Personality Disorders To Be Removed From Psychiatrists’ Bible

DSM-IV-TRVia ScienceDaily:

A newly published paper from Rhode Island Hospital reports on the impact to patients if five personality disorders are removed from the upcoming revision to the Diagnostic and Statistical Manual, 5th edition (DSM-5).

Based on their study, the researchers believe these changes could result in false-negative diagnoses for patients. The paper is published in the Journal of Clinical Psychiatry and is now available online in advance of print.

The DSM-5 Personality and Personality Disorders work group made several recommendations to change the approach toward diagnosing personality disorders. One of those recommendations is to delete five personality disorders as a way to reduce the level of comorbidity among the disorders. The ones originally slated to be removed include paranoid, schizoid, histrionic, narcissistic and dependent personality disorders.

More recently, the Work Group recommended that narcissistic be retained. Lead author Mark Zimmerman, M.D., director of outpatient psychiatry at Rhode Island Hospital, points out, however, that no data were cited describing the impact this deletion had, or might have, on the overall prevalence of personality disorders. Likewise, no research was cited for the Work Group’s reversal in deciding to retain narcissistic personality disorder …

Read more here.

37 Comments on "Personality Disorders To Be Removed From Psychiatrists’ Bible"

  1. I wonder what the impact of mental illness would be if all the diseases and disorders would be deleted from the DSM.

    • DeepCough | Jan 26, 2012 at 12:21 pm |

      I wonder what medicine would be like if there were no quack medical charlatan headshrinkers interjecting their pseudoscientific  psychopharmacology into the equation.

      • Calypso_1 | Jan 26, 2012 at 3:45 pm |

        I wonder if you’d be interested in knowing about the new classes of antidepressants being developed from psilocybin or all the advances in neuro-protectives gained from LSD.  Pseudoscience is an easy pejorative to throw around instead of separating science from the politics and business of manipulating scientific advances to be used as means of control and profit.   

        • DeepCough | Jan 26, 2012 at 7:36 pm |

          For the record, I am 100% in favor of using entheogenic substances to address all sorts of diseases (provided the use is apt and beneficial, of course), as psilocybin, lysergic acid diethalymide, and even pharmaceutical diacetylmorphine (heroin) have shown remarkable results in flat-out curing psychiatric and neurological problems of all sorts, but due to the industrial complex of American medicine, along with drug prohibition, these substances become demonized and marginalized because of greedy pharmacrats and pseudoscientific dogmatists.

          • Calypso_1 | Jan 26, 2012 at 7:43 pm |

            ; ) Based on your previously stated views, I took your sentiment as such, but wanted to draw a distinction between science, learned application of psychological knowledge and the ‘pharmacological-industrial complex’.

          • DeepCough | Jan 26, 2012 at 9:47 pm |

            I don’t wanna come off as a certain member of a certain cult mafia organization that makes it a certain raison d’etre to certainly refute and reject everything in the field of clinical psychology with certain overproduced documentaries for about the hundredth time on this website–but I’m afraid science is rarely if ever involved in the “learned application of psychological knowledge” because the “mind” is purely a metaphysical concept that lends itself to just about any definition, the most fallacious of which is the one that equates it with the brain itself. And the “pharmacological industrial complex” has far too much interest in a fascist policy of “harm reduction” in the area of psychiatric disorders rather than a vested interest or profit motive in financing and promoting cures; and moreover, the standard aetiology of even the most popular mental illnesses purported by the psychiatric community are all damn well non-existent, since, sadly, that is mainly due to a financial ulterior motive as opposed to any real scientific conclusions about psychological disorders.

