Talk:Personality disorder/Archive 1

Archive 1

Dead links?

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)

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)

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.

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)

"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)

Hear, hear. This is to add a note about the "diagnostic usefulness" of Wikipedia, and some cautions about the audience. At this stage, the article quality in this section is too erratic for Wikipedians to be suggesting otherwise. Wikipedia is not yet a reliable resource in this field. The external links lead to often rather amateurish online perspectives -- press coverage, articles with careless editing. This really is an abysmal self-help resource for anyone looking for a hub site on a theme. I normally am an avid Wikipedia booster, but I'm disappointed in the quality of PD entries even two years after the above user left his comment.

But taking a turn as well at offering a constructive suggestion or two:

It would be a real help to see, somewhere readily accessible, a comparative index / table of the PD research paradigms (both disorders and treatments) that Wikipedia contains. The aim would be to help lay users evaluate the degree of eccentricity in certain theories reported here. (1) When a particular strain of interpretation (or treatment) has not yet found its way into a DSM standard, are there other pre-DSM professional standards that it can reach? (2) A taxonomy of the paradigms would also be an enormous help, so that one can better discern the relationship between particular constellations of symptoms. (3) If an article is not on this master table, then one can assume that it has not yet been heavily vetted, or that its audience is a rather thin niche of practitioners, who may be outliers in their handling of PDs. This might be a useful capstone resource for the PD section. It would be helpful to see an MD in the field take a whack at the first draft, so that it's fairly reliable off the bat.

A comprehensive directory of professional associations and interest groups working on each of these PD paradigms would be another tool that would do wonders for people looking for self-help resources here. My complaint above about the quality of self-help resources directly stems from the fact that a number of supposedly well-maintained Wiki PD articles are terribly spotty in identifying the relevant professional associations -- and the final impression left is that Wikipedia articles aren't terribly representative of the views of the main professional communities. Lay users come to Wikipedia for their bearings in self-help now, and many are using it as a jumpstation for assistance or insight or community around particular PD experiences. The final concern would be that such a directory be contained as a central article, rather than under each individual research paradigm, since, as per user Carlton's point above, many people seeking help may have manifestations of a number of issues, none of which are particularly dominant, or which are inextricably co-morbid. It often strikes me as a shame when I hear someone having invested enormous amounts of their energy trying to make sense of certain behaviors as X, when it could easily be Y. Centralizing this directory of professional associations would be valuable for self-helpers, as a reminder of the interactions among different PDs and associated stressors.

Does anyone else think these resources might be a priority?

Thanks!

A.k.a. (talk) 14:42, 11 April 2009 (UTC)

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)

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)

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)

WHO research on prevalence in different countries

http://bjp.rcpsych.org/cgi/content/abstract/195/1/46 "Little is known about the cross-national population prevalence or correlates of personality disorders. [...] To estimate prevalence and correlates of DSM–IV personality disorder clusters in the World Health Organization World Mental Health (WMH) Surveys."
It might be useful? 82.33.48.96 (talk) 21:54, 1 July 2009 (UTC)

Copyright problems with diagnostic criteria

The American Psychiatric Association has not released its Diagnostic and Statistical Manual of Mental Disorders into public domain, but claims copyright. The Wikimedia Foundation has received a letter of complaint (Ticket:2010030910040817, for those with access) about the use of their diagnostic criteria in this and a number of other articles. Currently, this content is blanked pending investigation, which will last approximately one week. Please feel free to provide input at the copyright problems board listing during that time. Individuals with access to the books would be particularly welcome in helping to conduct the investigation. Assistance developing a plan to prevent misuse of the APA's material on Wikipedia projects would also be welcome. Thank you. Moonriddengirl ^(talk) 14:21, 11 March 2010 (UTC)

A requirement in the diagnosis

In the page about OCPD it says: "It is a requirement of DSM-IV that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria".

I can't find this criteria.

Help please.

The criteria are in the Diagnosis section of this article. Jim Michael (talk) 21:33, 23 December 2011 (UTC)

Helping us to understand the DSM

From the article: "Antisocial personality disorder, by definition, cannot be diagnosed at all in persons under 18."

