4 Personality Disorders Potentially Axed

Personality disorders are up on the chopping block for the revised DSM-V slated for release in 2013. The committee selecting them is paring down their numbers from the present 10 to 6. This is the situation anyway according to a report in the La Times, Personality disorders category is likely to be dramatically revised for next psychiatry textbook.

Initially there was talk of dropping narcissistic personality disorder until committee members thought better of the idea. The demonizing of suspects in criminal court cases must go on, and we can’t manage compound such demonizing without the narcissistic personality disorder designation. Ditto the pathologizing of vain and self-absorbed people in general.

The committee working on the personality disorders chapter of the DSM-5, which is due to be published in 2013, has proposed six types of disorders: antisocial, avoidant, borderline, narcissistic, obsessive/compulsive and schizotypal. They have proposed dropping paranoid, histrionic, schizoid and dependent personality disorders.

In a recent post we encountered a Georgia Supreme Court case where it was determined that personality disorders were real “mental disorders” because they were listed in the DSM. This decision flies in the face of a federal Supreme Court decision releasing a man from “hospitalization” because the federal Supreme Court bought the opposite argument, personality disorders are not real “mental illnesses”. Well, now you can worry…

However, to qualify for a diagnosis, a patient would have to have a high level of impairment in two areas of personality functioning — self and interpersonal. Patients would be assessed for how they view themselves and how they pursue their goals in life, for example, as well as how they get along with other people and whether they think about the consequences of their actions. The new model is less rigid than the existing diagnostic model. It is designed to reflect that behavior can change over time while personality traits tend to remain stable.

It’s a good thing our Georgia defendent didn’t have one of the excised personality disorders, or then we’d be right back in court, wouldn’t we?

Acquire 2 levels of dysfunction, and you’ve got your advanced degree in a personality disorder. If personality traits are consistent, they won’t wash off, will they?

“In the past, we viewed personality disorders as binary. You either had one or you didn’t,” said Dr. Andrew Skodol, chairman of the DSM work group on personality disorders, in a news release. “But now we understand that personality pathology is a matter of degree.”

What was I saying? Oh, yeah, this puts personality disorders back on a continuum. Step over a certain line, and you can be certified, or receive a degree. This is sort of like saying that personality disorders are merely a matter of excess. Everybody has a personality disorder, but everybody hasn’t gone onto recieve a degree in disturbing behaviors. Next question, is Dr. Skodol trying to say that personality disorders are not actually “mental illnesses”?