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Personality Disorders Change Over Lifetime
Personality Disorders Change Over Lifetime
Symptoms Become Better or Worse, Therapy Helps
By Jeanie Lerche Davis
WebMD Medical News Reviewed By Charlotte Grayson, MD
on Thursday, October 07, 2004
Oct. 7, 2004 -- There is new evidence that the symptoms of personality disorder don't remain stagnant but actually wax and wane over time. It also turns out some personality disorders may also be more treatable than previously thought, researchers say.
Antisocial personality disorder, obsessive-compulsive personality disorder, and borderline personality disorder -- these are just a few of the personality disorders addressed by researcher Mark F. Lenzenweger, PhD, a clinical psychologist with the State University of New York at Binghamton. His report appears in this month's Archives of General Psychiatry.
People with personality disorders have extreme and inflexible personality traits that are distressing to the person and can cause problems in every aspect of life. Difficulty forming stable relationships is one aspect of these disorders. Also, the person's patterns of thinking and behavior significantly differ from society's expectations -- and are so rigid that they interfere with the person's normal functioning.
"They feel emotionally distraught and horrible most of the time," Lenzenweger explains. "Like most complex disorders, there probably is a neurobiological and genetic basis to the disorder, which is impacted by environmental factors, like severe childhood sexual abuse."
The American Psychiatric Association has long viewed personality disorders "as very carved in stone, that once you have a personality disorder, it stays with you throughout your life, that there's not much you can do about it," he tells WebMD. "Conventional treatments such as psychotherapy, group therapy, family therapy, or medication are not much help."
His study is helping change that mindset.
A Lifetime Study
It is a lifetime study of this pattern, Lenzenweger says. He and his colleagues gave personality disorder assessment tests to 2,000 college freshmen. Out of the group of 250 --134 had symptoms of possible personality disorder, some with more symptoms than others. The rest of the students were controls in the study, and had no signs of personality disorders.
The data he presents are from the students' first four years in college, when they were between 18 and 21 years old. Three times during the four-year study period, students were tested for personality disorder symptoms.
"We saw massive changes in personality disorder features over just four years," Lenzenweger tells WebMD.
On average, the students showed a significant decline of symptoms from the personality disorder with every passing year, he reports. This was true whether students got treatment from a health care professional or not.
Also, the presence of another mental illness -- such as depression -- did not impact the decrease in personality disorder symptoms, Lenzenweger notes. "People have often thought that people with a personality disorder actually have major depression, which is throwing their personality out of order. But our study showed that presence of major depression didn't affect the decrease in the other symptoms."
This study "highlights that change is possible, and that's good news," he says. "We know that one in 10 people in the U.S. probably suffers from personality disorder. These disorders have a tremendous impact on people's lives. But if the disorders are flexible, then we need to apply newer approaches to treatment. And what's exciting is newer approaches are beginning to appear."
Modified versions of psychotherapy and cognitive behavioral therapy are taking the focus off the past and bringing it to "the here and now," Lenzenweger tells WebMD. "In traditional treatment, patients talk about their parents, about their childhood, yet their current life is a wreck. In modified therapy, we focus on how they handled the transaction at the bank, how they dealt with the boss, how they're dealing with their therapist."
Researchers will study this group across their lifespan, he says. "As they now approach their 30s, we are eager to see what their life looks like -- their marital relationships, employment, etc. Are they more impaired, less impaired?"
"This study shows that, while a lot of kids have symptoms of personality disorders, a certain percentage of them may grow out of it. This runs counter to folklore in psychiatry," says Kenneth Levy, PhD, professor of psychology at Pennsylvania State University in Pittsburgh.
While not involved in the study, Levy offered his insights.
Another important aspect: "It shows that how well people function may be due to environmental events," Levy tells WebMD. "They may have symptoms of a personality disorder, but function relatively well if things are going well in their lives, as long as things are calm. As soon as things erupt, as they do in anyone's life, they may fly off the handle."
"I expect this study to open up more sophisticated research on the effects of stress on personality disorders," he tells WebMD.
SOURCES: Lenzenweger, M. Archives of General Psychiatry, Oct. 2004; vol 61: pp 1013-1024. Mark F. Lenzenweger, PhD, a clinical psychologist with the State University of New York at Binghamton. Kenneth Levy, PhD, professor of psychology at Pennsylvania State University in Pittsburgh. WebMD Medical Library with the Cleveland Clinic: "Types of Mental Illness."
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Last edited by Andi; 08-24-05 at 10:19 AM..
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Re: Personality Disorders Change Over Lifetime
Unfortunately most of those with Personality Disorders and that can be a danger to others never seek help. Never get it or lie seamlessly past counselors. I know all to well.
But this is great news if there is a person with lighter issues and strong enough to admit there is something wrong, that they need help. I hear of these types but generally have met the types that are perfectly content being the way they are. To my experience those are the Narcissists with NPD.
Don't get me wrong. If it is true that these Personality Disorders may be helped more than was thought, GREAT. I just do not know how in some cases it matters. As there must be a willingness to endure therapy. Endure is a proper term to as it will cause pain in realizing the deep deficiencies one has with such disorders.
The men I know would never in a million years allow their thought processes to be tampered with. Short of taking away the rights of criminals in this area and forcing therapeutic methods. The worst , that are a danger to innocents, will never be helped. Just like in "A Clockwork Orange".
Loving that film as I did in my youth I never imagined why it would be so telling and symbolic of a portion of my personal environment.
I will say I am focused mostly on NPD and have no experience on Borderline Personality Disorder. Though I do hear much of the same things as I state.
I do not mean to insult anyone here with my words. I am not not saying all personality disorders belong to criminals. I do not want to label all generically. But there is no denying the extreme end of these disorders. People with Sociopathic tendencies.
I am merely saying you can't cure the unwilling. If the persons that really need the help won't get it then this possible cure spoken of six years ago as of this writing is only going to be left for our Grandchildren to decide.
As I see some portion of these Disorders as a societal problem with no solution as things are now. I don't have the answer either.
I cannot say I am for taking away peoples rights and forcing them to treatment .... because of the innocently convicted all of the time in the US. If our system were perfect then that would be a different story.
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