"Personality Disorders" -- Unscientific & Vague --One of the Most Abused Diagnostic Categories Must Be Reformed
The YouTube Video above from Human Rights Watch describes how women were discharged from the Military for reporting rape, and then labelled with a "personality disorder."
Now most of the harm done by the poor science associated with personality disorder is really unintentional, but as is the case here it can easily be manipulated for purposeful harm because the categories are so vague, and even with the vague categories and criteria-- more often than not it devolves into: "YOU ARE A ROYAL PAIN IN THE BUTT SO YOU MUST HAVE A PERSONALITY DISORDER OF SOME SORT OR ANOTHER." Well, if there is some kind of issue that needs to be addressed -- address the issue. We have seen this as a problem in the Colorado Mental Health Institute at Pueblo. This stuff is so pernicious that you can have a whole battery of highly educated, well-meaning mental health professionals repeating highly inflammatory "Personality Disorder" diagnoses even when the person DOES NOT meet the criteria ALTHOUGH the person does meet the criteria for being a royal pain in the butt!
Our Barely Fictional Account of Ugly Face, Jerk Off Personality Disorder Psychiatrist: Now my diagnosis Bob is Ugly Face, Jerk Off Personality Disorder. I want to assure you that I am as bothered by some of the names of these "disorders" as anybody.
What's important to remember is that names are just for purposes of classification so we can better understand and help and treat you, Mr. Ugly Face Jerk Off, I mean Bob. Bob: Well, I don't really feel very comfortable with this AND even with what seemed to be VAGUE criteria, I don't even meet it. Psychiatrist: I think I'm in the best position to be the judge of that. You sound anxious, maybe even a little paranoid Bob -- that is common for Ugly Face, Jerk Off Personality Disorder. Bob: I used to be a psychologist, not a real one, but I used to play one on TV. Psychiatrist: That sounds pretty grandiose Ugly Face, I mean Bob. It is certainly not uncommon for people to walk out of my office with a list of diagnoses as long as your arm, & Jerk Off I think your list is going to be even longer. Bob: If I ever wake up from this nightmare, I'm going to demand tighter scientific controls on mental health diagnostic criteria, and then I think I'll go run an inn in Vermont. |
Psychiatric Times
Personality Disorders Unscientific " Why do we have about 10 personality “disorders”? Because psychoanalysts believe in those ideas. Were those ideas tested with observational studies, and then revised based on confirmations and refutations of their content? Not before 1980, and hardly since.
"As an example, Taylor describes a DSM-IV conference on personality where a huge amount of scientific research was presented on personality traits, and then the DSM-IV leaders stated clearly that they would ignore that scientific evidence and would hardly change the DSM-III personality disorder definitions at all.3 "Twenty years later, after literally thousands more studies with some of the best possible scientific evidence possible in experimental psychology, the DSM-5 task force had no choice but to admit the need to add personality dimensions to the nosology [branch of medicine dealing with the classification of diseases]. It got all the way to the APA Board of Trustees, and within weeks of publication, was simply rejected tout court [without further explanation or qualification]. "The original DSM-III personality disorders were almost completely based on psychoanalytic opinion, with hardly any scientific validity literature to support them, as documented well by Hannah in her archival research. In the intervening 30 years, a number of scientific validity studies (using the classic nosology [branch of medicine dealing with the classification of diseases] validators of phenomenology [concentrates on the study of consciousness and the objects of direct experience ], of course, genetics, and biological markers) have invalidated most DSM-IV personality disorders; in other words, they have been falsified scientifically. "In fact, this was the scientific conclusion of the personality disorder research summary provided for DSM-5 by the world’s most prominent personality researchers.4 And yet DSM personality disorders have remained little changed in DSM-5 by fiat. This is another proof of being unscientific: the DSM nosology [branch of medicine dealing with the classification of diseases] refuses to accept the falsification of its cherished beliefs. "This is the problem. It’s not complicated, and philosophically difficult. If you have opinion, and nothing else, it’s not science. If you refuse to change your opinions, it’s not science. Most of DSM has been based on opinion, and our profession has refused to change most of that opinion for 2 generations. "How can anyone imagine that any profession would ever experience progress, much less scientific progress, if it refuses to change its opinions, themselves based on nothing but prior opinion? "We are much more ignorant than Hippocrates over 2 millennia ago. He knew that opinion breeds ignorance, while science is the father of knowledge. We mistake our opinions for science." - See more at: http://www.psychiatrictimes.com/blog/why-dsm-iii-iv-and-5-are-unscientific#sthash.tBaMIcfU.dpuf |