Why can't it be diagnosed "by definition?" It says in the Wikipedia entry under Antisocial Personality Disorder:

"Antisocial personality disorder (APD) is a mental disorder defined by the American Psychiatric Association's Diagnostic and Statistical Manual: "The essential feature for the diagnosis is a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood due to the lack of love and care for the child."[1] Deceit and manipulation are considered essential features of the disorder. Therefore, it is essential in making the diagnosis to collect material from sources other than the individual being diagnosed. Also, the individual must be age 18 or older as well as have a documented history of a conduct disorder before the age of 15."[1]

So, it can be present before 18, but it just has another label? And then what? The fairy with a magic wand makes someone antisocial instead of conduct disordered after the clock strikes twelve and someone turns 18?

Please forgive my critical personality disorder.

A lot of these disorders sound like they have roots in moral judgments and bias. Perhaps not antisocial personality disorder, but using terms like "conduct" and "character" make me suspicious. Perhaps someone can elighten us on how the DSM is written up and who decides on the labelling and language, especially in cases where disorders are not harmful to others or even necessarily to the individual, since apparently they can be mild or severe. —Preceding unsigned comment added by 121.44.46.217 (talk) 10:05, 7 August 2008 (UTC)

The point is that before the age of eighteen these behaviours can possibly be attributed to other things, adolescents aren't exactly stable human beings anyway, so it is not considered appropriate to diagnose a personality disorder when maturity could result in a reduction the behaviours or an absolute cessation of them. When the person turns eighteen and the behaviours still reach the criteria for antisocial personality disorder, then it is safe to say they are antisocial rather than conduct disordered. Although, I vaguely remember reading somewhere that if they are under eighteen and the behaviours exist for over a year s personality disoreder may be diagnosed. Valethar (talk) 18:40, 26 December 2009 (UTC)

Well, when I was 16 I received a diagnosis of "schizoid personality with borderline personality organization". It may be debatable if that diagnosis was valid, and how valid such diagnosis was in the first place, or if it is still valid now I am an adult in my 30's, but it goes to show that at least 15 years ago, these diagnosis where used for people under 18. —Preceding unsigned comment added by 188.120.134.135 (talk) 21:27, 20 May 2011 (UTC)

Anti-social PD is a special case; the other disorders can be diagnosed in minors if the behaviour is extreme and persists more than one year. ASPD NEVEr can be diagnosed in minors--194.38.144.2 (talk) 11:58, 11 August 2011 (UTC)

Antisocial personality disorder is in most cases preceded by conduct disorder, which is the child / adolescent precursor to ASPD. A person under 18 who meets the criteria for ASPD (other than being to young to be diagnosed with it) has CD, and will likely have ASPD when he becomes an adult. Jim Michael (talk) 21:34, 23 December 2011 (UTC)

Sex ratios in disorders

I noticed that in only one case is the sex ratio given for a disorder. The number given is accurate, but why is a ratio given only for this specific disorder and, not for, say, schizoid or narcissistic or avoidant? --NellieBlyMobile (talk) 23:53, 10 October 2011 (UTC)

These figures should be stated, as should the prevalence of each. The article does not indicate which PDs are the most common. Jim Michael (talk) 21:30, 23 December 2011 (UTC)

General criticism of PDs

I'd say that this article desperately needs some balance by adding some of the common criticisms of the idea of Personality Disorders in general, as being "permanent", especially given the fact that the article itself points out the probable cause of at least some of them as being environmental (abuse), which means that it's not a personality issue, but an environmental one. Anyone have any good sources to get this common criticism from so it can be included in the article to make it more balanced and less biased? TurilCronburg (talk) 15:03, 2 December 2010 (UTC)

I don't understand why you think it should be a disorder if it is innate and something else if it is caused environmentally? I think that most theorists accept that personality is a mix of innate traits and developmental responses learned in the early environment. In this context 'enduring' is usually a better word than 'permanent'. -- Egmason (talk) 22:56, 9 January 2012 (UTC)

Personality disorders have the least reliable diagnosis of any psychiatric disorder - I can let you know when I have found the source for this. ACEOREVIVED (talk) 14:33, 18 July 2011 (UTC)

I agree! That's why I added the in-universe template: which to first look at one could get an exaggerated idea of antipathy and bias in my personal feelings about personality disorders.'Personality disorders' are theories that are supposedly agreed upon as describing reality; but there are other well-established views. I hope with a sense of humour the template is there to put a point across! Wikipedia shouldn't be a psychiatry textbook: neither should it be - according to what i think the jist of wikipedia policy - really at all the first place that we gather an understanding of a technical-psychiatry-to-folk/popular-psychology interactions but it should report as best is able to bring together a credible outsiders view! Or at least an NPOV! I write/edit and stand interested as a 'service-user'/patient patient who has experienced diagnostic controversy within the UK to get things clear! Psychiatry has it's structures - the public needs theirs! Kathybramley (talk) 15:47, 20 January 2012 (UTC)

