Saturday, September 11, 2010

Top 10 Controversial Psychiatric Disorders -Part 2

8. Narcissistic Personality Disorder - Someone with an inflated ego, need for constant praise and lack of empathy for others might sound like a shoe-in for psychotherapy. But the introduction of narcissistic personality disorder into the DSM in 1980 was not without controversy. The biggest problem was that no one could agree on who had the disorder. Up to half of people diagnosed with a narcissistic personality also met the criteria for other personality disorders, like histrionic personality disorder or borderline personality disorder, according to a 2001 review in the Journal of Mental Health Counseling. Which diagnosis they got seemed almost arbitrary. To solve the problem, the American Psychiatric Association has proposed big changes to the personality disorder section of the DSM-5 in 2010. The new edition would move away from specific personality disorders to a system of dysfunctional types and traits. The idea, according to the APA, is to cut out the overlap and create categories that would be useful for patients who have personality problems, not just full-blown disorders.

7. Dissociative Identity Disorder -
Once known as multiple personality disorder, dissociative identity disorder was made famous by the book "Sybil" (Independent Pub Group, 1973), which was made into a movie of the same name in 1976. The film and book told the story of Shirley Mason, pseudonym Sybil, who was diagnosed as having 16 separate personalities as a result of physical and sexual abuse by her mother. The book and the movie were hits, but the diagnosis soon came under fire. In 1995, psychiatrist Herbert Spiegel, who consulted on Mason's case, told the "New York Review of Books" that he believed Mason's "personalities" were created by her therapist, who -- perhaps unwittingly -- suggested that Mason's different emotional states were distinct personalities with names. Likewise, critics of the dissociative identity diagnosis argue that the disorder is artificial, perpetuated by well-meaning therapists who convince troubled and suggestible patients that their problems are due to multiple personalities. Nonetheless, dissociative identity disorder has weathered this criticism and won't undergo any major changes in the DSM-5. (ed. note - Having met someone who underwent extensive therapy and reached recovery with this diagnosis, I'm having trouble believing it doesn't exist... it may be rare, but I think it's real.)

From an article by Stephanie Pappas. First installment here.

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