View Full Version : can you develop a personality disorder?


2lgsr
01-18-11, 07:48 PM
Hi I was just wandering if you could develop a personality disorder overtime? I was took a quiz and it said I was very high in Aviodant, and high in Dependant, and Schizotypal

daveddd
01-18-11, 07:59 PM
yes, its the only way to get a personality disorder

daveddd
01-18-11, 07:59 PM
but i wouldnt take an online quiz very seriously

sarey
01-18-11, 08:31 PM
I agree with above. Do not take online quizzes seriously. They cannot diagnose you as having anything, and the scores are not always correct.

If you suspect you have a PD, go to a psychiatrist & speak to them about your concerns.

& to answer your question, yes, you can develop a PD, that's how it works, you develop a PD.

nova2012
01-19-11, 01:37 AM
yes, its the only way to get a personality disorder

Not exactly. Personality disorders are a complex result of interactions between genetics and environment. Temperament is largely, but not completely, genetic (one such study: http://www.ncbi.nlm.nih.gov/pubmed/8625721). Whether one goes on to develop a personality disorder is, however, mostly a matter of the experiences that accumulate and interact with biological and genetic factors.

As PDs are not usually officially diagnosed before 18, antisocial PD childhood precursors like conduct disorder often (I believe around 1/3 of the time) turn into AsPD, which may or may not be psychopathy, depending on the case. It would seem logical that AsPD without psychopathy is more environmentally determined than AsPD with psychopathy (the latter is a subset of the former). However, environmental factors (upbringing, relationship between child and parent) likely determine a lot of the ultimate outcome in both cases.

Research on borderline personality disorder points to some sort of genetic predisposition (in at least 75% of cases) that interacts with a traumatic or invalidating childhood to produce anatomically evident emotional dysregulation in the limbic system.

These are just a couple of examples. To say that personality disorders are entirely environmental is not much different than saying personality is entirely environmental. One simply represents a pathological extreme of the other.

Bluerose
01-19-11, 06:44 AM
Everything above……

And a reminder to take note that it is not what is happening to you or what you think is happening to you that is important.

The important thing is how you react to what is happening to you or what you think is happening to you.

Worries like this can cause us to have some strange thoughts.

So stay calm and avoid letting your imagination run away with you.

Get a professionals input.

daveddd
01-19-11, 09:25 AM
Hi I was just wandering if you could develop a personality disorder overtime? I was took a quiz and it said I was very high in Aviodant, and high in Dependant, and Schizotypal

oh, i forgot to mention social anxiety/introverts will likely score high on these type of personality disorders

daveddd
01-19-11, 09:27 AM
Not exactly. Personality disorders are a complex result of interactions between genetics and environment. Temperament is largely, but not completely, genetic (one such study: http://www.ncbi.nlm.nih.gov/pubmed/8625721). Whether one goes on to develop a personality disorder is, however, mostly a matter of the experiences that accumulate and interact with biological and genetic factors.

As PDs are not usually officially diagnosed before 18, antisocial PD childhood precursors like conduct disorder often (I believe around 1/3 of the time) turn into AsPD, which may or may not be psychopathy, depending on the case. It would seem logical that AsPD without psychopathy is more environmentally determined than AsPD with psychopathy (the latter is a subset of the former). However, environmental factors (upbringing, relationship between child and parent) likely determine a lot of the ultimate outcome in both cases.

Research on borderline personality disorder points to some sort of genetic predisposition (in at least 75% of cases) that interacts with a traumatic or invalidating childhood to produce anatomically evident emotional dysregulation in the limbic system.

These are just a couple of examples. To say that personality disorders are entirely environmental is not much different than saying personality is entirely environmental. One simply represents a pathological extreme of the other.

youre right, they say psychopaths are born psychopaths


and scizotypal is being talked about being moved from personality disorders to the schizophrenia spectrum

Scooter77
01-19-11, 05:36 PM
Online tests are fun - but not in any way reliable.
Diagnosing PD's takes a lot more than a few generalised questions. If you're concerned then you need to go and see a Dr who will look at many things - genetics, history, coping ability, habits etc.... and will rule out similar disorders.

Eg - I always come up as avoidant, but I'm not really, I'm an Aspie.

Lunacie
01-19-11, 06:54 PM
Hi I was just wandering if you could develop a personality disorder overtime? I was took a quiz and it said I was very high in Aviodant, and high in Dependant, and Schizotypal

Did you take the quiz out of ordinary curiousity, or do you have some suspicions that you're looking for more information about?

2lgsr
01-19-11, 09:20 PM
just out of curiosity.But some of the traits of avoidant sound like me in a way. I have alot of social anxiety though

nova2012
01-19-11, 11:46 PM
just out of curiosity.But some of the traits of avoidant sound like me in a way. I have alot of social anxiety though

There's huge overlap between the two. I'm not really convinced about the existence of any separate avoidant personality disorder, except in extreme cases. But, even then, I don't find it particularly helpful as a diagnosis, since little treatment exists for the personality disorder itself. The treatment is geared toward generalized social phobia, and even that's a tough nut to crack.

daveddd
01-19-11, 11:55 PM
There's huge overlap between the two. I'm not really convinced about the existence of any separate avoidant personality disorder, except in extreme cases. But, even then, I don't find it particularly helpful as a diagnosis, since little treatment exists for the personality disorder itself. The treatment is geared toward generalized social phobia, and even that's a tough nut to crack.

werent they talking of eliminating AVPD and just sticking with generalized SP

nova2012
01-20-11, 12:01 AM
werent they talking of eliminating AVPD and just sticking with generalized SP

Possibly, not sure... it wouldn't surprise me. There's a book about avoidant PD that I've yet to read, but supposedly the author makes a fairly compelling case for the PD as a discrete diagnosis. As far as I'm concerned, all the anecdotes of people with supposed avoidant PD seem very similar to generalized social phobia, although the latter is not a prerequisite for the PD diagnosis and some avoidants supposedly don't have it.

daveddd
01-20-11, 12:09 AM
supposedly , one of the 2 judge what they are doing and not others

and the other judges what they are doing as well as the reactions of others

daveddd
01-20-11, 12:10 AM
plus ive read that high doses of ssris help people with supposed AVPD

Icecream
01-20-11, 12:15 AM
I always develop a personality disorder caused by doctors. All personality disorders are developed.

nova2012
01-20-11, 12:15 AM
supposedly , one of the 2 judge what they are doing and not others

and the other judges what they are doing as well as the reactions of others

I've heard that argument, too, and I think it's BS. With that theory, AvPD is other-focused, GSP is self-focused. Most of the GSPs on the social anxiety forum I belong to are other-focused in a big way. There's huge overlap between the two, to the extent that I really don't believe in avoidant.

plus ive read that high doses of ssris help people with supposed AVPD

If they don't have social phobia, this may be true. Few people with true social phobia are helped for any significant length of time with SSRIs (12+ months).

daveddd
01-20-11, 12:16 AM
I always develop a personality disorder caused by doctors. All personality disorders are developed.

your doctors cause you to develop personality disorders?

nova2012
01-20-11, 12:16 AM
your doctors cause you to develop personality disorders?

I think his disorder goes well beyond that of personality... hah.

daveddd
01-20-11, 12:17 AM
I've heard that argument, too, and I think it's BS. With that theory, AvPD is other-focused, GSP is self-focused. Most of the GSPs on the social anxiety forum I belong to are other-focused in a big way. There's huge overlap between the two, to the extent that I really don't believe in avoidant.



