Personality disorder in adults

Published

Contents
  1. 1. Main facts and figures
  2. 2. By ethnicity and sex
  3. 3. Methodology
  4. 4. Data sources
  5. 5. Download the data

1. Main facts and figures

  • in 2014, there were no meaningful differences between ethnic groups in the percentage of people aged 16 and over who screened positive for a personality disorder
  • although the table shows differences between ethnic groups, sample sizes were too small to draw reliable conclusions
  • these figures shouldn’t be used as evidence of real differences in the population as a whole
Things you need to know

A positive screen for personality disorder only indicates that someone reported having a certain number of personality characteristics that suggest they may have a personality disorder. The questions in the Adult Psychiatric Morbidity Survey (APMS) are used to estimate how common personality disorder is likely to be in the adult population, but they aren’t used as part of any national screening programme in England.

The survey covers people aged 16 or over who live in private households. It doesn’t include those who live in institutional settings (such as hospitals or prisons) or in temporary housing (such as hostels or bed and breakfasts) or those who sleep rough. People living in such settings are likely to have worse mental health than those living in private households. There were 7,546 respondents to the survey.

These statistics have been age-standardised so comparisons can be made between ethnic groups as if they had the same age profile (an age profile shows the number of people of different ages within an ethnic group). The statistics do not tell you the actual percentage of people in each ethnic group who would screen positive for a personality disorder.

Keep in mind when making comparisons between ethnic groups that all survey estimates are subject to a degree of uncertainty as they are based on a sample of the population. The degree of uncertainty is greater when the number of respondents is small, so it will be highest for minority ethnic groups. In this situation, the number of respondent in each group was too small to make any conclusions about differences between them.

These statistics are based on participants’ direct responses (as opposed to someone else filling in the survey). As a result, socially undesirable or stigmatised feelings and behaviours may be under-reported. This is a risk with any survey based on self-reported data.

The ethnic groupings used here are broad; there is no breakdown of data for the more specific ethnic groups each contains. Some of the specific ethnic groups have very different experiences to one another. For example, the Black/Black British group could include both recent migrants from Somalia and Black people born in Britain to British parents.

What the data measures

This measure shows an estimate of the percentage of people aged 16 and over in England who would screen positive for any personality disorder. The data for this measure was collected in the Adult Psychiatric Morbidity Survey (APMS) that was conducted in private households across England in 2014.

A personality disorder is defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as an enduring pattern of inner experience and behaviour that:

  • deviates markedly from the expectations of the individual’s culture
  • is pervasive and inflexible
  • has an onset in adolescence or early adulthood but is stable over time
  • leads to distress or impairment
The ethnic categories used in this data

For this data, the number of people surveyed (the ‘sample size’) was too small to draw any firm conclusions about detailed ethnic categories. Therefore, the data is broken down into the following broad groups, based on the ONS harmonised ethnic group questions for use on national surveys.

  • Asian/Asian British
  • Black/Black British
  • Mixed/Multiple and Other ethnicities
  • White British
  • Other White

2. By ethnicity and sex

Percentage of people aged 16 years and over who screened positive for personality disorder, by ethnicity and sex
Ethnicity All Men Women
Asian 17.3 22.7 10.8
Black 17.0 16.1 17.7
Mixed other 16.7 10.2 21.9
White British 13.9 13.0 14.9
White other 14.2 16.8 11.7

Download table data (CSV) Source data (CSV)

Summary

This data shows that:

  • no significant difference between ethnic groups was observed in terms of the likelihood of screening positive for personality disorder

  • the percentage of people aged 16 years and over screening positive for personality disorder ranges from 13.9% to 17.3% depending on their ethnic group (but again these differences are not statistically significant)

3. Methodology

The Standardised Assessment of Personality: Abbreviated Scale (SAPAS) was used to measure the likelihood that an individual has a personality disorder in a more general sense, as opposed to screening for specific types of personality disorder. Each of the 8 questions on the SAPAS asked participants to indicate whether or not they had a particular personality characteristic, for example “Are you normally an impulsive sort of person?” Participants could answer either ‘yes’ or ‘no’. A score of one was given for each item answered ‘yes’, generating a score of 0 to 8. Those scoring 4 or more were defined as screening positive for possible personality disorder.

