Personality Disorders 101 : How are PDs diagnosed?

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Abnormal psychology has received more public attention than many other branches of psychology, but this attention isn’t always beneficial. Its subject matter- “abnormal” behaviour- is associated with sensationalist news headlines more than sensible conversation. As a result, many psychological differences are known about through their portrayals in mass media, rather than from factual explanations.

Out of the many studied psychological differences, personality disorders are some of the least understood. Individual personality disorders (PDs) are often mis-represented, while the idea of a “disordered personality” has inspired criticism from many sides including anti-psychiatry groups and people diagnosed with PDs.

So, what are PDs?

The current definition of personality disorders considers them to be traits, experiences and behaviours that are significantly different from the majority of people; that affect their thinking, emotions and impulses; and are associated with personal distress and dysfunction.These general criteria needs to be met for any PD diagnosis.

So to be diagnosed with a PD, someone needs to have a collection of unusal behaviours and traits which affects a large portion of their everyday life. Those behaviours and traits must start before early adulthood. They need to cause negative consequences for the person, who should be upset by or annoyed at those behaviours.  The name “personality disorder” attempts to represent how far-reaching and impactful those behaviours and experiences are upon almost every aspect of the person’s understanding of themselves and their ability to relate to others.

Currently, the DSM-V follows the same approach as previous editions. Personality disorders (PDs) are diagnosed through a system of criteria based both on a person’s observed behaviour and the feelings and symptoms they report. If a person meets enough criteria for any particular PD, the psychiatrist then needs to establish if the person’s traits and the consequences of those traits have enough impact on their understanding of themselves and others to represent a personality disorder.

PDs are split into three groups, or “clusters”. Cluster A is collectively known as the “eccentric”  or “odd” disorders, and it includes :

Cluster B disorders are the “dramatic” or “emotional” disorders, consisting of:

Cluster C disorders are the “anxious” disorders, consisting of:

The International Classification of Diseases, the main European diagnostic guide, is slightly different from the DSM. Borderline PD is instead named Emotionally Unstable PD, while Obsessive-Compulsive PD is known as Anankastic PD.  The ICD also includes an “Other/Unspecified” category, which is used when people have unclear symptoms which don’t exactly match one PD.

Because of the problems which have already been identified with diagnosing and researching PDs, the DSM-5 also includes a theoretical Alternate Model of PDs. This approach is currently being investigated to see if it can make PD diagnoses more specific and helpful. The Alternate Model starts by evaluating whether a person’s difficulties impair their understanding of themselves and others severly enough to represent a PD. If the person’s  self-understanding and relationships are significantly impaired, the conversation moves on to identifying which traits are behind that impairment. This method intends to reduce the amount of overlapping symptoms found in the current system, which should result in people requiring fewer but more specific diagnoses.

Now that I’ve covered the basic idea of PDs, I’ll go through them in turn to find out more about each is diagnosed, and how people with each condition have been portrayed in mass media. I’ll also talk about some of the problems involved in diagnosing each condition.

Stay tuned for the rest of the series!

The header image is from Wikipedia, and can be found at https://commons.wikimedia.org/wiki/File:Psi2.svg.

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