If they don't have social phobia, this may be true. Few people with true social phobia are helped for any significant length of time with SSRIs (12+ months).

have you tried ssris? i havent , im supposed to start prozac monday

nova2012
01-20-11, 12:26 AM
have you tried ssris? i havent , im supposed to start prozac monday

I'm not a fan of them. I tried Zoloft for two days when I was 16, if that counts, for anxiety. :p Promptly quit because of nausea, sexual dysfunction, and general zombie-like feelings. I probably didn't give it enough time. My mom did very well on Zoloft.

But, I also think that most early-onset (< 25) depressions are of a bipolar etiology (usually bipolar II or the so-called "soft" bipolar spectrum disorders). This would explain the black box warning on SSRIs in children and adolescents, who are most liable to experience mixed state switching--the most suicidal of any bipolar state. Sometimes, this comes with psychosis (if they are really bipolar I), but usually it's just dysphoric hypomania or agitated depression (same thing, really).

If you're on Lamictal, you might be okay. But, I'm concerned about switching since you switched on WB. Prozac is more likely, statistically, to cause switching than WB. It's one of the more activating SSRIs, along with Zoloft.

You might consider adding an additional mood stabilizer like lithium or Depakote to prevent manic switching.

daveddd
01-20-11, 12:29 AM
i know its risky


im gonna chance it though, and i will have outside monitoring

nova2012
01-20-11, 12:35 AM
i know its risky


im gonna chance it though, and i will have outside monitoring

Good luck!

Bluerose
01-20-11, 02:26 AM
Sometimes it sounds like we go to the doctor and pick up a bag of diagnoses, and they can sound pretty scary. It’s worth remembering that most of these usually develop because the original complaint was misdiagnosed.

Tommy Wilhelm
01-21-11, 12:19 AM
I've been diagnosed as having social anxiety, and for a short time I went to group cognitive therapy for it; but a different psychiatrist (or psychologist) told me that what I had looked more like avoidant disorder. And that's the last I heard of it, professionally. I don't know anything about personality disorders at all. Is it a good idea to look into this, you think?

nova2012
01-21-11, 12:53 AM
I've been diagnosed as having social anxiety, and for a short time I went to group cognitive therapy for it; but a different psychiatrist (or psychologist) told me that what I had looked more like avoidant disorder. And that's the last I heard of it, professionally. I don't know anything about personality disorders at all. Is it a good idea to look into this, you think?

You would know best if you have social anxiety. Do you experience anxiety in social situations, particularly with strangers, groups, authority figures (bosses, teachers/professors, doctors--basically, anyone you perceive to be "above" you), the telephone, etc.? Try taking this social anxiety quiz (it's not one of those stupid Internet ones; it's used in clinical settings): http://www.socialanxietysupport.com/disorder/liebowitz/

Avoidant PD can't really be treated, per se, and thus I think it's a pointless diagnosis. I think most people with avoidant PD have generalized social phobia anyway; if that's treated, avoidant tendencies can be much more easily worked on.

Fortune
01-21-11, 01:34 AM
Huh, said test says I don't suffer from social anxiety.

Kind of what I thought would be the result. Still, a bit odd after thinking I had it.

nova2012
01-21-11, 01:44 AM
Huh, said test says I don't suffer from social anxiety.

Kind of what I thought would be the result. Still, a bit odd after thinking I had it.

What was your point aggregate? I believe I got somewhere around 80 when I took it, but I think even that's low for me. Mine is pretty severe.

Fortune
01-21-11, 02:17 AM
I got 46, which points to some anxiety, but like pretty mild. I mean I have phone issues, but they're not about using them in public. Some of them the context was lacking and I had to pick which situation applied (generally the one with the most anxiety).

Tommy Wilhelm
01-21-11, 05:27 AM
It says I don't have it either. I got 47. I did a lot of tests like that before though, and they were professional tests. I got diagnosed by volunteering for some kind of test at the university; they gave me the tests to see if I had it. Maybe I've improved. -Actually, I wonder if I was on stimulants yet by that point. One thing though: it seemed like it jumped abruptly, from moderate to severe. I wonder if I'd score higher if it were between one and ten. Hm.

Bluerose
01-21-11, 07:29 AM
It’s a good idea to take those tests three or four time spread out over a few weeks. I think you’ll get a more accurate reading.

As for reading up on personality disorders. It’s always a good idea to be armed with as much information as possible. If for no other reason than to understand what the docs are on about.

But everyone needs to keep in mind, these tests on the net are not all that reliable, and whoever you are talking to is just one person diagnosing you based on their knowledge of your described symptoms. So before you start worrying yourself to death, learn all you can about your suspected diagnoses and don’t be afraid to ask questions.

iwaw2f
01-21-11, 08:51 AM
Personality disorders are a curse! Don't burden yourself with this, you'll regret it :(

Bluerose
01-21-11, 08:58 AM
You may be right but if there is a problem it’s best not to ignore it.

iwaw2f
01-21-11, 09:09 AM
Yes this is true, there is a lot of insight to be gained in understanding why we do the things we do. But there's a lot to be lost too :\ sorry this is a very personal subject for me.

Fortune
01-21-11, 09:21 AM
You may be right but if there is a problem it’s best not to ignore it.

I would suggest that perhaps one should be very careful about getting a PD diagnosis on records.

1) Therapists may view you as difficult or impossible to treat
2) Insurance won't want to insure you.

Trooper Keith
01-21-11, 11:52 AM
Personality disorders form as a result of early traumas interrupting the normal development of the personality. They don't just show up one day when you're 30, if that's what you're asking.

Tommy Wilhelm
01-21-11, 04:10 PM
It's not what I'm asking, but maybe the OP was.

Fortune
01-21-11, 04:25 PM
Personality disorders form as a result of early traumas interrupting the normal development of the personality. They don't just show up one day when you're 30, if that's what you're asking.

Somewhat surprisingly to me at the time, someone suggested on this very forum that having social anxiety disorder and not socializing would cause avoidant personality disorder to develop.

That someone was not, as far as I am aware, any kind of medical professional.

nova2012
01-21-11, 04:50 PM
I would suggest that perhaps one should be very careful about getting a PD diagnosis on records.

1) Therapists may view you as difficult or impossible to treat
2) Insurance won't want to insure you.

I personally don't use insurance for any mental health issues other than, depending on what it is, medication for the subsequent discounts. I do this purposefully to avoid just the second problem you mentioned. It is a lot costlier, but insurance companies share information, and particularly with the threat of nationalized health care that will inevitably actualize, I'd like to minimize my exposure to that information-sharing, especially as it relates to mental issues.

Trooper Keith
01-21-11, 10:22 PM
Somewhat surprisingly to me at the time, someone suggested on this very forum that having social anxiety disorder and not socializing would cause avoidant personality disorder to develop.

That someone was not, as far as I am aware, any kind of medical professional.

Personality develops early in childhood and remains relatively constant over time. Personalities do not take wild swings and changes, and shifting to a personality disorder is an example of an extreme change from a relatively normal person.

Social anxiety disorder is a form of transient neurosis, it is generally superficial and can be treated. Avoidant personality is a form of character neurosis and is much harder to change. A person with neurotic social anxiety will be aware that his or her behavior is abnormal and troublesome (i.e., their anxiety will be ego dystonic), whereas a person with an avoidant personality will not; to them, the idea that they ought not be socially anxious will be foreign, as the ego has integrated the anxiety from an early stage and it is fundamental (ego syntonic).