I've been wondering how could start addressing this kind of thing properly and source it, i mean the article refers to a couple of diagnostic issues, but to bring it together & out from under the theoretical/clinical frameworks as you say... Maybe you could start something and could take it from there? Eversync (talk) 16:57, 20 January 2012 (UTC)

I think it could be useful to start an 'anti-psychiatry' portal or rather to start with to use the Anti-psychiatry article as a parent and take sections out of it and also create as new several in-depth articles on particular subjects of controversy and particular perspectives: this would allow development outside of the stricter standard for references in medical articles but they could then also be cherry-picked for the high-quality references that can be put back to add to the quality of medical articles. A very bad reference to Ethan Watters' book I put on another page today has been pulled already! And the notes are to the effect 'good idea but even properly referenced that book isn't quite within the rules as they are; find other sources'. WP:MEDRS Thanks for the encouragement! Kathybramley (talk) 20:04, 20 January 2012 (UTC)

It is an issue that for this subject area there's a medical/psychiatric portal/wikiproject/manual etc (& psychology) but not a neutral or if you like anti- viewing point. In the meantime for this article, alternative views or sources could always be raised here if not edited in directly. Eversync (talk) 23:11, 25 January 2012 (UTC)

More than one PD concurrently?

Do some people have more than one personality disorder at the same time? Jim Michael (talk) 21:33, 23 December 2011 (UTC)

Think that's a good point for the article to include. It seems people can meet criteria for more than one personality disorder, and that actually it happens quite often which is partly why the DSM-V people want to get rid of some of the overlapping stuff & introduce more dimensions rather than just categories. Eversense (talk) 00:02, 4 January 2012 (UTC)

I'd like to suggest a couple of other things re the article - it currently says in the first sentence 'formerly referred to as character disorders' but how formerly is that, like decades ago, or has it been more recently and widely used in some quarters? Also the last paragraph is on split brain patients which seems to link them into this article based on a slang term for them with a lurid unrepresentitive example of choking. I suggest that could be reduced to a sentence in the history section as an aside. And one other thing is, the article has a 'psychological manipulation' template, but... ok that may be part of some symptoms of some PDs, at least as perceived by others (and judged to be more than is usual in people in society) - but i'm not sure that justifies linkign this whole topic with that, as it tars everyone with the same brush. Dunno what others think about any of this. Eversense (talk) 00:02, 4 January 2012 (UTC)

It is well established that you can have a mix of PDs, see for example Theodore_Millon#Millon.27s_personality_disorder_subtypes. The psychological manipulation template is here as PDs feature quite heavily in psychological manipulation.--Penbat (talk) 07:44, 4 January 2012 (UTC)

I noticed that article had a paragraph listing personality disorders, with a sweepingly vague statement that 'manipulators' have those conditions, sourced apparently to an opinion expressed as a warning for people in a pop psychology self-help book. I'll address it there so thanks for the tip re the template.

I'm struggling with the last paragraph here that I mentioned, because the reference is weird - there's a ref name tag for the milton book cited elsewhere, but then within the tags it's a different author, but then the title seems to be a mix of two different books or something, with an ISBN number that doesn't work, and searching in either on Google books doesn't turn up any hits on split brain or corpus callosum etc. Any ideas? Eversense (talk) 02:15, 5 January 2012 (UTC)

Realised you've already dealt with the sourcing issue over there, and I respect that it shouldn't just be academic, i will try & add another point of view though. I can't turn up any usage re. the split brain experiments so will remove that paragraph here shortly unless anyone can clarify the citation. Every (talk) 01:25, 8 January 2012 (UTC)

Controversial

From the article:

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

--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

^Not sure how that's relevant to the article, but to add to that: BPD is much more prevalently diagnosed in women, and is often seen as a 'feminine' PD, while Narcissistic and Anti-Social are both typically considered male PDs and are more prevalently diagnosed in men. Cluster A & C don't have as strong stereotypes. I doubt you'll find this in sources, but cluster A & C are probably thought of more in the context of men. But cluster B has strong stereotypes (you will find this in the lit.): narcissistic & anti-social are typically male; borderline and histrionic are typically female. Charles35 (talk) 02:18, 19 November 2012 (UTC)

