A scoping review of psychosocial functioning in young people with personality pathology: current evidence and methodological issues

Abstract Background Despite evidence that personality pathology often emerges during the transition from adolescence to adulthood and leads to lasting psychosocial impairment, research on how these impairments manifest and develop in young people remains limited. Objectives This review aims to map existing literature on psychosocial functioning in individuals aged 12–25 with clinical or subclinical personality pathology, examining definitions and measures of functioning, its relationship with personality pathology, and the impact of early interventions, while identifying gaps for future research. Findings A total of 37 studies were included: 14 cross-sectional, 7 longitudinal, and 16 on early interventions. In clinical samples, overall functioning was most assessed, whereas community studies focused on specific domains. Across studies, adolescents with personality pathology showed greater psychosocial impairment than both healthy controls and other psychopathology groups, both cross-sectionally and prospectively. Improvement in global psychosocial functioning has been documented across varying interventions but there was the lack of differences between treatment approaches. Conclusion While emerging evidence highlights psychosocial dysfunction in young people with personality pathology, methodological limitations hinder comparisons across studies. Developmentally appropriate, culturally sensitive, and domain-specific assessments are needed to track psychosocial impairment alongside symptom progression in young people.