The outcomes for these two types are wildly different. People whose problematic behaviors are ego dystonic (ego alien) will have a much easier time of overcoming the problem, whereas those with ego syntonic problems will take some convincing.

Fortune
01-21-11, 10:49 PM
Yeah, I didn't believe him at all, and had no idea where it came from. I mean it sounded like a psychiatric version of "if you keep making that face, it'll get stuck that way."

Mignon
01-21-11, 10:56 PM
can you develop a personality disorder?


Of course you can. Post - death is a particularly vulnerable time. Albert Einstein is up to what - six, seven?

Rebelyell
01-21-11, 11:14 PM
I think its like kmiller said it happens when your young or your chemically imbalanced and something triggers it off like mignon stated.I dont have a personality disorder altho I have developed a serious attitude problem to boot w my adhd:D

Trooper Keith
01-21-11, 11:16 PM
can you develop a personality disorder?


Of course you can. Post - death is a particularly vulnerable time. Albert Einstein is up to what - six, seven?

Not to mention how he developed autism and ADHD, too.

Death is a very traumatic time, mental health-wise, evidently.

nova2012
01-22-11, 02:42 AM
Edited: never mind

Bluerose
01-22-11, 06:54 AM
I personally don't use insurance for any mental health issues other than, depending on what it is, medication for the subsequent discounts. I do this purposefully to avoid just the second problem you mentioned. It is a lot costlier, but insurance companies share information, and particularly with the threat of nationalized health care that will inevitably actualize, I'd like to minimize my exposure to that information-sharing, especially as it relates to mental issues.


Unfortunately this is very true. There is still an awful stigma attached to mental health issues.

This guy seems to be fighting a one man battle to change that.


http://www.independent.co.uk/life-style/health-and-families/health-news/the-mad-doctor-the-extraordinary-story-of-dr-rufus-may-the-former-psychiatric-patient-440381.html


The mad doctor: The extraordinary story of Dr Rufus May, the former psychiatric patient

At the age of 18, Rufus May was diagnosed as an incurable schizophrenic and locked up in a psychiatric hospital. Now, he is a respected psychologist and a passionate campaigner on mental health issues. He is also the guest editor of this special issue. Here, he tells his extraordinary tale.....

Bluerose
01-22-11, 07:14 AM
Personally speaking a personality disorder can emerge at any age. Many begin in childhood where we struggle to understand our world before we are equipped to do so. Especially if it seems like a particularly stressful and even violent world. Sudden changes at any time in our life, like an accident, a vicious attack, death of a loved one, or even the break up of a relationship, can cause a personality change. On the positive side someone may choose to get help and be diagnosed as having depression even serious depression. Treated properly the person may be able to carry on a normal everyday existence. On the negative side they may go down a very slippery road, drinking and self medicating, all the time becoming more and more prone to some serious mental issues.

Rebelyell
01-22-11, 10:41 AM
Thats the reason i want to get off my meds and do it naturally is that last paragraph of that article,and let people accept me as the real true me w out being hidden behind meds.

Scooter77
01-22-11, 05:50 PM
SP is more environmental. More likely to be triggered by stressful experiences and settling somewhat over time as the person de-stresses. It's more of an up-and-down thing related to the persons life events.

AVPD is more chronic and evident over the life span. It's a general way of being rather than a reaction to an event.

In saying that, plenty of people have AVPD characteristics without actually being AVPD. These traits need to severely impact on general well-being, without being related to other disorders, to warrant a dx.

I believe there's some argument over whether it's really a 'disorder'. Many ppl coined AVPD don't see it as much of a problem - other people do.

Fortune
01-22-11, 07:17 PM
Personally speaking a personality disorder can emerge at any age. Many begin in childhood where we struggle to understand our world before we are equipped to do so. Especially if it seems like a particularly stressful and even violent world. Sudden changes at any time in our life, like an accident, a vicious attack, death of a loved one, or even the break up of a relationship, can cause a personality change. On the positive side someone may choose to get help and be diagnosed as having depression even serious depression. Treated properly the person may be able to carry on a normal everyday existence. On the negative side they may go down a very slippery road, drinking and self medicating, all the time becoming more and more prone to some serious mental issues.

I've been doing a lot of reading on personality disorders lately, and everything I've read indicates that they start developing in childhood but are not fully apparent until young adulthood.

While events in our lives can cause sudden changes in how we behave, do these really translate to personality disorders or does something else explain the change better?

Of course I wonder at the whole idea of categorizing personality disorders the way they are. I have to wonder whether this is remotely accurate.

nova2012
01-22-11, 08:37 PM
SP is more environmental. More likely to be triggered by stressful experiences and settling somewhat over time as the person de-stresses. It's more of an up-and-down thing related to the persons life events.

AVPD is more chronic and evident over the life span. It's a general way of being rather than a reaction to an event.

I don't think the etiology of social phobia is any more known than that of AvPD. It too is also chronic and generally lifelong (particularly the generalized subtype).

I believe there's some argument over whether it's really a 'disorder'. Many ppl coined AVPD don't see it as much of a problem - other people do.

Just because the disorder isn't a "problem" to the person doesn't mean it isn't a disorder or that it isn't a problem to those around them.

Many people with personality disorders, particularly antisocial personality disorder (especially with psychopathy), narcissistic personality disorder, histrionic personality disorder, even borderline personality disorder (to some degree, although their suffering causes them to wonder what's going on) don't think they have a problem.

People with these disorders usually only find out they have a disorder when either they or their significant others seek treatment for issues that seem to be chronic, severe, and untenable. Even then, getting them to stick with a treatment regimen is like pulling teeth, and proven treatments simply don't exist for some of these disorders.

daveddd
01-22-11, 08:43 PM
SP is more environmental. More likely to be triggered by stressful experiences and settling somewhat over time as the person de-stresses. It's more of an up-and-down thing related to the persons life events.

AVPD is more chronic and evident over the life span. It's a general way of being rather than a reaction to an event.

In saying that, plenty of people have AVPD characteristics without actually being AVPD. These traits need to severely impact on general well-being, without being related to other disorders, to warrant a dx.

I believe there's some argument over whether it's really a 'disorder'. Many ppl coined AVPD don't see it as much of a problem - other people do.

the person with avpd seeing it as problem is a big part of the differential


it must cause distress, because they long to be with other people , but have severe SA


and they are very aware of their problems

there is no such thing as a disorder that doesnt cause life impairment


if their issues of social isolation isnt a problem, and there is still a disorder present (based on extensive reading only) , it would lean towards schizoid

daveddd
01-22-11, 08:48 PM
i also believe personality disorders tend to group together the multiple amount of "comorbids" that people have together pretty well


a lot of PDs are also being seen to improve with meds now, two studies show drastic improvement , if not full remission in borderline PD with lamictal/prozac

ive even just read something saying several autisitics showed complete symptom relief with high doses of prozac

daveddd
01-22-11, 08:56 PM
I don't think the etiology of social phobia is any more known than that of AvPD. It too is also chronic and generally lifelong (particularly the generalized subtype).



Just because the disorder isn't a "problem" to the person doesn't mean it isn't a disorder or that it isn't a problem to those around them.

Many people with personality disorders, particularly antisocial personality disorder (especially with psychopathy), narcissistic personality disorder, histrionic personality disorder, even borderline personality disorder (to some degree, although their suffering causes them to wonder what's going on) don't think they have a problem.

People with these disorders usually only find out they have a disorder when either they or their significant others seek treatment for issues that seem to be chronic, severe, and untenable. Even then, getting them to stick with a treatment regimen is like pulling teeth, and proven treatments simply don't exist for some of these disorders.