DSM/ICD

The classification section seemed to have framed and linked the ICD system in to terms used by the DSM, and I've adjusted that to simply reflect what it itself says. Could do with a paragraph summary of the similarities and differences though. The diagnosis section I discovered seems to be quoting and interpreting the DSM General diagnostic criteria (reproduced here, but attributing it to the ICD-10 (which only seems to have general introductory writing) and inserting references to ICD codes, unless I'm mistaken, so I think that needs to change too. Eversync (talk) 01:36, 14 January 2012 (UTC)

^ I see that that is from 10 months ago, but if that is still here, it is definitely a problem. PDs are generally more of a DSM paradigm. I don't the the ICD really has an organized 'personality disorder' scheme. I know it has Emotionally Unstable Disorder and some things like that, but its diagnostic procedures and treatment procedures are not organized in a consistent way like the DSM. This article probably should not cite ICD related material unless the section is specifically referring to PDs in the context of the ICD (ie if it is saying "here are some other recognized PDs: Emotionally Unstable, et al"). Charles35 (talk) 02:23, 19 November 2012 (UTC)

Selfishness

All antisocials and narcissists are extremely selfish. Is this also true of borderlines and histrionics, thus making it a promininent feature of all Cluster B PDs? This should be clarified in the article. 89.194.130.107 (talk) 17:29, 5 June 2012 (UTC)

Not necessarily. It's much more complicated than that. People think of certain PDs as 'selfish', but that isn't entirely accurate; it isn't the whole picture. These people see the world in a fundamentally different way. All humans have a concept of reciprocity (I'll give a brief summary, but you can find more info on this here & here). The key here is the dichotomy of generalized vs negative reciprocity. Generalized is seen, at the most extreme form, in families. People do things for each other freely and without expectation of a return favor. A good example is a mother dying to save her child. Negative reciprocity is seen in business relationships and economics. People do things for each other only when they know for sure what they will get in return and that they will in fact get it. Any exchange of goods using money is a good example. In generalized, one cares about the other person; in negative, they don't.

People with PDs tend towards negative reciprocity. So, they don't do things for others if they don't feel that the favor will be returned. You might call this selfish, but that's not really what it is. It has to do with their psychological makeup. These people have very weak self-images and little self-respect. It doesn't take much to make them feel they are being taken advantage of. They have a sensitive ego prone to injury because of their lack of significant self-esteem. So they feel hurt and insulted if they feel that they have done something for somebody who is not doing something for them. It's not because they don't care about the other person; it's because they are insecure that the other person doesn't care about them, which typically is the result of a childhood or adolescent betrayal of some sort (absent parent, abuse, trauma, etc).

This sort of scenario is typically thought of in narcissistic, borderline, anti-social, histrionic, and even schizoid. On the other hand, in many situations, people with PDs might do things that seem the opposite of selfish - submissive. The obvious one is in dependent PD, but also in self-defeating, borderline, and sometimes histrionic. My earlier example of negative reciprocity and economic/business relationship makes a lot of sense here: people with PDs are often very particular with money. This seems irrational to other people and is often seen as selfish/submissive. For the example of selfishness, these people might feel particularly upset after they've been 'ripped off' (because they see it as a threat to their self-esteem), and they might demand money for trivial things, such as money for gas if they've given someone a ride. Conversely, in submission, these people might offer money in inappropriate situations. If someone has done them the favor of picking them up and driving them somewhere, they might offer money and insist that the other person takes it. This is seen as irrational by the other person. They do this because they assume that the other person sees the world the same way they do (with negative reciprocity). They assume that the other person will feel insulted if they are not offered/given money. They fail to recognize (mentalization that other people's egos and self-images are not as fragile and susceptible to injury as theirs are.

I hope this makes sense. In reality, these people are not selfish. They are just very, very insecure. The thing about this that one needs to understand is that all PDs, at the core, are fundamentally the same issue. They manifest in different ways, according to genetic predispositions to certain personality styles as well as social and environmental causes, but one of the defining characteristics of PD is extremely weak self-esteem and extremely fragile and sensitive egos (those egos didn't develop properly). All of the PDs have low self-esteem. People think that the different PDs are set in stone and say things like "all narcissists are..." or "all borderlines..." That isn't true. Any personality disordered individual can come across with any style on any given day. Narcissists can, at times, seem extremely submissive, something more generally associated with dependent or borderline. But, what makes them a narcissist, is the fact that they tend to snap back to the narcissistic style. They can take any form in any given situation, but in general, they tend to manifest one style. When avoidants feel very comfortable and are with people they've known for a long time and trust very much, they can be the life of the party. Borderlines can be calm and happy when they feel validated. It is so flexible and people should understand that. In the right situations, PDs can seem perfectly fine, and sometimes act in the exact opposite way that you'd expect.

