Personality Disorders

  1. How fixed are they? Are they ever cured, especially anti-social personality disorder and borderline personality disorder, or they all just life long?

    Are they genetic or from trauma? Is the biological medical model true for some cases while the trauma model (sexual abuse, neglect, etc) is true for others?

    Psychiatrists treat personality disorders with medications. Is psychotherapy helpful for treating and maybe curing them?
     
  2. jcsd
  3. Student100

    Student100 590
    Gold Member

    There is no "cure" for mental illness. Much like cancer, success is measured in episodic remission.

    No one really knows what causes mental illness, most likely it's some combination of factors that must be present. Psychiatry, or medical science for that matter, is an ever evolving and relatively young field of study.

    Again, there is no cure, but psychiatrists are medical doctors that are trained in using the DSM and prescribing medications to help control and treat mental illness.

    Psychologists and other practitioners of mental therapy (holistic therapists) are based on much flimsier science, if any at all.
     
  4. SteamKing

    SteamKing 9,415
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    Some mental disorders, like bipolar disorder or schizophrenia, may have a genetic component in their appearance in certain individuals.

    http://en.wikipedia.org/wiki/Bipolar_disorder

    http://en.wikipedia.org/wiki/Schizophrenia

    Certain traumas to the head can lead to changes in personality over the course of a person's life. In particular, repeated blows to the head seem to produce cumulative damage to the brain, which in turn can lead to dementia as a person ages, even though the trauma may have ceased years before the onset of symptoms.

    Our knowledge of the brain is far from complete, so figuring out how much a certain personality disorder may be due to genetics, or trauma, or abuse of some kind, or a combination of factors, is often not possible.
     
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  5. I'm talking about the personality disorders as shown in Axis 2 of the DSM-IV. They are fixed and from childhood or birth. For, anti-social personality disorder as an adult, you have to have what is called a conduct disorder before age 15. That's where you hurt animals, start fires, fight a lot, do criminal things, etc. as a young person.

    Then you become ASPD as an adult whereby you manipulate others, lie constantly, do criminal acts, and have no empathy at all for your victims. Also, you have no insight that it is wrong. You just don't see that being evil is wrong although you fear being caught and exposed.

    I'm wondering if these people ever get cured, but almost all never will because they don't want to change and don't see that they have a problem. They would blame they're parents or others for being in prison.

    Borderline personality disorder is different. It is where someone has ongoing identity crisis. They want to be some other race or ethnicity. Plus, they can really like you a lot one second whereby they idolize you; then they can hate you to death because of some perceived slight. It's an extreme all-or-nothing view. There are other traits to it as well, but all of that is in the Diagnostic Manual (DSM). I'm wondering if these people ever get cured in psychotherapy.
     
  6. By episodic remission, you're talking an individual case that gets better or "cured" for an unexplained reason, right? Has there ever been an episodic remission of a group of people?

    I read that the DSM-5 puts the illnesses in the same group that were previously separated into Axis 1 and Axis 2 disorders in the DSM-IV-TR, but for some reason I still separate them in my mind. I've never heard of schizophrenia or bipolar illness being cured. I guess the same would be for a personality disorder.

    I do believe that the mind can be healed and that psychology is a real science though.
     
  7. AlephZero

    AlephZero 7,298
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    The map is not the territory. The DSM is only a map, and it keeps being redrawn. It's a very profitable map: the American Psychiatric Association makes $5m a year selling copies of it.

    The clue is in the word "disorder". Replace that by "we don't understand it, but people who behave like that don't match our ideas about how society should function, so we can make money from trying to change it".
     
  8. Aleph Zero,

    Are you that there is no mental illness? That people are just different? They shouldn't be treated or changed?

    I'm not sure that I agree. Some of those medicines keep people alive and able to support themselves financially.
     
  9. They might be right : the characteristics of ASPD are consistent with someone normalized to neglect and abuse , (during their formative years).
     
  10. anti-social personality disorder is an organic brain disorder.
    brain scans show they have different brains than normal people.
    they have low serotonin and high dopamin levels in their spinal fluid.
    it can be treated with SSRIs plus low doses of antipsychotics.
     
  11. Student100

    Student100 590
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    Where's the evidence? Just what is an organic brain disorder, what does that mean, what causes it?

    Anyone that claims to know with any level of certainty what causes or is the process of mental disorders should be taken with a large grain of salt.
     
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  12. Evo

    Staff: Mentor

    Please be sure to back up all information with a verifiable source from a mainstream journal. It removes any confusion.

    Thank you.
     