BPD has been shown to improve with meds


NPD and psychopaths have shown drastic improvement with schema therapy (but like you said , if they stick with it)

Trooper Keith
01-22-11, 09:22 PM
I'm going to make a megapost on personality disorders. I'll try to remember to link to it here, otherwise look for it in the PD section.

daveddd
01-22-11, 09:40 PM
http://books.google.com/books?id=OFF8Vu0rjioC&pg=PA58&dq=avoidant+personality+disorder&hl=en&ei=MoY7TbDNFML6lweg7YCfBw&sa=X&oi=book_result&ct=result&resnum=4&ved=0CDwQ6AEwAw#v=onepage&q=avoidant%20personality%20disorder&f=false


heres my source on that

daveddd
01-22-11, 09:42 PM
http://books.google.com/books?id=HG4XgLEiwg0C&pg=PA35&dq=narcissism+schema+therapy&hl=en&ei=Joc7TbLiDYS8lQedmMDqBQ&sa=X&oi=book_result&ct=result&resnum=2&ved=0CDsQ6AEwAQ#v=onepage&q=narcissism%20schema%20therapy&f=false


and source for the narcissism schema therapy

Trooper Keith
01-22-11, 11:09 PM
On Personality and Personality Disorders (http://www.addforums.com/forums/showthread.php?t=96190). I haven't written the part about disorders yet, the personality part is a novel.

Mignon
01-22-11, 11:13 PM
the personality part is a novel.

Oh? If you don't mind my prying do you have a publisher or are you self publishing? I'm taking "novel" literally, maybe it's a joke about length IDK.

daveddd
01-22-11, 11:13 PM
Personality develops early in childhood and remains relatively constant over time. Personalities do not take wild swings and changes, and shifting to a personality disorder is an example of an extreme change from a relatively normal person.

Social anxiety disorder is a form of transient neurosis, it is generally superficial and can be treated. Avoidant personality is a form of character neurosis and is much harder to change. A person with neurotic social anxiety will be aware that his or her behavior is abnormal and troublesome (i.e., their anxiety will be ego dystonic), whereas a person with an avoidant personality will not; to them, the idea that they ought not be socially anxious will be foreign, as the ego has integrated the anxiety from an early stage and it is fundamental (ego syntonic).

The outcomes for these two types are wildly different. People whose problematic behaviors are ego dystonic (ego alien) will have a much easier time of overcoming the problem, whereas those with ego syntonic problems will take some convincing.

this is why i stated i thought AVPD were self aware

bottom right under core symptoms of avoidant personality


but you seem to know a lot more than i do about this stuff

http://books.google.com/books?id=RGpa49Y894wC&pg=PA173&dq=avoidant+personality+ego+dystonic&hl=en&ei=uZw7TczIIMWclgeQ67DqBQ&sa=X&oi=book_result&ct=result&resnum=3&ved=0CDQQ6AEwAg#v=onepage&q=avoidant%20personality%20ego%20dystonic&f=false

Trooper Keith
01-22-11, 11:29 PM
this is why i stated i thought AVPD were self aware

bottom right under core symptoms of avoidant personality


but you seem to know a lot more than i do about this stuff

http://books.google.com/books?id=RGpa49Y894wC&pg=PA173&dq=avoidant+personality+ego+dystonic&hl=en&ei=uZw7TczIIMWclgeQ67DqBQ&sa=X&oi=book_result&ct=result&resnum=3&ved=0CDQQ6AEwAg#v=onepage&q=avoidant%20personality%20ego%20dystonic&f=false

Interesting. I inadvertantly chose a bad disorder to say that about, and I'm going to defer to the authors of this book. Take everything I said about things being ego dystonic and keep it in mind, then just change the disorder to something else.

Apparently, AvPD is ego dystonic (ego alien) and therefore should have better outcomes than other personality disorders (all of the other ones are ego syntonic by definition).

Thanks for pointing this out to me.

daveddd
01-22-11, 11:32 PM
yep, looking foward to the rest of your other thread

nova2012
01-23-11, 05:28 PM
a lot of PDs are also being seen to improve with meds now, two studies show drastic improvement , if not full remission in borderline PD with lamictal/prozac

I have a hard time believing that BPD can be treated with meds alone. There are behavioral patterns and coping strategies that need to be modified, and meds don't do that. DBT and meds together probably provide the best and most synergistic response in BPD.

ive even just read something saying several autisitics showed complete symptom relief with high doses of prozac

What would "complete symptom relief" mean in the context of autism? Autism is a neurological disorder, and it manifests as a totally different way of experiencing the world--much more so than ADHD. Saying that autists can experience "complete symptom relief" is not much different than saying mentally retarded people can experience the same thing. At the end of the day, you're still either autistic or retarded--not to put too fine a point on it. Autism (not necessarily HFA or AS, but more severe autism) is an unfortunate condition whose future probably lies more in prevention than in treatment.

BPD has been shown to improve with meds


NPD and psychopaths have shown drastic improvement with schema therapy (but like you said , if they stick with it)

I don't believe psychopaths can truly be treated, mostly because they almost universally have no interest in being treated--they don't believe they have a problem. Their disorder is probably as ego-syntonic as they come, because it seems much more clearly neurobiological than other disorders.

It would be more plausible to treat NPD, to some degree, but those tendencies will likely always be there. Treating NPD is much like trying to perform surgery on a bullet-riddled brain to remove the fragments and curb swelling. Yes, perhaps in some cases, it's partially possible, but lasting and irreversible damage has already been done, and treatment response and prognosis are unpredictable. And, good luck getting any true narcissist to go to any therapist once, let alone more than once.

http://books.google.com/books?id=HG4XgLEiwg0C&pg=PA35&dq=narcissism+schema+therapy&hl=en&ei=Joc7TbLiDYS8lQedmMDqBQ&sa=X&oi=book_result&ct=result&resnum=2&ved=0CDsQ6AEwAQ#v=onepage&q=narcissism%20schema%20therapy&f=false


and source for the narcissism schema therapy

I haven't been able to find any real evidence for efficacy of that therapy on NPD.

Trooper Keith
01-23-11, 07:28 PM
Nova, you're partially right. You're also partially wrong.

Many personality disorders, including psychopathy, can be treated. The caveat to that is that the prognoses aren't great. When a person's character is disordered, we can only expect modest improvement. However, we can expect improvement.

There is a popular myth in the "mainstream" psychological community that these disorders are completely untreatable. This is because the "mainstream" practices (specifically CBT, who tend to be the big empirical bullies) offer little to no assistance for personality disorders.

However, psychodynamic psychotherapy has been demonstrated to yield results in treating personality disorders (http://www.apa.org/pubs/journals/releases/amp-65-2-shedler.pdf) with very strong effect sizes. It is an effective treatment, but it takes time and energy that many therapists aren't willing to put in. It also puts a very technical understanding of the origins of personality that most therapists don't have. My other thread describes the origins of personality, and in the near future I will post either a reply to that thread or a follow-up thread where I describe how, when those processes go wrong, personality disorders form.

nova2012
01-23-11, 10:32 PM
Nova, you're partially right. You're also partially wrong.

Many personality disorders, including psychopathy, can be treated. The caveat to that is that the prognoses aren't great. When a person's character is disordered, we can only expect modest improvement. However, we can expect improvement.

Some improvement may be expected with sufficient cooperation, focus, and dedication by the patient, but I don't personally believe that psychopathy or narcissism can be treated to any significant degree--i.e. so that the person no longer qualifies for either diagnosis and may instead have traits, but not the full-blown personality disorder.