Charles35 (talk) 02:46, 19 November 2012 (UTC)

Title of the Article

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

imo its seriously dumb calling this article personality disorder not personality disorders and also having the move option disabled.--Penbat (talk) 08:44, 31 July 2012 (UTC)

I disagree, because all personality disorders are fundamentally the same thing. They simply manifest differently. Each personality disordered individual takes on a different personality style, in the same way that each person in general has a different personality. Did you know that the most commonly diagnosed PD is PD NOS? If I remember correctly, it's something like 41%. These different disorders the DSM describes are just an artificial paradigm that theoretical psychiatrists draw. In different cultures, the PDs are different. They don't reflect biology; they reflect social and environmental factors. But, all PDs do have a similar biology. Whether it's BPD or AvPD or ASPD or HPD, they all, at the core, have the same problem, which is an extremely low self-esteem, a fragile ego, etc. They tend to be neurotic to begin with, but usually become "disordered" when they experience one or, in most cases, several serious traumas, losses, rejections, cases of abuse, etc. The more neurotic the person was to begin with, the lower their threshold for disorder is. For example, for some people, sexual or physical abuse results in a mild personality disorder, but for others, all it might take is particularly harsh rejection from their first 'crush' and mocking from their peers to result in a severe, devastating, debilitating PD. Charles35 (talk) 03:08, 19 November 2012 (UTC)

Hi Charles, this is an old discussion, because the name of the article presently is "Personality Disorders" and no longer "Personality Disorder" Lova Falk talk 09:13, 21 November 2012 (UTC)

 Done

I'm not sure I understand. That is the reason I am writing. I disagree with the change; I think it should be "Personality Disorder", for the reasons specified above. Are you saying that, because you have already changed the title, it cannot be changed again? This change is set in stone? I was not aware that that is how wikipedia works.... Charles35 (talk) 17:46, 21 November 2012 (UTC)

No, i did not understand that you wanted to reopen the discussion. Anyway, because they article mentions a lot of different personality disorders, I oppose. Lova Falk talk 18:18, 21 November 2012 (UTC)

• Support singular title - I agree the new plural title is problematic and does not follow article naming guidelines. We use plural titles for terms that are always plural, otherwise singular (see WP:SINGULAR and WP:PLURAL). Almost all technical, scientific, medical articles discuss multiple instances of the topic without using a plural title and I don't see a reason to treat this article any differently. Jojalozzo 22:51, 21 November 2012 (UTC)

Yup - mental disorder (not disorders), as well as mood disorder, anxiety disorder, Somatoform disorder, factitious disorder, sleep disorder, adjustment disorder, etc. But, more importantly, personality "disorders" are all really different strains of the same disorder. They are simply different manifestations, as I elaborated above. I will give a more lengthy explanation for that if need be. Charles35 (talk) 01:46, 22 November 2012 (UTC)

"[5••,6••,7]" ??

What's that supposed to mean? -- 92.224.244.113 (talk) 13:14, 21 November 2012 (UTC)

I have no idea. Thank you for notifying us, it is now gone. Lova Falk talk 15:05, 21 November 2012 (UTC)

 Done

Requested move

The following discussion is an archived discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review. No further edits should be made to this section.

The result of the move request was: page moved. Jojalozzo 21:16, 1 December 2012 (UTC)

---

Personality disorders → Personality disorder – This article's name was changed a few months ago to the plural form. The naming guidelines, WP:SINGULAR and WP:PLURAL, tell us to use singular titles except when the topic is always referred to in the plural or when the topic is a "class" like Bantu languages. While we might argue that Mental disorders is a class, I do not think that is the intention of the guideline. This topic is no different than Mental disorder, Mental disability or thousands of other medical, scientific, technical topics that use a singular title but discuss many specific instances under that title. Jojalozzo 02:01, 22 November 2012 (UTC)

Survey

Feel free to state your position on the renaming proposal by beginning a new line in this section with *'''Support''' or *'''Oppose''', then sign your comment with ~~~~. Since polling is not a substitute for discussion, please explain your reasons, taking into account Wikipedia's policy on article titles.