          • Calypso_1 | Jan 26, 2012 at 11:10 pm |

            First, I don’t feel you are coming off in such a manner.  Second, you introduced a lot of ground to cover here – more so than we’ll cover in this thread, and I’m happy to get into this over an extended time. 
            “I’m afraid science is rarely if ever involved in the “learned application of psychological knowledge” because the “mind” is purely a metaphysical concept that lends itself to just about any definition, the most fallacious of which is the one that equates it with the brain itself.”
            Differences in the understanding of mind itself is an interesting starting point as to why science (or the whole system that applies its knowledge) exists in the form it does and why the modalities through which it achieves outcomes are more palliative and profit based than curative and enlightening.  These qualities are endemic to our society at large and define the fundamental operations of most large scale human endeavors. 
            I’m not sure I agree with the idea that this is because “mind” is purely a metaphysical concept and that the most fallacious definition is of mind/brain connection.  So I am wondering if you would clarify your stance here, because that is a quick dismissal of the entire (admittedly often metaphysical) field of cognitive science.  Do you see any room for mind as an emergent phenomenon?  Do you differentiate between mind and consciousness?  What specifically are your difficulties with biological-mind relationships and are you familiar with quantum mind models- specifically Penrose-Hamerof OR Model? 
            For the record, I personally, don’t believe that consciousness is solely tied to the brain or mind but that the human mind is largely an emergent phenomenon of the human brain.

          • DeepCough | Jan 27, 2012 at 3:18 am |

            I’m gonna make this post as short as possible.

            The mind has no substance. None. Zero. It is a concept that suffers from the malady of “cultural relativity” since the concept owes its origin to old belief systems in ancient theologies. The aetymology of the word “Psychology” literally means “rationale of the soul” as the word “psyche” can mean “mind, soul or breath,” and the latter meaning is actually built into the very phonetic intonation of the word itself.

            But grammar aside, what ultimately disqualifies Psychology as a true science, at least for me, is its inability to stand up to simple axioms of logic used in science today, along with its inability to properly abide by the scientific method from hypothesis to conclusion. Sure, Psychology might seem like a profound course of study, if you’re living in the 18th century, but when Occam’s Razor is applied to it, it just plain doesn’t stand up to the muster of an accepted science like, say, evolutionary biology. As I said before, the great fallacy of Clinical Psychology is that it has no real connection to the brain whatsoever, and that’s not just my opinion, it’s the opinion of the Surgeon General of the Clniton administration in 1999. The fact there is not a shred of proof or a hard diagnostic test to accurately demonstrate the chemical imbalance of monoamines in the brain to determine bipolar disorder, for instance, is nothing short of damning, and it begs the question, How does anyone know a person is actually mentally ill? The truth is, it’s impossible to know this. It can be intuited, it can be argued, and it can even be arbitrated in a court of law in most states of the Union, but that does mean mental illness is diagnosable, and therefore extant. Sure, some people think bigfoot exists, but without a shred of proof for such an organism (that is, beyond apocryphal footprints and videotape), then, all things being equal, sasquatch does not exist, period. And I don’t even wanna go into the area of quantum mechanical explanations for the “mind,” because it’s so far reaching that the Higgs-Boson comes off as plausible in comparison. The fact that there are “scientists” trying to prove the genetic origins of schizophrenia without first establishing the organic or chemical cause of such a condition just further cements the quackery of this “study of the mind.”

            And from what I’ve read of your posts, you seem already aware of the conundrums with Psychology and its clinical applications, as this discipline allows itself too much to be altered in accordance with the politics of a given culture. And the fact that this course of study associates itself with the law has only institutionalized ass-backward and inhumane policies in society.

          • Okay, lets assume for a moment that humans do not have minds.  That raises an interesting question, which is what do you believe is a legitimate course of action regarding people who hear voices the rest of us don’t telling them to harm themselves or others, or veterans who suffer from nightmares and jump at loud sounds, or teenage girls who were molested and cut themselves, or fathers who won’t stop drinking and abuse their wives and children, or people who occasionally get so euphoric they spend all their money and have loads of unsafe sex.

          • DeepCough | Jan 27, 2012 at 1:32 pm |

            Nothing a few joints couldn’t cure.

          • So you do support a psychiatric approach!

          • DeepCough | Jan 27, 2012 at 4:25 pm |

            And who the fuck needs a psychiatrist’s permission to smoke a jay in the first place?

          • I was joking, dude!

          • Stop using the word CURE until you can produce some bloody studies yourself.

            Comparing bigfoot to observable symptoms was a laugh though.
            Even biology is a crock when it comes to science. If you apply your above logic, mathematics is the only pure science.
            PS Something, something, something pride before the fall, or something like that…

          • DeepCough | Jan 27, 2012 at 4:24 pm |

            Hmmm…. It is my firm opinion as an e-psychiatrist that you are a douche.