Psychopathy in particular seems almost purely neurobiological. These are kids that may or may not have grown up in dysfunctional households (many don't), but quite often torture animals and exhibit other patently anti-social behaviors.

There is a popular myth in the "mainstream" psychological community that these disorders are completely untreatable. This is because the "mainstream" practices (specifically CBT, who tend to be the big empirical bullies) offer little to no assistance for personality disorders.

However, psychodynamic psychotherapy has been demonstrated to yield results in treating personality disorders (http://www.apa.org/pubs/journals/releases/amp-65-2-shedler.pdf) with very strong effect sizes. It is an effective treatment, but it takes time and energy that many therapists aren't willing to put in. It also puts a very technical understanding of the origins of personality that most therapists don't have. My other thread describes the origins of personality, and in the near future I will post either a reply to that thread or a follow-up thread where I describe how, when those processes go wrong, personality disorders form.

Psychodynamic psychotherapy, from my understanding, is basically "psychoanalysis lite... and revived." Is this incorrect?

I only briefly skimmed that article, but it doesn't seem to break out treatment efficacy in specific personality disorders. That's what I'm most interested in, particularly with such profound personality disorders like NPD and AsPD (especially with psychopathy).

Also, CBT is effective and a deriviative, DBT, is perhaps the most effective treatment for borderline personality disorder, so it's not really accurate to say CBT offers "little to no assistance for personality disorders."

Trooper Keith
01-23-11, 10:44 PM
Some improvement may be expected with sufficient cooperation, focus, and dedication by the patient, but I don't personally believe that psychopathy or narcissism can be treated to any significant degree--i.e. so that the person no longer qualifies for either diagnosis and may instead have traits, but not the full-blown personality disorder.

It's not reasonable to assume that these people are going to fundamentally reshape their personalities such that they no longer meet the conditions of the disorder. Like alcoholism, once a personality disorder, always a personality disorder. It's not so much accurate to call these disorders as it is "maladaptive personality types." Just like an introvert won't become an extravert, a narcissist will rarely stop employing narcissistic ego defenses. It is possible, however, to control those ego defenses and using various techniques this can be done effectively.

Psychopathy in particular seems almost purely neurobiological. These are kids that may or may not have grown up in dysfunctional households (many don't), but quite often torture animals and exhibit other patently anti-social behaviors.

Temperament, environment, and key developmental milestones contribute to psychopathy.

Psychodynamic psychotherapy, from my understanding, is basically "psychoanalysis lite... and revived." Is this incorrect?

Yes, more or less.

I only briefly skimmed that article, but it doesn't seem to break out treatment efficacy in specific personality disorders. That's what I'm most interested in, particularly with such profound personality disorders like NPD and AsPD (especially with psychopathy).

No, I don't recall it giving specifics on each individual disorder. I'd have to do extra research to find those rates. One major problem is that due to the impossibility of standardizing psychoanalytic therapy (it can't be done from a manual), it's very hard to study except using pre-/post-treatment evaluations.

Also, CBT is effective

Evidence?

and a deriviative, DBT, is perhaps the most effective treatment for borderline personality disorder, so it's not really accurate to say CBT offers "little to no assistance for personality disorders."

DBT is the only empirically supported treatment (CBT is not empirically supported) but that does not make it the most effective. And I specifically said CBT, not DBT, because DBT has good research support. It also has a whole whole lot more than just CBT in it. I know of no evidence (though am welcome to stand corrected) of CBT alone being effective for the treatment of any personality disorder.

nova2012
01-23-11, 11:20 PM
It's not reasonable to assume that these people are going to fundamentally reshape their personalities such that they no longer meet the conditions of the disorder. Like alcoholism, once a personality disorder, always a personality disorder. It's not so much accurate to call these disorders as it is "maladaptive personality types." Just like an introvert won't become an extravert, a narcissist will rarely stop employing narcissistic ego defenses. It is possible, however, to control those ego defenses and using various techniques this can be done effectively.

I'm curious as to what, specifically, those "various techniques" entail. I've yet to see much of any concreteness with regard to the treatment of narcissism or psychopathy. I did read one article that somewhat detailed the schema therapy approach (http://www.lcmedia.com/mind333.htm), but it still isn't particularly concrete, nor is there any apparent research evidence to back up Dr. Young's claims--at least, that I've found.

Temperament, environment, and key developmental milestones contribute to psychopathy.

Temperament is almost entirely genetic. It's quite well-known that many serial killers (and, obviously, these are extreme examples of psychopathy) had apparently normal childhoods ("environments" and "key developmental milestones"). Some studies have analyzed this very question and, based on twin analyses, concluded that much of psychopathy appears to be genetic--one such study: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2242349/ Here is a review of studies analyzing neuroanatomical brain differences in psychopathy: http://www.ncbi.nlm.nih.gov/pubmed/18327824

No, I don't recall it giving specifics on each individual disorder. I'd have to do extra research to find those rates. One major problem is that due to the impossibility of standardizing psychoanalytic therapy (it can't be done from a manual), it's very hard to study except using pre-/post-treatment evaluations.

A non-standardized treatment protocol sounds like a recipe for disaster. That's one of the many reasons I don't really believe in psychoanalysis (and its contemporary counterparts).

Evidence?

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1852259/

DBT is the only empirically supported treatment (CBT is not empirically supported) but that does not make it the most effective. And I specifically said CBT, not DBT, because DBT has good research support. It also has a whole whole lot more than just CBT in it. I know of no evidence (though am welcome to stand corrected) of CBT alone being effective for the treatment of any personality disorder.

DBT is best seen as a modified form of CBT, adding certain specific features that relate to the borderline personality, mostly from Eastern meditation traditions.

Trooper Keith
01-24-11, 12:19 AM
I'm curious as to what, specifically, those "various techniques" entail.

Providing the patient with insight into ego defenses and utilizing practice and dare I say CBT-like techniques to reduce the deployment of those defenses. It's not something that happens overnight.

Temperament is almost entirely genetic.

No ****?

It's quite well-known that many serial killers (and, obviously, these are extreme examples of psychopathy) had apparently normal childhoods ("environments" and "key developmental milestones"). Some studies have analyzed this very question and, based on twin analyses, concluded that much of psychopathy appears to be genetic--one such study: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2242349/ Here is a review of studies analyzing neuroanatomical brain differences in psychopathy: http://www.ncbi.nlm.nih.gov/pubmed/18327824

Hadn't acquainted myself with this research, thank you. I would say that probably the "normal childhoods" likely entailed some degree of trauma that we don't know about. Remember that traumata need not take the shape of abusive parents or whatnot.

A non-standardized treatment protocol sounds like a recipe for disaster. That's one of the many reasons I don't really believe in psychoanalysis (and its contemporary counterparts).

When you show me two identical human minds, I will show you a treatment that will work identically for both of them. Manualized therapy does not get longterm results, as the Shedler article demonstrates. This is really neither here nor there, though.

DBT is best seen as a modified form of CBT, adding certain specific features that relate to the borderline personality, mostly from Eastern meditation traditions.

Thank you for this definition, I had no idea what DBT was!

nova2012
01-24-11, 12:50 AM
Providing the patient with insight into ego defenses and utilizing practice and dare I say CBT-like techniques to reduce the deployment of those defenses. It's not something that happens overnight.