• Support We default to singular in article titles. A search for "Personality disorders" will find either title, so it's just a style thing and won't affect the reader experience. --Anthonyhcole (talk) 13:14, 22 November 2012 (UTC)
• Support As I have pointed out above, mental disorder (not disorders), mood disorder, anxiety disorder, Somatoform disorder, factitious disorder, sleep disorder, adjustment disorder, etc. But, more importantly, personality "disorders" are all really different strains of the same disorder. They are simply different manifestations, as I elaborated above. I will give a more lengthy explanation for that if need be. Charles35 (talk) 06:14, 25 November 2012 (UTC)
• Support rationale looks straightforward enough. Hekerui (talk) 12:51, 1 December 2012 (UTC)

Discussion

How many votes until action can be taken? Charles35 (talk) 06:15, 25 November 2012 (UTC)

Jojalozzo - since you voted *support* in the section above, I think you should put your vote in here for the "official" vote to make it clear that 3 people have not voted. Charles35 (talk) 06:20, 25 November 2012 (UTC)

Okay, it seems unanimous. I don't know how to actually make the change. Anyone care to help out here? Charles35 (talk) 20:11, 1 December 2012 (UTC)

 Done Jojalozzo 21:14, 1 December 2012 (UTC)

The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page or in a move review. No further edits should be made to this section.

Contested deletion

This page should not be speedily deleted because its deletion is a hoax. — Preceding unsigned comment added by 80.62.117.166 (talk) 02:30, 13 December 2012 (UTC)

Contested deletion

This page should not be speedily deleted because encyclopedic entries are not listed in pluralis. Should "cow" be redirected to "cows" or "depression" to "depressions." It's a scam, unfortunately. — Preceding unsigned comment added by 80.62.117.63 (talk) 02:57, 13 December 2012 (UTC)

Suggestion to move "History"

To me, it would make sense to have the history appear earlier in the article. --Smhenry87 (talk) 15:02, 29 January 2013 (UTC)[[2]]

Where exactly would you like to have this section? Lova Falk talk 16:18, 29 January 2013 (UTC)

Personally i would have it as the 1st section after the lede but for some reason there is a Wiki convention for medical articles (MEDRS) which say that History has to be towards the end so there you go.--Penbat (talk) 17:57, 29 January 2013 (UTC)

Oh! I didn't know that. Good to know! :) S. Henry (talk) 15:16, 21 February 2013 (UTC)

Clarification of table under the subheading "Comorbidity in personality disorders"

Is it possible for someone to precede or follow the table titled "DSM-III-R personality disorder diagnostic co-occurrence aggregated across six research sites" with a description of the data in the table? Specifically, what units describe the numbers in the table? Do these numbers represent the percent of people in the study that have "X" personality disorder (PD) and also have "Y" PD? Or are these data reported as the raw numbers of people with each pairwise combination PDs? Also, why are two numbers reported for each pair of PDs? For example, when paranoid personality disorder (PPD) is represented by a row and schizoid personality disorder (SzPD) is represented by a column, their shared number is 8. When their locations are reversed (PPD in column, SzPD in row) their shared number is 38. Does this mean that 8% of people with PPD also have SzPD and 38% of SzPD patients also have PPD, or vice-versa? What is the significance of the positions (column or row) of the PD listings in the table? I appreciate any clarification on these points, and hope I myself have been clear in raising these points of confusion. LisaKBrents (talk) 19:24, 1 May 2013 (UTC)

Good questions, but I don't have access to the source, and I cannot help you... Lova Falk talk 21:11, 18 May 2013 (UTC)

I wondered the same thing. Google Books has the answer, but I'm not sure about the rules of copying and pasting into Wikipedia, so I leave that up to you:

http://books.google.ca/books?id=JsgoNVVN9RQC&pg=PA226&lpg=PA226&dq=DSM-III-R+personality+disorder+diagnostic+co-occurrence+aggregated+across+six+research+sites&source=bl&ots=2Rl0IZPRH3&sig=E1R4FdKRVYHrTlSXlx0TBLOlNuM&hl=en&sa=X&ei=PtOuUfr-EomWiAK9wYHgDA&ved=0CFgQ6AEwBw#v=onepage&q=DSM-III-R%20personality%20disorder%20diagnostic%20co-occurrence%20aggregated%20across%20six%20research%20sites&f=false 75.159.123.216 (talk) 06:01, 5 June 2013 (UTC)

