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From the article:

"Personality disorders are represented on Axis II of the DSM-IV, and are particularly controversial because they often seem sexist, "

Which ones are regarded as being sexist? -- The Anome 10:04, 23 Jun 2004 (UTC)

--Histrionic PD has been said to represent the extreme of "feminine" characteristics. Also, two PDs, Self-defeating and Sadistic, have been proposed but are not in DSM-IV because of potential bias against women. It seemed possible that Sadistic PD could be used as a legal defence against charges of spousal assault, and that Self-defeating could pathologize being a victim of spousal assault. User:Sassafrased

Two of the links at the bottom are dead, it might be worthwhile fixing them.

(this sentence has since been removed from the article) Sietse 13:41, 16 Oct 2004 (UTC)

Contents 1 Criticisms 2 List of personality disorders not covered in this page 3 Change title? 4 Help 5 "Diagnosis Deferred" 5.1 ICD and APA DSM

[edit] Criticisms

I think the criticisms as they currently stand are an excellent academic critique but a little abstruse. Terms like "diagnostic heterogeneity", "construct validity", and "temporal stability" could be simplified or explained like the "diagnostic heterogeneity" one is. What about replacing "temporal stability" with "consistency of symptoms over time"? I think the overall impression is fine but I suspect many a reader will not understand the basic thrust of the complaint. It might be worth saying that none of the current criticism denies the existence of PDs as such. It is also worth mentioning the clusters as being the outcome of cluster analysis studies and a recognition of the essentially blurred categories. Now I don't know enough about that to write about it.

At present there is no real antipsychiatry debate. None of the "myth of mental illness" that was based on psychopathy after all. It's been ages since I read it but I guess I could pick it up again. --CloudSurfer 10:23, 14 Oct 2004 (UTC)

I didn't notice this before. You're right. I tried to make it more accessible.

I doubt the claim that noone denies the existence of PD's however. In my opinion, the dimensional position is a denial of the existence of PD's (at least their existence as disorders which are qualitatively different from 'normal' functioning). Sietse 10:54, 15 Oct 2004 (UTC)

Yeah, I reread what Sam had written and I agree - on a dimensional basis as described. The counter argument is that ALL disorders and diseases are dimensional but someone draws a line in the sand and says on this side it is sub-clinicial and on that side it is a diseases. We could be talking about asthma or PDs. Diseases are not black/white, they are dark grey - grey - light grey. All of the criteria in DSM could be seen as dimensional. By the way, I made a comment on the project psychopathology talk page about symptoms/signs having only just seen your reply. --CloudSurfer 11:45, 15 Oct 2004 (UTC)

OK Guys, I have now gone into bat for the DSM to provide some balance. See what you think. [Grin] --CloudSurfer 10:22, 16 Oct 2004 (UTC)

Okay, DSM versus Critics: 1-1. But seriously, the section indeed needed some pro-DSM arguments to make it less one-sided. Good work!

I would also like to add something to the things I have written about the position that PD's 'do not exist'. Of course, you are right that (just about) every disease or disorder can be seen as dimensional instead of categorical. Seeing PD's as not categorically different from normal functioning is in itself not enough reason to deny that they exist. In my opinion, the difference with other diseases is that, presumably, no one would argue that the criteria/symptoms of, say, asthma are neutral. Never shortness of breath is good. Often shortness of breath is bad. I assume that practically everybody would agree. The case is different for personality disorders in my opinion. For example, I don't agree that more emotional flatness, or more desire for solitude is necessarily a bad thing. The argument, as I understand it, is that personality disorders are not categorically different from 'normal functioning', and that the dimensions on which there is a difference are arguably neutral to some extent. Sietse 16:22, 17 Oct 2004 (UTC)

Yes! This is the nub of it. The key DSM criterion is, "The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning". (General diagnositc criteria for a PD. By the way, these general criteria really belong on the article page.) So, if the person does not present their personality as causing clinically significant distress, that is one point. Then comes the subjective part. The judgement as to whether the remaining elements are present. However, usually the person is willingly sitting in your office because of such problems so there is usually no contest. --CloudSurfer 23:21, 16 Oct 2004 (UTC)