And how would having insight into these so-called "ego defenses" help a psychopath in gaining empathy and a conscience--two fundamentally temperamental (and human) emotions that are lacking in psychopaths? That seems akin to trying to build a "better" house where a house already exists, without first demolishing the original house. You're basically trying to create a new person at that point, and that doesn't seem likely.

I don't consider a lack of empathy or guilt to be ego defenses. Are bipolar disorders "ego defenses?" There doesn't seem to be a huge difference; both are clearly neurobiological. You are trying to attribute psychological theories to a matter of neurobiology--square peg in a round hole.


No ****?

My point there was that the three factors you attributed to the development of psychopathy do not all appear to have the significance you ascribed to them. Perhaps the prenatal "environment" factors into this, but I lump that in with "temperament."

Hadn't acquainted myself with this research, thank you. I would say that probably the "normal childhoods" likely entailed some degree of trauma that we don't know about. Remember that traumata need not take the shape of abusive parents or whatnot.

Something like seven out of ten children experiences some form of trauma. But, far fewer than that become psychopaths. Perhaps trauma can "trigger" an underlying predisposition, but I find that very implausible, given that traumatic incidents do not often anatomically reshape the brain.

When you show me two identical human minds, I will show you a treatment that will work identically for both of them. Manualized therapy does not get longterm results, as the Shedler article demonstrates. This is really neither here nor there, though.

One of the aims of psychiatry is to standardize diagnostic criteria and treatment protocols to achieve the best results for the most patients. The motives and interests of psychology are likely quite different, because it is not a branch of medicine, but clinical psychology too aims to standardize diagnoses and treatments.

Whether the various steps in these protocols works is quite variable and often a matter of chance, but the fact that standardized protocols exist means that comparing patients and their responses becomes much easier than simply throwing, in random order, a bunch of different-colored darts and hoping that one sticks.

Unfortunately, because of the fundamental lack of understanding of the neuroscience of psychiatric disorders, psychiatry (and psychology) is still often a matter of throwing darts at a board, but typically in a specific order and methodically to minimize side effects and maximize treatment response.

Thank you for this definition, I had no idea what DBT was!

You seemed not to acknowledge that DBT is, fundamentally, CBT with some specific additions. CBT, however, is intrinsically customized to the issues and disorders of the individual, often employing augmentative breathing and meditation techniques, so there isn't a huge difference, except that one's standardized and the other isn't. So, to say that CBT does not treat personality disorders is incorrect. In addition, I linked to a study that analyzed the efficacy of CBT, not DBT, in treating borderline personality disorders and concluded that it was significant.

Hoshi
01-24-11, 02:24 AM
If I remember right, the DSM says PD's have to be evident from an early age (like adolescence) and doesn't just appear out of nowhere at middle age. It's pervasive and deep-seated. Some PD's are nearly impossible to treat because many PD's keep the patient from admitting there is anything wrong with them. Even if they do, the behaviors are very set and difficult (though not impossible) to change.
They also have to cause obvious impairment socially and at work/school. Online tests are just for fun, not by any means a diagnosis.

daveddd
01-24-11, 02:31 PM
If I remember right, the DSM says PD's have to be evident from an early age (like adolescence) and doesn't just appear out of nowhere at middle age. It's pervasive and deep-seated. Some PD's are nearly impossible to treat because many PD's keep the patient from admitting there is anything wrong with them. Even if they do, the behaviors are very set and difficult (though not impossible) to change.
They also have to cause obvious impairment socially and at work/school. Online tests are just for fun, not by any madolenceeans a diagnosis.

PDs shouldnt be dx in adolescence due to the fact that they are trying to find an identity

as KMiller pointed out that on the fact of PDs many will end up in therapy due to axis 1 issues, courts , and family

just because they are unaware there is a problem doesnt mean they cant except it when pointed out

daveddd
01-24-11, 02:35 PM
NOVA

this legit study is trying to move towards the autism that we see on here more, with the obsessions, interests, social problems and emotional issues may be closely related to a mood disorder

prozac was shown to give full symptom relief in several

adhd is a neuro disorder that can get full symptom relief by meds

a lot of docs thought the "aspie" and less obvious types of autism may be a correctable disorder


http://neuro.psychiatryonline.org/cgi/content/full/16/2/199

daveddd
01-24-11, 02:37 PM
and they relate the bipolar "giftedness" to savant style autism

nova2012
01-24-11, 03:15 PM
NOVA

this legit study is trying to move towards the autism that we see on here more, with the obsessions, interests, social problems and emotional issues may be closely related to a mood disorder

prozac was shown to give full symptom relief in several

adhd is a neuro disorder that can get full symptom relief by meds

a lot of docs thought the "aspie" and less obvious types of autism may be a correctable disorder


http://neuro.psychiatryonline.org/cgi/content/full/16/2/199

That is not a study; it's an opinion. Although it's interesting, it doesn't really prove anything; it hypothesizes that in some cases, autism seems phenomenologically and genetically linked to mood disorders. It also does not provide a metric by which "response" to fluoxetine is measured. What is an "excellent response" considered in the context of autism?

To me, it seems that these disorders may be linked insofar as many (most?) probands with psychiatric disorders have a significantly increased prevalence of these and other psychiatric or neuropsychiatric disorders in their families. There must be some common thread, at some point, but this may evolve into different phenotypical, even neurobiological, presentations by way of epigenetics or GxE interactions. I think it's a far cry to say that mood disorders and autism are truly related beyond perhaps that "common thread," if it exists. Certainly, particular areas of the brain are much more often associated with dysfunction than others, and similarities across disorders can likely be found, but this does not necessarily imply the two disorders are etiologically "related," even if they sometimes respond to similar treatments.

I'd still like to understand how the author defines "response," in the context of fluoxetine administration to autistics.

Psychostimulants do not effect "full symptom relief" any more than mood stabilizers or antidepressants effect "full symptom relief" from mood disorders. The underlying disorder is still there and symptoms will and do inevitably show through. It's not like you're simply covering a small cut with a bandaid and waiting for it to heal. You're covering a gaping wound with a huge bandage to slow the bleeding and giving the person some morphine, so they get some temporary relief. In the end, they still have that gaping wound. ADHDers can still develop tolerance to and issues with stimulants (and they probably aren't ideal for the brain or body, in general), and their symptoms will still "bleed" through, both during and following the effects of the medication.

daveddd
01-24-11, 03:22 PM
all of psychology is nothing more than a opinion

how is this not a study

what s a study to you?

daveddd
01-24-11, 03:25 PM
However, our clinical experience suggests that the frequent improvement in socialization, language, adaptive skills, and mood indicates that effective medication does modify, though not cure, the core symptoms of autism.


this is what i meant

in other words the most popular "opinion" is that the core symptoms of autism cant be treated with meds

this suggests otherwise

daveddd
01-24-11, 03:26 PM
and i meant the best symptom relief that most disorders get

bipolar isnt cured

adhd doesnt get cured

SA doesnt get cured

by full symptom relief, i meant all symptoms were affected, as opposed to commonly occurring comorbids like previously believed

Trooper Keith
01-24-11, 03:49 PM
Drugs can't change personalities; drugs can only provide relief from symptoms of maladaptive personalities.

nova2012
01-24-11, 03:51 PM
all of psychology is nothing more than a opinion

how is this not a study

what s a study to you?

This is an opinion-based article, as it states at the top. It's not a proper clinical study, which is done using a large population, a certain study methodology (ideally double-blind, randomized and controlled), a specific hypothesis or dependent variable, and a statistical analysis and clinical annotation of the results.