Each survey involved interviewing a large stratified probability sample of the general population, covering people living in private households. The full adult age range was covered, with the youngest participants aged 16 and the oldest over 100.

The two-phase survey design involved an initial interview with the whole sample, followed up with a structured assessment carried out by clinically trained interviewers with a subset of participants. People were assessed or screened for a range of different types of mental disorder, from common conditions like depression and anxiety disorder through to less common neurological and mental conditions such as psychotic disorder, attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD).

The resulting statistics for positive screen for personality disorder have been age-standardised. This is because the prevalence of mental disorders is related to age and the age profile (the number of people of different ages within an ethnic group) can differ considerably between ethnic groups. This adjustment allows comparisons to be made between ethnic groups as if they had the same age profile.

The survey covers people who live in private households. It doesn’t include those who live in institutional settings (such as hospitals or prisons) or in temporary housing (such as hostels or bed and breakfasts) or those who sleep rough. People living in such settings are likely to have worse mental health than those living in private households (Gill et al. 1996; cited in APMS 2014).

Where a selected participant could not take part in a long interview due to a physical or mental health condition, some information about this was recorded by the interviewer on the doorstep. This information may be biased due to it having been collected from another household member.

Socially undesirable or stigmatised feelings and behaviours may be underreported. While this is a risk for any study based on self-report data, the study goes some way to minimising this by collecting particularly sensitive information in a self-completion format.

Some people selected for the survey could not be contacted or refused to take part. The achieved response rate (57%) is in line with that of similar surveys (Barnes et al. 2010; cited in APMS 2014). Weighting helps take account of those who were selected for the survey but didn’t take part.

Weighting is used to adjust the results of a survey to make them representative of the population and improve their accuracy. For example, a survey which contains 25% females and 75% males will not accurately reflect the views of the general population which we know is around 50% male and 50% female.

More detailed information on the weighting used here can be found on page 24 of the Methods chapter of the Adult Psychiatric Morbidity Survey 2014.

Confidence intervals

The confidence intervals for each ethnic group are available in the ‘download the data’ section.

14.9% of White British women surveyed screened positive for personality disorder. This is a reliable estimate of the percentage of White British women in England who experience any personality disorder. Because the APMS results are based on a random sample of people aged 16 or older, however, it’s impossible to be 100% certain of the true percentage.

It’s 95% certain, however, that somewhere between 13.3 to 16.5% of all White British women in England would screen positive for a personality disorder. In statistical terms, this is a 95% confidence interval. This means that if 100 random samples were taken, then 95 times out of 100 the estimate would fall between the lower and upper bounds of the confidence interval. But 5 times out of 100 it would fall outside this range.

The smaller the survey sample, the more uncertain the estimate and the wider the confidence interval. For example, fewer women from the Black/Black British ethnic group were sampled for this survey than British White women, so we can be less certain about the estimate for the smaller group. This greater uncertainty is expressed by the wider confidence interval of between 9.6% and 30.5% for Black/Black British women.

Suppression rules and disclosure control

There is no risk to disclosure as the analysis is based on broad ethnic groups, without further disaggregation. Therefore no data has been suppressed.

Rounding

Percentages have been rounded to one decimal point.

Quality and methodology information

Further technical information

APMS 2014 Background Data Quality Statement (PDF)

4. Data sources

Source

Type of data

Survey data

Type of statistic

National Statistics

Publisher

NHS Digital

Publication frequency

Every 7 years (further publications dependent on further surveys being commissioned)

Purpose of data source

The APMS series provides England's National Statistics for the prevalence of mental illness and treatment access in the household population.

5. Download the data

APMS_screen_positive_for_personality_disorder - Spreadsheet (csv) 1 KB

The percentages of individuals who screened positive for any personality disorder in England, 2014, by sex and broad age group with 95% confidence intervals.