I think I see what you mean, but I don't agree. The impairment-criterium sounds neutral. I concur that in most cases clients would agree about whether they have such impairments, but I still think that such judgements can be especially subjective when they concern people with personality disorders. For example, judging social impairment in someone who is thought to have a paranoid personality disorder almost by definition involves disagreement with the client. The client will surely blame someone else. In addition to possible disagreement about impairments, I also think that at least some kinds of impairment are only problematic if they are seen as such by the client (e.g. social impairments that do not involve antisocial behaviour), even if the clinician thinks that it causes problems. Clients come to treatment to solve problems, but personality disorders are often secondary diagnoses, so a client may think that an impairment is not a problem. For these reasons, I think that the impairment-dimension is also (arguably) neutral. Sietse 16:22, 17 Oct 2004 (UTC)

I'll reply to your points about Insanity, symptom categories, and Homosexual panic on the talkpages of those articles. Sorry if I missed any earlier replies. My watchlist apparently sometimes misses updates. Sietse 13:41, 16 Oct 2004 (UTC)

[edit] List of personality disorders not covered in this page

• Intermittent Explosive Disorder [1]
• Bipolar Disorder
• Psychotic Disorder

This list may be indicative of absence of systematic taxonomical distinctions (in my own mind) between what appear just to be called "disorders" and "personality disorders". Matt Stan 10:33, 18 Dec 2004 (UTC)

Bipolar Disorder isn't a personality disorder, it's an axis-I mood disorder. Although the boundary between particularly rapid cycle bipolar and borderline PD can be blurry, it's a discrete subset of illnesses.

[edit] Change title?

Perhaps it should be "Personality Disorders" because there is more than one?

Bipolar disorder is NOT a PERSONALITY disorder. They might exist together, but are seperate Axis I, and Axis II disorders distinctly.

[edit] Help

Hello I am new to this site and I need some answers. I am having some mixed feelings about an incident that happened.

I took psychology one quarter at school and I want to know if this theory was used it's called

Cognitive Dissonance Theory for those who don't know what it means the defination is:

The theory that we act to reduce the discomfort ( dissonance )we feel when two of our thoughts ( cognitions )are inconsistent.

For example, When our awareness of our attitudes and of our actions clash, we can reduce the resulting dissonance by changing our attitudes.

If there are any psychologists on this website who post or respond to these can you help me on this. My question is this:

If someone who lies all the time and they know that what they are saying is a lie does that mean that they are using the theory I mentioned above or is there another word for it. it's like they knew that it was wrong to say but changed it to make it sound ok.

I know there has to be some honest people out there who don't lie alot or at all for that matter that use this theory. Like for instance say you were supposed to write an essay about something you didn't believe in and you start telling yourself that you don't believe most of what I'm supposed to be writing but I believe a small part of it and you start believing your phony words so that it makes it easier for you to write so you don't fail.

[edit] "Diagnosis Deferred"

I'm a clinician who uses the deferred diagnosis under Axis II. To begin with, most people don't have personality disorders. Secondly, it is almost never fair to give someone a personality disorder that will follow them around if you haven't known or observed them over-time or you don't have a very extensive history. Often clinicians only see patients at a time of extreme stress or crisis and their behavior is not representative or "pervasive."

What I am trying to say is that "Diagnosis Deferred" is a way of tactfully withholding judgment not "an evasion." Also many forms and insurance companies require that something be listed under Axis II, but that's another issue.

Carlton 09:09, 7 November 2006 (UTC)

[edit] ICD and APA DSM

This article seems very biassed towards the American Psychiatric Association lists of personality disorders. Perhaps it could be improved with more reference to the International Classification of Disease, and the disorders it specifies under ICD-10. Any comments, please? ACEO 19:58, 14 November 2006 (UTC)ACEO 19:59, 14 November 2006 (UTC)

If classification or personality disorder throughout the world tends to be broadly in line with the APA's thinking, then some rewriting and extension of the article would be appropriate, but much of what is here should stay, with the US serving as an instructive example. On the other hand, if the US is out of line with much of the rest of the world then this article should be largely rewritten. Don't be at all afraid to correct unwarranted US-centrism where it occurs in wikipedia. Ireneshusband 05:27, 17 November 2006 (UTC)