However, our clinical experience suggests that the frequent improvement in socialization, language, adaptive skills, and mood indicates that effective medication does modify, though not cure, the core symptoms of autism.


this is what i meant

in other words the most popular "opinion" is that the core symptoms of autism cant be treated with meds

this suggests otherwise

I read that. He still does not specify exactly what symptoms improve and how this improvement is measured. I cannot even conceive of how truly autistic individuals could improve in these ways, and he doesn't make that conception any easier or more scientifically or statistically evidenced.

and i meant the best symptom relief that most disorders get

bipolar isnt cured

adhd doesnt get cured

SA doesnt get cured

by full symptom relief, i meant all symptoms were affected, as opposed to commonly occurring comorbids like previously believed

I still don't understand what it would mean to cure a disorder, namely autism, that seems much more clearly neurological than any of these other disorders. What does "full symptom relief" mean in the context of autism, where social cues and behaviors are fundamentally not understood; routines and rituals are embraced and strictly adhered to and change and novelty are eschewed; in higher-functioning cases, the mind attaches to particular interests and seeks to achieve depth of knowledge in those interests, rather than breadth; mental retardation may be present; use of language is highly stereotyped and pedantic; imagination and empathy are often impaired; "stimming" is compulsively performed to ostensibly "stabilize" or "center" the nervous system and sensory input in response to overstimulation, anxiety, excitement, or other stimuli (I don't think this phenomenology is really understood); there are often obsessions with lining things up, order, rules, avoiding chaos, etc.--but markedly different from OCD; etc.

I just don't "get" what response would entail.

daveddd
01-24-11, 03:54 PM
so are you saying all those symptoms that you listed couldnt be caused by something that could be modified by meds

daveddd
01-24-11, 03:58 PM
Drugs can't change personalities; drugs can only provide relief from symptoms of maladaptive personalities.

so by relieving symptoms of a maladaptive personality at a early age prevent the development of a maladaptive personality later in life?


similar to treating adhd at a young age can sometimes prevent a lot of the separate issues that adults develop when going untreated

daveddd
01-24-11, 04:15 PM
got to apologize nova , just found a bigger study showing little effect on repetitive behavior in autism with prozac

but they gotta be thinkin something to be investigating this

Hoshi
01-24-11, 04:46 PM
PDs shouldnt be dx in adolescence due to the fact that they are trying to find an identity

as KMiller pointed out that on the fact of PDs many will end up in therapy due to axis 1 issues, courts , and family

just because they are unaware there is a problem doesnt mean they cant except it when pointed out
I'm not saying they should be diagnosed before 18. I'm saying the patterns of behavior should be evident from that age, as in you can look back and see that behavior that matches up with the PD. The PD doesn't just magically start at 18, it's a pervasive pattern of behavior that starts early in life.

nova2012
01-24-11, 04:46 PM
so are you saying all those symptoms that you listed couldnt be caused by something that could be modified by meds

I don't believe the majority could be modified or significantly improved by meds, no, at least any meds that are currently in use. As I mentioned before, I think the future of approaching developmental disorders lies more in prevention than in treatment.

daveddd
01-24-11, 04:51 PM
I'm not saying they should be diagnosed before 18. I'm saying the patterns of behavior should be evident from that age, as in you can look back and see that behavior that matches up with the PD. The PD doesn't just magically start at 18, it's a pervasive pattern of behavior that starts early in life.

i know you meant that

i just read that teens searching for an identity can be mistaken as a PD

daveddd
01-24-11, 04:54 PM
maybe the kids who were helped by the prozac, relly did just have a mood disorder misdx as autism

Hoshi
01-24-11, 08:54 PM
maybe the kids who were helped by the prozac, relly did just have a mood disorder misdx as autism

I haven't looked at the study you're referring to, but a misdiagnoses is doubtful. They are very, very careful about the participants they select for studies.

Autism is incredibly complicated and varies so much in severity. It does so much stuff to the brain that we haven't even figured out yet, so I don't doubt that antidepressants could help some with particular kinds or severities of autism. There's bound to be some neurotransmitter abnormalities going on in their brain too.

Trooper Keith
01-24-11, 10:26 PM
I don't believe the majority could be modified or significantly improved by meds, no, at least any meds that are currently in use. As I mentioned before, I think the future of approaching developmental disorders lies more in prevention than in treatment.

The future of approaching personality disorders lies in sound psychological theory coupled with prevention. I agree with your assessment that meds won't improve things, because meds can only correct neurological inclinations, not pervasive patterns of thinking and fundamental ways of perceiving and interacting with the world.

Vraiment
02-13-11, 11:54 AM
Whats a personality disorder

daveddd
02-13-11, 11:57 AM
Whats a personality disorder
http://www.addforums.com/forums/showthread.php?t=96190

nova2012
02-13-11, 03:43 PM
Whats a personality disorder

Seriously?

Lunacie
02-13-11, 07:14 PM
Seriously?

Why does that surprise you?

Vraiment is very new to this forum, and may be in the very early learning stages about mental disorders. I knew very little when I first joined this forum - it's been a great place to learn about these things.

nova2012
02-13-11, 11:58 PM
Why does that surprise you?

Vraiment is very new to this forum, and may be in the very early learning stages about mental disorders. I knew very little when I first joined this forum - it's been a great place to learn about these things.

Apparently he has never heard of Google. That question could have been answered in approximately three seconds without wasting bandwidth, his time, or other people's time.

I'm not trying to be a jerk here, especially to a new member, but I really don't like it when people ask questions to which they can so easily find the answers. It promotes or perpetuates a helpless attitude.

EDIT: I'll even help him out. Here, Vraiment: http://en.wikipedia.org/wiki/Personality_disorder

EDIT 2: Here's a copy-and-pasted short definition from Wikipedia. "Personality disorders, formerly referred to as character disorders, are a class of personality types and behaviors that the American Psychiatric Association (APA) defines as "an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it".[1][2] Personality disorders are noted on Axis II of the Diagnostic and Statistical Manual of Mental Disorders or DSM-IV-TR (fourth edition, text revision) of the American Psychiatric Association." Wikipedia explains it better than most of us can without going into painfully elaborate detail.

Bluerose
02-14-11, 01:01 PM
I agree. If Vraiment had bothered to read the thread he would have had to ask that question.

JOHNCG
03-07-11, 12:37 AM
The future of approaching personality disorders lies in sound psychological theory coupled with prevention. I agree with your assessment that meds won't improve things, because meds can only correct neurological inclinations, not pervasive patterns of thinking and fundamental ways of perceiving and interacting with the world.