          • Ad hominem usually indicatesthe reverse actually. Have a nice day.

    • DeepCough | Jan 26, 2012 at 12:21 pm |

      I wonder what medicine would be like if there were no quack medical charlatan headshrinkers interjecting their pseudoscientific  psychopharmacology into the equation.

    • Calypso_1 | Jan 26, 2012 at 7:33 pm |

      …or the impact on human health if diseases, disorders, injuries and conditions were deleted from the ICD-9.   People would still get sick.

  2. Hmmm.  Is there 5 members on the panel?  

    • Calypso_1 | Jan 26, 2012 at 3:26 pm |

      There are 13 work groups with an average of 11 members with over 500 clinician/researchers engaged as advisors.

  3. Hmmm.  Is there 5 members on the panel?  

  4. Anarchy Pony | Jan 26, 2012 at 3:02 pm |

    But I fit the bill for mild paranoid and schizoid personality disorder. If they take that away from me, I won’t be remotely interesting at all. It’s a conspiracy I tell you!

    • Calypso_1 | Jan 26, 2012 at 3:32 pm |

      Don’t worry, they’re not eliminating the symptoms, just folding them into other diagnoses that are more in line with evidence-based biomedical models.  Those old personality disorders come from the psychoanalytic tradition, which for better or worse is getting tossed on the trash heap. 

      • Psychiatry is replacing psychology?

        • Calypso_1 | Jan 26, 2012 at 4:14 pm |

          Certainly, as far as the DSM is concerned – we are talking about the American Psychiatric Association.  If you look at the history of the DSM it’s been a long political battle of edging out influence of psychology – at least in the clinical ‘psychoanalytic’ tradition in favor of research based ‘medical’ disorders.  Ever edition has edged out more analytic labels.  There are alternatives used by analysts.  Look at the Psychodynamic Diagnostics Manuel.
          However, my statement was not intended to say Psychiatry is replacing or should replace modern Psychology in a broader sense – they are completely intertwined particularly with behavioral neurosciences.

          • Ebarclay413 | Feb 16, 2012 at 3:32 am |

            the psychoanalytic tradition is being edged out beause insurance won’t pay as easily as it will when disorders are considered  to be medical. it is easier to measure outcomes produced by medication than by therapy. in the very near future all counseling will be made to address the mental health component, and treat with medication. the biggest hoax being spoon fed to the citizenry ever! create disorders that will cause people to take unneeded meds in the  hopes of solving their problems!

          • Calypso_1 | Feb 16, 2012 at 4:26 am |

            What would you say is the general goal of analysis and how does that fall under health coverage?

    • jigglyboobs | Jan 26, 2012 at 8:37 pm |

      lol, if you were schizoid, you wouldn’t be so concerned with whether or not others find you interesting. Try again.

      • Anarchy Pony | Jan 26, 2012 at 8:49 pm |

        Oops, ya got me. 

        • Calypso_1 | Jan 26, 2012 at 11:27 pm |

          Given your awareness of NPD on the other thread I might suspect you to be a malingering narcissist.  So we can just change your code – if your insurance will still cover treatment. ; )

          • Anarchy Pony | Jan 26, 2012 at 11:50 pm |

            NPD? Never mind, stupid question. But which thread?

          • Calypso_1 | Jan 27, 2012 at 12:24 am |

            Sorry, my mistake. That was Deep Cough, you had a reply underneath. NPD is Narcissistic Personality Disorder.

  5. Anarchy Pony | Jan 26, 2012 at 3:02 pm |

    But I fit the bill for mild paranoid and schizoid personality disorder. If they take that away from me, I won’t be remotely interesting at all. It’s a conspiracy I tell you!

  6. How about Ron Paul? Where does he fit in as a personality disorder?

  7. Tchoutoye | Jan 26, 2012 at 8:08 pm |

    It’s not a bible, it’s a grimoire.

  8. It is a reference manual, providing a common language and description for a range of mental illnesses.
    Narcissism was to be originally removed because it was not considered a individual illness but a combination of several mental illnesses.
    This is being revised to account for autonomic empathic response the human norm and an absence of that response as a actual physical genetic defect, leads to a range of psychological development failures subject to the degree of absence of that response (nature) and nurturing provide to mitigate (reduce not eliminate) the impact of that absence.

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