Table of gender differences in the frequency of personality disorders

This table is unclear. Presumably, the Gender column indicates the gender in which each type personality disorder is more common, but it risks incorrectly implying that a type of personality disorder is exclusive to the stated gender. Also, in the case of "Equal", how equally balanced is the distribution between genders? If this table is to be retained, it would greatly benefit from quantitative information if this is available from the source, for example columns for both "Female incidence %" and "Male incidence %", to avoid gender bias and bearing in mind that gender is not binary. AlanS1951 (talk) 20:39, 30 May 2013 (UTC)

Percentages would be useful. Antisocial is the most male-dominated as well as the most common PD in men. At least three times as many men (3%) as women (1%) have ASPD. Histrionic is the most female dominated as well as the most common PD in women. About four times as many women (4%) as men (1%) have HPD. Jim Michael (talk) 23:09, 27 June 2013 (UTC)

Classification

External links should be provided next to the World Health Organization http://www.who.int/en/ and American Psychological Association http://www.apa.org titles on this page for reference and acknowledgement of research and official definitions in this subject.Wjl5326 (talk) 04:31, 2 December 2014 (UTC)

Under Cluster B, Narcissistic personality disorder requires a better explanation as it is more than just "grandiosity and admiration". The definition as currently shown on the page is too vague. Per [1]Wjl5326 (talk) 04:31, 2 December 2014 (UTC)

Narcissistic personality disorder: a pervasive pattern of grandiosity, Wjl5326 (talk) 04:27, 2 December 2014 (UTC)self-admiration, exaggeration of talents and achievements, arrogance, Wjl5326 (talk) 04:27, 2 December 2014 (UTC) [2]and a lack of empathy for other people. Wjl5326 (talk) 04:27, 2 December 2014 (UTC)

Diagnosis

I stumbled upon this page, saw that a lot of the information was outdated and decided it needed to be fix it. The information currently present is outdated since it's based off criterion set by DSM-IV, which is an earlier edition. The DSM-5 has revised the diagnostic criterion for personality disorders and I have summed it up in the section below. This is the information I would like to put in place of what is currently there. I am new to editing Wikipedia pages so if you have any feedback, opinions, or advice it would be very much appreciated!

Diagnostic Criterion

In the most recent edition of the DSM, DSM-V, the diagnostic criteria of a personality disorder have been revised. The general criterion for a personality disorder specifies that an individual's personality must deviate significantly from what is expected within their culture. Also, particular personality features must be evident by early adulthood.

In order to diagnose a personality disorder, the following criteria must be met:

• "Significant impairments in self (identity of self-direction) and interpersonal (empathy or intimacy) functioning."
• "One or more pathological personality traits domains or trait facets."
• "The impairments in personality functioning and the individual's personality trait expressions are relatively stable across time and consistent across situations."
• "The impairments in personality functioning and the individual's personality trait expressions are not better understood as normative for individual's developments stage or sociocultural environment."
• "The impairments in personality functioning and the individual's personality trait expressions are not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma)."

--Barr091 (talk) 22:49, 3 December 2014 (UTC)

Prevalence

Are prevalence numbers given lifetime prevalence or 12-month prevalence? Please clarify. --1000Faces (talk) 02:40, 13 January 2015 (UTC)

Last Paragraph of the Lead

The last paragraph seems to be unnecessary IMO. It is also making the lead 5, instead of the limited 4 paragraphs, determined by policy. I would like to remove this paragraph entirely or at least select a couple of the main points and integrate them into the earlier paragraphs. Will wait a while to see if other editors object.Charlotte135 (talk) 02:20, 31 May 2016 (UTC)

Transgenderism and the ICD

In case my edit gets reverted, the mention of transgenderism is inappropriate in this article. Personality disorders are F60 and F61. Transgenderism is in a much broader class of personality *and behavioral* disorder, which also includes drug addictions and "egodystonic sexual orientation" (the medical code you would bill for conversion therapy).

The way the difference between ICD-10 and DSM-V was discussed also created the false appearance of current controversy where none exists. The ICD-10 classification is considerably older than the DSM-V, and in the ICD-11 transgenderism will cease to be a psychiatric diagnosis at all and be moved to a category of diseases related to sexual health. Jan sewi (talk) 13:11, 19 January 2017 (UTC)

Relationship of socioeconomic status with personality disorders.