I disagree, I think that in the future it will be increasingly accepted that Personality Disorders have a predominantly biological diathesis; as suggested by Personality theorists like Albert Ellis. Borderline personality will be understood as essentially the result of dysfunction in the limbic system (and other brain regions yet to be identified), Antisocial Personality Disorder will , likewise, be explained in terms of dysfunction in brain regions like the Orbitofrontal cortex. The treatments for Personality Disorders will therefore (in the future) be increasing neurogenetic/ pharmacological in the future. Borderline Personality, for example, has been shown to respond very positively to treatment with anticonvulsant drugs like valpraote sodium (Dekapot)

nova2012
03-07-11, 12:43 AM
I disagree, I think that in the future it will be increasingly accepted that Personality Disorders have a predominantly biological diathesis; as suggested by Personality theorists like Albert Ellis. Borderline personality will be understood as essentially the result of dysfunction in the limbic system (and other brain regions yet to be identified), Antisocial Personality Disorder will , likewise, be explained in terms of dysfunction in brain regions like the Orbitofrontal cortex. The treatments for Personality Disorders will therefore (in the future) be increasing neurogenetic/ pharmacological in the future. Borderline Personality, for example, has been shown to respond very positively to treatment with anticonvulsant drugs like valpraote sodium (Dekapot)

I think almost every PD has a biological diathesis, but clearly there are environmental factors at work, and they're significant. Temperament is almost exclusively genetic. But clearly, the pathological extremes of these genetic propensities are largely influenced by one's environment, both in the womb and throughout early and late childhood and, probably to a lesser extent, throughout early adolescence. There is a lot of room--and therapeutic benefit--for psychotherapies tailored to particular maladaptations of personality. The brain is highly malleable and CBT is evidence of that. It's extremely effective for a lot of issues. I think we'll start to see more efficacious varions on it in the near future, as we did with DBT.

daveddd
03-07-11, 01:24 AM
I think almost every PD has a biological diathesis, but clearly there are environmental factors at work, and they're significant. Temperament is almost exclusively genetic. But clearly, the pathological extremes of these genetic propensities are largely influenced by one's environment, both in the womb and throughout early and late childhood and, probably to a lesser extent, throughout early adolescence. There is a lot of room--and therapeutic benefit--for psychotherapies tailored to particular maladaptations of personality. The brain is highly malleable and CBT is evidence of that. It's extremely effective for a lot of issues. I think we'll start to see more efficacious varions on it in the near future, as we did with DBT.

this is one supposedly better variation of cbt for PDs

http://books.google.com/books?id=lfJ0jO180DQC&printsec=frontcover&dq=borderline+personality+disorder&hl=en&ei=sKRETYOvAcXflgeSv5gH&sa=X&oi=book_result&ct=result&resnum=9&ved=0CFoQ6AEwCDgK#v=onepage&q&f=false

JOHNCG
04-02-11, 06:34 AM
I think almost every PD has a biological diathesis, but clearly there are environmental factors at work, and they're significant. Temperament is almost exclusively genetic. But clearly, the pathological extremes of these genetic propensities are largely influenced by one's environment, both in the womb and throughout early and late childhood and, probably to a lesser extent, throughout early adolescence. There is a lot of room--and therapeutic benefit--for psychotherapies tailored to particular maladaptations of personality. The brain is highly malleable and CBT is evidence of that. It's extremely effective for a lot of issues. I think we'll start to see more efficacious varions on it in the near future, as we did with DBT.

I should have said that Personality Disorders are ESSENTIALLY biologically/nuerogenetically based. It is my personal view that in the future, pharmacotherapy/ neurogenetic therapy will eventually be demonstrated as the most effective frontline treatment for Personality Disorders.

I get weary of the "brain is malleable"/neurogenesis argument. The fact of neurogenesis is often used to say that CBT can perform all these wonders/miracles, whereby a damaged brain repairs itself, etc and the psychiatric condition that person had resolves. Let's face it , in the real world that just doesn't happen. If we could get neurological abnormalities in the brain to rectify themselves by (solely) thinking "happy thoughts"; then we would be well aware of the fact right now.

The fact is that Personality Disorders have a long clinical history of very stubborn resistance to CBT ( and all sorts of other psychotherapies, generally. That is, lots and lots people with Borderline PD have received years of intensive CBT to no avail - it just didn't work (at all). That is, the (highly malleable in theory) brain did not magically repair itself and make the problem disappear

Fortune
04-02-11, 12:01 PM
While I think it is possible to take malleability and neurogenesis too far, a form of CBT called dialectical behavioral therapy does work with BPD.

JOHNCG
04-13-11, 07:28 PM
While I think it is possible to take malleability and neurogenesis too far, a form of CBT called dialectical behavioral therapy does work with BPD.

Yes, I know that DBT has been scientifically documented as an effective treatment for BPD. Though whether DBT effects a remediation of BPD symptomology through neurogenesis is not clear; at least no claim is made in any of the literature that it does.

From memory DBT is an eclectic mixture of psychotherapies including conventional-style CBT, stuff like "mindfulness" skills and training in the use of Eastern (Zen, I think) meditation practices. So perhaps DBT delivers an essentially spiritual mode of healing?? Who knows??

Fortune
04-13-11, 10:34 PM
Yes, I know that DBT has been scientifically documented as an effective treatment for BPD. Though whether DBT effects a remediation of BPD symptomology through neurogenesis is not clear; at least no claim is made in any of the literature that it does.

From memory DBT is an eclectic mixture of psychotherapies including conventional-style CBT, stuff like "mindfulness" skills and training in the use of Eastern (Zen, I think) meditation practices. So perhaps DBT delivers an essentially spiritual mode of healing?? Who knows??

I don't know what mechanisms are involved, although it is pretty great that there is working treatment. I was specifically replying to this paragraph, not to whether it involves neurogenesis:

The fact is that Personality Disorders have a long clinical history of very stubborn resistance to CBT ( and all sorts of other psychotherapies, generally. That is, lots and lots people with Borderline PD have received years of intensive CBT to no avail - it just didn't work (at all). That is, the (highly malleable in theory) brain did not magically repair itself and make the problem disappear

Trooper Keith
04-14-11, 12:16 AM
Otto Kernberg. (http://scholar.google.com/scholar?q=otto+kernberg&hl=en&btnG=Search&as_sdt=1%2C36&as_sdtp=on)

That is all.

Bluerose
04-14-11, 09:10 AM
I only speak for myself here. I have done quite a bit of reading but found that sharing personal experiences helped too.

Mindfulness training and meditation are very helpful in that they calm the mind and allow us to control our erratic thoughts.

The more upset we get the more intense and scary the symptoms get. Staying calm while experiencing 'extra mental activity' is not always easy but it is important.

Keeping a journal can provide much needed information and insight into our own particular disorder.

I go along with the idea that personal and spiritual development delivers an essentially spiritual mode of healing.

Bluerose
04-14-11, 09:23 AM
I go along with -

"The future of approaching personality disorders lies in sound psychological theory coupled with prevention." KMiller

And that prevention involves taking better care of our children.

I'm no expert and I don't claim to know anything for sure apart from my own experiences.

But it looks like some if not all theses disorders develop out of Post Traumatic Stress Disorder (PTSD). And PTSD is the result of trauma. And in my case, childhood trauma.

I could be wrong but I wonder if untreated, misdiagnosed or undiagnosed PTSD could develop into a personality disorder.

If we dealt with PTSD first could all the other **** be avoided?

Bluerose
04-14-11, 10:06 AM
"If we could get neurological abnormalities in the brain to rectify themselves by (solely) thinking "happy thoughts"; then we would be well aware of the fact right now." JOHNCG


I've worked with Positive Thinking and meditation for about twenty years. I agree that it's not a cure. But it can be a very useful tool when used to combat the more negative suicidal thoughts that come with some personality disorders.

I agree too that most disorders have a long clinical history but not necessarily because of stubborn resistance to treatment. It could be that the type of treatment is all wrong and or that some people have been misdiagnosed or gone a long time without being properly diagnosed.

I agree that treatment doesn't work. All these people can do is listen to us lament and offer some suggestions that might make life a bit easier for a few days.

Medication doesn't work either. And the best we can hope for there is an antidepressant that may or may not relieve some of the depressive symptoms and let us get on with our life to the best of our ability.

There is no miraculous cure and the best most of us can hope for is to develop the skills that help us cope with our own particular disorder.

Acceptance is a good place to start. Accept that you are who you are and begin to look around for things that will make your life easier.

The only people getting anything out of this are the people who make the pills and potions.