  13. In the case of ASPD Its going to be difficult separating nature from nurture ...

    http://www.patient.co.uk/doctor/Antisocial-Personality-Disorder.htm

    If their parents were their biological-parents that association wouldn't rule out the sociopathic tendencies being inherited, rather than taught by example.

    A monozygotic-twins-seperated-at-birth study would normally be able to expose any genetic predisposition, but you'd need monozygotic-twins-seperated-at-birth who were removed from biological-parents for reasons other than "parental inadequacies", as those inadequacies could have affected the twin's brains before birth, e.g. mild fetal-alcohol-syndrome, or stress-induced brain-damage.
     
  14. Evo

    Staff: Mentor

    Actually the cause of antisocial personality disorder is classified as "unknown", it can be genetic, it can also be seen to relate to being abused as a child.

    http://www.nlm.nih.gov/medlineplus/ency/article/000921.htm
     
  15. SteamKing

    SteamKing 9,415
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    An organic brain disorder means that something is wrong with the physical structure of the brain, often as a result of injury or disease, sometimes because of poor nutrition or a disease in another part of the body, like an improperly functioning thyroid gland. These disorders are not typically considered to be a mental illness.

    http://www.dralzainomara.com/books/1/1-3/7.pdf

    Dementia and epilepsy are considered to be examples of organic brain disorder, the first of which is the impairment of the cognitive function of the brain and can result from a variety of causes, while the second appears to result from an improper function of the electrical or neurological activity in the brain itself.

    http://en.wikipedia.org/wiki/Dementia

    http://www.mayoclinic.org/diseases-conditions/epilepsy/basics/definition/con-20033721
     
  16. Organic or Traumatic

    Some psychiatrists still lie to their patients by telling them that they have a chemical imbalance even though no one knows what chemicals are imbalanced, and there's no test for the imbalance. The psych meds affect neurotransmitters. They don't balance chemicals. But the psychiatrists don't know themselves, some have little empathy for their patients, and patients don't like the meds. The doctors do whatever they need to do to get the patients to take their meds.

    http://psychcentral.com/lib/antipsychotic-medications/000449
    http://psychcentral.com/blog/archiv...my-mood-disorder-due-to-a-chemical-imbalance/
     
  17. @Naranja: The reason of why DSM-5 puts the illnesses in the same group instead of separated into Axis1&2 and even the previous version DSM-4 where illnesses were much more splitted is due to provide more chances to be covered by the social welfare.
     
  18. Pythagorean

    Pythagorean 4,622
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    I think a productive discussion needs to get the nosology clear. That is, diseases are classified three different ways - by cause, by mechanism, and by symptoms. The DSM is based only on symptoms; causes and mechanisms are often elusive - further, what defines a "symptom" may be controversial (for instance, homosexuality was once a disease according to the DSM, personality disorders have similar elements of controversy). It's often been found that several different causes and mechanisms can have the same symptom, so by grouping diseases by symptom, it's easy to make the cognitive error that treatment should be the same, whereas once you realize that distinct mechanistic faults can lead to the same symptom, you'd need a specific treatment plan for each that addresses the failed mechanism. This is why the NIMH has withdrawn support from DSM [1]. Psychology, with neuroscience, is starting to move in a new direction that emphasizes understanding of mechanisms and causes [2].

    [1] http://www.psychologytoday.com/blog/side-effects/201305/the-nimh-withdraws-support-dsm-5
    [2] http://ajp.psychiatryonline.org/article.aspx?articleid=1906049
     
  19. The lifetime risk of bipolar disorder for a monozygotic co-twin is 40 to 70 percent [9]. As an example, a study of 30 monozygotic and 37 dizygotic twins in which one twin from each pair had bipolar disorder found that the concordance rate for bipolar disorder in the co-twin was eight times greater for monozygotic twins than dizygotic twins (40 versus 5 percent of the twin pairs) [13]. By contrast, the estimated lifetime prevalence rate of bipolar disorder in the general population of the United States is 2 percent [6], and the cross-national rate is 1 to 3 percent [1,3].

    http://www.uptodate.com/contents/bipolar-disorder-in-adults-epidemiology-and-pathogenesis
     
  20. A mental illness or personality disorder is a "syndrome" or collection of symptoms. Every so often they figure out the cause of one of these things, at which point it gets moved to another department. In other cases they have clues about possible causes, such as a certain percentage of cases linked to a certain gene, in which case it might still remain in the mental health department pending further research. Sometimes the "incurable" part has to do with how the symptoms are defined: three or more acute episodes before age 25, or some such thing. Lots of people have inborn tendencies, such as a tendency to overeat, that they can overcome. The tendencies may not entirely go away, but the behavior can change.
     
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