I am thinking about adding information about the effects of socioeconomic (SES) associated risks on PD symptom levels. This study looks at independent SES effects on personality disorders over an individuals entire age span. They identify key elements that can cause developmental failures and ultimately lead to the development of personality disorders. Agarwal.son (talk) 15:49, 25 July 2017 (UTC)

References

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This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Agarwal.son.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 06:26, 17 January 2022 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 22 January 2019 and 24 May 2019. Further details are available on the course page. Student editor(s): Yulieee.13.

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The following Wikimedia Commons file used on this page or its Wikidata item has been nominated for speedy deletion:

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Questioning the inclusion of Millon's subtypes on all personality disorder articles

Should Millon's subtypes be included in articles on personality disorders?

Here is my opinion why they should be removed: Most of these subtypes are over 20 years old, not used or studied in modern psychology (to my best knowledge and by being unable to find sources for it), and have been criticised for not being empirically founded, replicable, or useful in any aspects of treatment. My understanding from reading a bit of some sources is the theory stems from psychoanalytic theory. Right now none of the pages mention the lack of empiricism or basis in psychoanalysis, and in my opinion they should all be removed entirely except on an article specifically related to the subtypes history since I don't think they are notable or reliable sources compared to more modern and peer reviewed publications.

The related Millon Clinical Multiaxial Inventory (MCMI) for example has apparently already had this treatment. The MCMI has had substantially more modern research on its validity (which is at least questionable), and the article there does not discuss essentially that all the positive results of validity studies presented were from primary sources. However, the effects the issue in this article doesn't spill into other personality disorder articles; the MCMI is only mentioned in Narcissistic personality disorder (NPD), and there its use is qualified to say the MCMI does not measure NPD directly.

I would appreciate any additional opinions to establish consensus before making any changes. Darcyisverycute (talk) 01:10, 19 June 2022 (UTC)

I don't think Millon's subtypes need to be listed in every personality disorder (PD) article, but I believe it's fine to list them in one place, probably Theodore Millon, and wikilink mention of his conceptualization in PD articles.

Millon's subtypes have not been "proven" via the scientific method, but the same could be said for many, if not most, DSM-5 diagnoses. In other words, a DSM diagnosis purportedly describes a disease entity. But the evidence for such a claim does not exist for most mental disorders, a problem that former NIMH director Thomas Insel highlighted when he announced the new (at the time) Research Domain Criteria.

"Clinical" insights have value, as do "empirical" or "evidence-based" approaches. Many established psychotherapies, for example, began with astute observation, theorizing, and discussion among psychologists and psychiatrists. Later the theories were put to the test via psychotherapy process and outcome research. Carl Rogers epitomizes this synergistic relationship between the consulting room and the research program. The complementary relationships among deductive, inductive, and abductive reasoning are analogous.

Thus, Millon's subtypes have value, particularly in a difficult area like personality disorders, but they should be regarded as heuristics or hypotheses, not fact. As an aside, Millon's treatise, Disorders of Personality: Introducing a DSM/ICD Spectrum from Normal to Abnormal, 3rd ed. (John Wiley & Sons, 2011), is important reading for mental health professionals and others interested in the topic.

- Mark D Worthen PsyD (talk) [he/him] 23:37, 10 July 2022 (UTC)

I agree to the letter with your description of the underlying conceptual framework here, but with the caveat that, as an editorial matter, whether the subtypes are to be mentioned in a particular article must, as a matter of policy, hinge more on WP:WEIGHT sources give to his models relative to particular PDs, rather than the weight we might subjectively assign them. In those terms, we really cannot make a blanket decision here, but rather must accept the WP:LOCALCONSENSUS of each article. If the OP's question was meant to inquire whether they should be mentioned in any PD articles at all, then yes, I think it's fair to say the subtype diagnoses will be WP:DUE in at least some. SnowRise ^{let's rap} 06:25, 11 July 2022 (UTC)

Well said! I agree with you 100%. Mark D Worthen PsyD (talk) [he/him] 06:30, 11 July 2022 (UTC)

Thanks for the feedback :) When I get around to it I'll try starting a local consensus per PD on their respective talk pages, for ones that seem at issue. Darcyisverycute (talk) 07:15, 12 July 2022 (UTC)