From Wikipedia, the free encyclopedia

Portal

This article is within the scope of WikiProject Psychology, which collaborates on Psychology and related subjects on Wikipedia. To participate, help improve this article or visit the project page for details on the project. Start This article has been rated as Start-Class on the quality scale. Mid This article has been rated as Mid-importance on the importance scale. Article Grading: The article has been rated for quality and/or importance but has no comments yet. If appropriate, please review the article and then leave comments to identify the strengths and weaknesses of the article and what work it needs.

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 6 Psychopathic Executives? 7 broken sentence

[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.

• Indeed, none of these are DSM-IV Axis II personality disorders. They are all Axis-I mental disorders. --Mehr licht 21:43, 18 April 2007 (UTC)

When dealing with the mentaly unstable one must always remember that there are many factors involved. Most of the time a person with paranoid personality disorder would not feel that he or she was being paranoid, but the people who are close to him or her would. Most of the time these disorders effect the family situation so badly that the disorder is found in a clyincal setting. In which case psychosocial testing and family information would be available.

[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.

Hi there. You describe a person who lies a lot and knows that they are lying. Much depends on whether or not the person actually considers the lie to be a good thing, or a bad thing. An individual who lies a lot, knows the lies to be such, knows lying to be wrong, cannot stop may be exhibiting compulsive behavior, not necessarily experiencing cognitive dissonance. An individual who lies a lot, knows the lying to be such, but doesn't think that there is anything wrong with lying to others is engaging in ego-syntonic behavior. Ego-syntonic behavior is such that is consistent with one's own ego and self-image. Ego-syntonic thinking and behavior is at the core of personality disorders. I hope this helps. Eleos^Prime 19:04, 17 May 2007 (UTC)

Pervasive lying behavior is referred to as pseudologia fantastica, and it is a common concern that issue forth from anything from low self-esteem to sociopathology. If the behavior is ego-syntonic, then the individual is likely engaging in anti-social behavior. If the behavior is ego-dystonic, then the behavior is more likely linked to something less pernicious, like low self-esteem or depression.

Cognitive dissonance has nothing to do with pseudologia fantastica, even within the context of ego-dystony or -syntony. DashaKat 16:26, 20 May 2007 (UTC)

[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)

• This is a fair comment: there should be more elaboration of the WHO ICD-10 categories of PD, in particular the 'anakastic' variation of OCPD, the 'dissocial' variation of ASPD; and the absence of narcissistic & schizotypal PDs in the ICD. I will try to find time for this edit. --Mehr licht 21:58, 18 April 2007 (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)

[edit] Psychopathic Executives?

Who agrees that the study involving British executives qualifies as activist science? It seems like an example of the latest fad amongst anti-corporate types -- to portray business people as closet psychopaths (a word that doesn't apply to those who suffer from any of the three disorders listed). It gives the impression that someone combed the DSM for ammunition, zeroing in on the traits that best characterize the enemy (superficial charm, exploitativeness, excessive devotion to work, dictatorial tendencies, etc). —Preceding unsigned comment added by 71.131.11.176 (talk) 09:59, 21 March 2008 (UTC)

Well, any discussion of psychopathy is a separate article from personality disorders unless, as cited, the researchers combined a study of the two. Whether researchers in this field are "faddish" is a matter of personal opinion; psychopathy and Axis II PDs have some overlapping traits. That said, the section is poorly organized. A more general overview of the subject from a pro in the field would be helpful. 3Tigers (talk) 17:11, 22 May 2008 (UTC)

The IP user might wish to consult Millon's coverage of PD subtypes. E.g. some executives who have a particular paranoid or obsessive-compulsive PD type tend to exhibit aforementioned traits. It would be interesting to check the Subtype summary that is available online. Mearcstapa (talk) 11:50, 10 June 2008 (UTC)

[edit] broken sentence

"This definition has a significant deviance from societal norms, such as conscientious objection to a social regime, to be classified as a mental disorder." - that's broken, but I'm not sure how it should read.--Anniepoo (talk) 13:24, 7 May 2008 (UTC)

I axed it. Highly specific info about how the Soviet Union abused psychiatry is a separate article that doesn't belong in an intro paragraph defining a category of mental disorder. 3Tigers (talk) 17:06, 22 May 2008 (UTC)