs for which
data on long-term growth are now available,
SZDPD also shows evidence of flexibility,
change, and malleability. The data from the
LSPD for SZDPD underscore this flexibility
for SZDPD on both structured diagnostic inter-
view assessments as well as self-report scores
on a psychometric inventory. In this study, we
sought to determine if changes in temperament
over time were in some manner related to
growth in SZDPD over time. The overall thrust
1226
of our findings was that true rate of change in
any of three core temperament dimensions
(emotionality, activity, sociability) was essen-
tially unrelated to true rate of change in SZDPD
over time. The only statistically significant pre-
dictive relationship that we found for a tempera-
ment construct was with sociability. That find-
ing was relatively straightforward in that we
found that participants with lower initial levels
of sociability exhibited higher initial levels of
SZDPD, for both the IPDE and MCMI-II
data. This consistency in finding across the
self-report and interview assessment instrument
modalities was encouraging and suggested to
us that sociability, perhaps reflective of the un-
derlying affiliation system (see Depue & Len-
zenweger, 2001, 2005), was an important deter-
minant of schizoid symtomatology. It also
accord well with a prior analysis of growth in
the Cluster A symptomatology in the LSPD
study participants in relation to growth in com-
munal positive emotion (affiliation; Lenzenwe-
ger & Willett, 2007), such that initial levels of
communal positive emotion were inversely re-
lated to initial levels of Cluster A features (on
the IPDE). Somewhat surprising to us was
that changes in emotionality, which consists
of anxiety, fear, and anger, were not associated
either with true initial level or rate of change in
SZDPD. This was surprising, because a wealth
of clinical observation and conjecture (see
Bernstein et al., 2009) suggests that consider-
able fear and anxiety attend schizoid pathology.
It is possible, however, that with only three
waves of data available on the outcome and pre-
dictors, that we did not have sufficient statistical
power to detect these relationships. The statisti-
cal power of any longitudinal research design,
and the reliability with which we can estimate
individual true rate of change (Singer & Willett,
2003), are strongly dependent on the number of
waves of data that have been collected, provid-
ing a considerable incentive for including addi-
tional waves of data in any panel. Finally, one
aspect of our results raises an interesting meth-
odological question for us, namely, why was it
that male/PPD participants showed a higher
(positive) rate of change (worsening of
SZDPD) over time on the MCMI-II, but not
on the IPDE? Could it be that in some instances,
male participants with some evidence of pathol-
M. F. Lenzenweger and J. B. Willett
ogy might be more disclosing on a psychomet-
ric inventory than in an interview? We hope to
pursue this issue in subsequent analyses.
One of the interesting developmental ques-
tions that arose for us in this set of analyses con-
cerned the ultimate fate of participants with ele-
vated SZDPD features. Could it be the case that
for some participants with noteworthy SZDPD
features at study entry cease to show SZDPD
features over time because their psychopathol-
ogy has shifted somewhat, perhaps toward
more severe Cluster A or (even) psychotic phe-
nomenology? There are few data bearing upon
this developmental question; however, a hint of
this possibility comes from the interesting work
of Sula Wolff. She and her colleagues (Wolff,
Townshend, McGuire, & Weeks, 1991) as-
sessed adult longitudinal outcomes in children
initially diagnosed as schizoid. A considerable
proportion (i.e., 75%) of those children initially
diagnosed as schizoid went on to develop more
clearly identifiable schizotypal (as opposed to
schizoid) personality disorder features in adult-
hood. In fact, of those studied (n ¼ 32), two
went on to develop clinically diagnosed schizo-
phrenia. Thus, the import of the Wolff et al.
(1991) findings for the present study is that
longer term longitudinal followup may shed
light on this critical question: Do many of the
more severely affected schizoid LSPD partici-
pants go on to develop schizotypal disorders
(or schizotypal features) as they move into the
later decades of life? Would such conversion
to schizotypal PD be associated with identifi-
able changes in temperament or would this re-
flect, perhaps, the developmental unfolding of
a schizophrenia-related liability (as opposed to
a temperament based alteration)? We hope to
examine this possibility as we develop a meth-
odological extension of the present latent
growth curve approach for that purpose.
On a broader methodological note of inter-
est, the latent growth modeling approach that
we utilized here offers powerful advantages in
the study of the predictors of change or growth
in developmental psychopathology research.
This is particularly true with respect to systems
that involve multiple component parts or pro-
cesses that could be affecting (or be correlated
with) a given outcome simultaneously. For ex-
ample, as it is likely that SZDPD (and all PDs
Change in schizoid personality disorder and temperament
for that matter) features reflect the phenotypic
manifestations of multiple dynamic interactive
neurobehavioral systems at work and each of
these interactive systems themselves likely
show change and growth across the life course,
then an understanding of this process requires
an appropriate analytic strategy that must be
able to handle simultaneous growth in several
systems, as well as take various background
variables into account (e.g., sex, age). Our la-
tent growth modeling approach achieves this
goal as it unifies the powerful growth curve
methodology (Rogosa, Brandt, & Zimoski,
1982; Rogosa & Willett, 1985) that has proven
so useful in the investigation of change in psy-
chological and behavioral phenomena over
time with the flexibility of covariance structure
analysis. In this way, we have been able to move
freely through an exploration of the impact of
multiple important variables, some changing
(emotionality, activity, sociability) and others
not (sex, group status, age at entry), in predict-
ing growth in SZDPD. We also note that our
present approach for investigating “growth on
growth” represents a compelling and superior
statistical alternative to the analysis of cross-
lagged correlations, which has been a common,
but problematic (Rogosa, 1980), way of exam-
ining relationships between two variables that
are changing simultaneously over time.
In exploring SZDPD data from the LSPD, it
has become evident to us that it is likely that our
study sample, like many in all areas of psycho-
pathology research, probably contains an ad-
mixture of participants. For example, our sam-
ple contains a proportion of participants that
were unimpaired at the baseline entry point of
the study and remained so throughout the study
period. Such participants reside within the data
set and, in a manner of speaking, they have their
own (somewhat) unique growth pattern: they
show no growth and inflate the data set with
zero values (i.e., known statistically as “zero in-
flation”). This suggests to us that the potential
utility of using mixture modeling approaches,
which have proven useful in other psychopathol-
ogy efforts (e.g., Lenzenweger, Clarkin, Yeo-
mans, Kernberg, & Levy, 2008; Lenzenweger,
McLachlan, & Rubin, 2007; Lenzenweger &
Moldin, 1990), to parse the observed growth tra-
jectories of the LSPD participants into identifi-
1227
able latent growth mixture components (Mu-
thén, 2004, 2006; Nagin, 1999, 2005; Nagin &
Tremblay, 2001; see also Connell & Frye, 2006).
Several caveats must also be considered with
these data. First, the LSPD sample is clearly
more homogenous in age, educational achieve-
ment, and social class than the US population at
large as well as consists of young adults, fea-
tures that may have differentially affected the
study results. Perhaps the most effective way
to assess the generalizability of findings from
the LSPD is to evaluate whether prior core
LSPD findings have been replicated, and they
have. For example, the LSPD-based estimate
for PD prevalence in the community (11%;
Lenzenweger et al., 1997) has now been
broadly replicated several times in US nonclini-
cal community samples (Crawford et al., 2005;
Samuels et al., 2002) and the US general popu-
lation (Lenzenweger, Lane, et al., 2007), as
well as in Norwegian (Torgersen, Kringlen, &
Cramer, 2001) and United Kingdom (Coid,
Yang, Tyrer, Roberts, & Ullrich, 2006) samples
(for review, see Lenzenweger, 2008). Further-
more, the basic patterns of change in mean levels
of general PD features over time initially re-
ported for the LSPD sample (Lenzenweger,
1999) were subsequently replicated in both clin-
ical (Shea et al., 2002; Zanarini et al., 2003) and
nonclinical community (Johnson et al., 2000)
samples. Thus, although the present sample is
somewhat more compressed in terms of demo-
graphic background characteristics, this has not
lead to findings at odds with those obtained in
other epidemiological or longitudinal PD re-
search. As noted above, the prevalence of
SZDPD in the population tends to run in the
range of 1.0%, which was precisely the rate of
SZDPD in the population studied here.
Second, we also note that adjustment to uni-
versity life across the college years may have
played some role in the changes we observed.
However, we do note that the IPDE specifically
requires one to respond after reflecting on 5
years of behavior (not just the current time or re-
cent past) (Loranger, 1999), and it is relatively
robust in the face of mental state alterations
(Loranger et al., 1991). Third, given that the
LSPD participants were selected from a popula-
tion of first-year university students, the sample
may have been somewhat censored for a portion
1228
of the most severely PD affected individuals.
However, one must be cautious in ascribing un-
due levels of mental health to participants who
happen to be selected for academic achieve-
ment as such selection does not confer immu-
nity to psychopathology. In fact, several forms
of PD might actually be enriched in such a sam-
ple (e.g., obsessive–compulsive PD, narcissis-
tic PD, schizoid PD). To this end, we note
that 16% (or one in every six) of the LSPD sam-
ple participants was diagnosed with a formal
Axis II disorder by the end of the study period
(i.e., by Wave III) using the highly conservative
IPDE. Many other participants met intermedi-
ate levels of PD criteria (e.g., two or three cri-
teria) that fell short of DSM diagnostic thresh-
old counts, but indicated the presence of some
degree PD disturbance of clinical intensity
nonetheless according to the IPDE. Such inter-
mediate levels of PD pathology are frequently
seen even in clinical samples (e.g., Loranger
et al., 1991). We note also that 45.2% of the
LSPD participants had a lifetime (or current)
Axis I disorder by the end of college and these
data are broadly consistent with the ubiquitous
nature of Axis I disorders in the US population
(see Kessler, Chiu, Demler, & Walters, 2005;
Kessler et al., 1994).
Fourth, we are mindful that there may be
other predictors of change in personality disor-
der. Some may be a consequence of important
time-varying processes (e.g., other personality
factors), whereas others may not (e.g., presence
of severe childhood sexual abuse would be a
time invariant predictor). Thus, there may
well be other factors that would be predictive
of true rate of change in the PDs over time.
We hope to establish such hypotheses, and
probe the LSPD database more deeply in terms
of SZDPD as well as the other PDs, in the com-
ing years to explore such possibilities as well as
collect additional data relevant to this possibil-
ity upon upcoming Wave IV and Wave V as-
sessments. On a related note, it may also be
the case that some of the DSM PDs may not re-
flect solely the functioning of personality sys-
tems, specifically the Cluster A PDs. It may
be the case that paranoid and schizotypal PDs
represent variants of schizophrenia and thus
are less related to personality (cf. Lenzenweger,
1998). Finally, we emphasize that our research
M. F. Lenzenweger and J. B. Willett
design is observational not experimental and
so, although we have specified the hypothe-
sized direction of relations in the growth model,
we cannot address questions of causation. The
temperament systems studied here are thought
to reflect underlying neurobehavioral, brain-
based systems and they may be, in part, respon-
sible ultimately for personality and personality
disorder; however, our data analyses cannot test
these conjectures.
It has long been assumed that SZDPD and the
other PDs are in place relatively early in the life
course (i.e., late adolescence, early adulthood;
see DSM; APA, 1980, 1987, 1994) and that
they stay in place for the most part across the
life span, as if carved in granite. In our prior anal-
yses of the LSPD (Lenzenweger, 1999; Lenzen-
weger, Johnson, et al., 2004) data, we have re-
ported evidence of flexibility in most PD
features over time, a fact that challenged this
long-held assumption regarding the traitlike qual-
ity of PDs over time. In short, those prior reports
documented that an appreciable amount of
change was occurring in the PDs on average
over time. However, those reports did not specify
what was driving, or was correlated with, such
change. The present paper extends those initial
observations by using an approach that seeks to
identify the temperament variables (constructs)
that do (or do not) predict individual change in
PD features over time, thus moving from a
merely descriptive to a more explanatory,
model-testing research posture. Although Wil-
liam James (1890, p. 121) claimed “by the age
thirty, the character has set like plaster, and will
never soften again,” we now know this is true
only for some some aspects of normal personality
(Srivastava, John, Gosling, & Potter, 2003; Ro-
berts, Walton, & Viechtbauer, 2006). Of impor-
tance, we now know, insofar as one might want
to suggest SZDPD is a form of character or per-
sonality, SZDPD is not set like “plaster” at an
early age with little prospects for change as as-
sumed by the official psychiatric nomenclature
and common clinical lore (Johnson et al., 2000;
Lenzenweger, 1999; Lenzenweger, Johnson,
et al., 2004; Shea et al., 2002; Zanarini et al.,
2003). Our research findings provide some initial
coordinates for future explorations of those as-
pects of both temperament and personality disor-
der where the plaster seems not to harden.
Change in schizoid personality disorder and temperament
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Appendix A

LISREL VIII program for fitting the hypothesized latent growth model in Figure 1

Job title
TI Temperament growth predicts schizoid personality disorder growth
Raw data input
DA NI¼16 NO¼250
RA FI¼C:\IPDESZD.dat
Variable labeling and selection
LA
szd1 szd2 szd3 emot1 emot2 emot3 act1 act2 act3 soc1 soc2 soc3 Male PPD GS Entry
SE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16/
Model specification
MO NY¼3 NE¼2 TY¼ZE LY¼FU,FI TE¼DI,FR C
NX¼13 NK¼10 TX¼ZE LX¼FU,FI TD¼DI,FR PH¼SY,FR C
AL¼FR GA¼FU,FR KA¼FR BE¼ZE PS¼SY,FR
LE
SzdPi1 SzdPi2
LK
Emotpi1 Emotpi2 Actpi1 Actpi2 Socpi1 Socpi2 Male PPD GS Entry
VA 1 LY(1,1) LY(2,1) LY(3,1)
VA 0.00001 LY(1,2)
VA 0.67 LY(2,2)
VA 1.34 LY(3,2)
EQ TE(1,1) TE(2,2) TE(3,3)
VA 1 LX(1,1) LX(2,1) LX(3,1) LX(4,3) LX(5,3) LX(6,3) LX(7,5) LX(8,5) LX(9,5)
VA 0.00001 LX(1,2) LX(4,4) LX(7,6)
VA 0.67 LX(2,2) LX(5,4) LX(8,6)
VA 1.34 LX(3,2) LX(6,4) LX(9,6)
VA 1 LX(10,7) LX(11,8) LX(12,9) LX(13,10)
EQ TD(1,1) TD(2,2) TD(3,3)
EQ TD(4,4) TD(5,5) TD(6,6)
EQ TD(7,7) TD(8,8) TD(9,9)
FI TD(10,10) TD(11,11) TD(12,12) TD(13,13)
VA .00001 TD(10,10) TD(11,11) TD(12,12) TD(13,13)
Creation of path diagram
PD
Creation of output
OU TV RS AD¼800 SS IT¼20000 ND¼4

Note: See Willett and Keiley (2000) and Singer and Willett (2003) for extended discussion of other examples of using
covariance structure analysis to model multivariate change over time.