Talk:Personality disorder

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Bipolar disorder

Bipolar disorder is NOT a PERSONALITY disorder. They might exist together, but are seperate Axis I, and Axis II disorders.

Bipolar disorder, also known as manic depression, is a mental illness that brings severe high and low moods and changes in sleep, energy, thinking, and behavior.

People who have bipolar disorder can have periods in which they feel overly happy and energized and other periods of feeling very sad, hopeless, and sluggish. In between those periods, they usually feel normal. You can think of the highs and the lows as two "poles" of mood, which is why it's called "bipolar" disorder.

The word "manic" describes the times when someone with bipolar disorder feels overly excited and confident. These feelings can also involve irritability and impulsive or reckless decision-making. About half of people during mania can also have delusions (believing things that aren't true and that they can't be talked out of) or hallucinations (seeing or hearing things that aren't there). Sonurajsharma (talk) 04:36, 30 July 2022 (UTC)

intro too abstract

I'm sorry but the introduction describes an amorphous psychological blob. I minored in psychology, and I can't understand it. From the first sentence:

″ enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating from those accepted by the individual's culture.″

That describes depression, bipolar, sociopathy, schizophrenia, and pretty much every other mental illness. The rest of the intro seems to go into detail, but there's a lot of repetition of the same abstract phrases; doesn't help. EG:

• enduring behavioral and mental traits
• enduring collection of behavioral patterns
• deviating from those accepted by the individual's culture
• deviate from social norms and expectations

Teach with examples. With bullet points, describe a handful of PD disorders (most common) and also describe similar but non-PD disorders, and why they're not classified as PD. Describe them in enough detail so that one could say "Oh yeah, I know a guy like that". Don't say "patient was deviating from social norms"; be more specific like "patient might pull his pants down in public" or something concrete like that. OsamaBinLogin (talk) 10:39, 26 April 2022 (UTC)

@OsamaBinLogin The page is meant to reflect what the relevant commonly uses; IMO many personality disorders in the past are now defunct in part for being arbitrary, and the ones that are still in the DSM-5 are defined fairly anomalously. The way that PDs are defined is that to meet a diagnosis a person only needs some subset of a list of symptoms, which necessarily means that statements about them end up being broad/vague because different PDs don't have much in common.

That also means what you are suggesting to add examples seems problematic at face value, as person 1 with a hypothetical 1-PD might "might pull their pants down in public", person 2 with 1-PD may not, and person 3 with another hypothetical 2-PD may only "pull their pants down in public" only when experiencing "frantic efforts to avoid real or imagined abandonment." (Which is one of the criteria for BPD.) If you can find a reliable source with qualitative reports that could be used as examples, that could potentially be used, but I think it would be WP:OR in any other case due to the diverse causes and presentations of PDs.

I will number the things you have pointed out as 1-4.To illustrate that these are accepted descriptions from the psychology community, I will quote the opening section on personality disorders from the DSM-5:

"A personality disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment."

1 and 2: an enduring pattern of inner experience and behavior

4: deviates markedly from the expectations of the individual’s culture

That being said, I do think the article could be better written and structured. I don't think it's possible to summarise all 10 currently recognised PDs in the lead section. But it could help to move the table "Millon's brief description of personality disorders" further to the top of the page, maybe WP:SS at least for the 10 ones in the DSM-5, maybe more clearly distinguishing those from PDs no longer recognised.

I started by filling in the epidemiology table, and hope to improve other parts of this article too.

Darcyisverycute (talk) 14:23, 26 April 2022 (UTC)

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Questioning the inclusion of Millon's subtypes on all personality disorder articles

Should Millon's subtypes be included in articles on personality disorders?

Here is my opinion why they should be removed: Most of these subtypes are over 20 years old, not used or studied in modern psychology (to my best knowledge and by being unable to find sources for it), and have been criticised for not being empirically founded, replicable, or useful in any aspects of treatment. My understanding from reading a bit of some sources is the theory stems from psychoanalytic theory. Right now none of the pages mention the lack of empiricism or basis in psychoanalysis, and in my opinion they should all be removed entirely except on an article specifically related to the subtypes history since I don't think they are notable or reliable sources compared to more modern and peer reviewed publications.

The related Millon Clinical Multiaxial Inventory (MCMI) for example has apparently already had this treatment. The MCMI has had substantially more modern research on its validity (which is at least questionable), and the article there does not discuss essentially that all the positive results of validity studies presented were from primary sources. However, the effects the issue in this article doesn't spill into other personality disorder articles; the MCMI is only mentioned in Narcissistic personality disorder (NPD), and there its use is qualified to say the MCMI does not measure NPD directly.

I would appreciate any additional opinions to establish consensus before making any changes. Darcyisverycute (talk) 01:10, 19 June 2022 (UTC)

I don't think Millon's subtypes need to be listed in every personality disorder (PD) article, but I believe it's fine to list them in one place, probably Theodore Millon, and wikilink mention of his conceptualization in PD articles.

Millon's subtypes have not been "proven" via the scientific method, but the same could be said for many, if not most, DSM-5 diagnoses. In other words, a DSM diagnosis purportedly describes a disease entity. But the evidence for such a claim does not exist for most mental disorders, a problem that former NIMH director Thomas Insel highlighted when he announced the new (at the time) Research Domain Criteria.

"Clinical" insights have value, as do "empirical" or "evidence-based" approaches. Many established psychotherapies, for example, began with astute observation, theorizing, and discussion among psychologists and psychiatrists. Later the theories were put to the test via psychotherapy process and outcome research. Carl Rogers epitomizes this synergistic relationship between the consulting room and the research program. The complementary relationships among deductive, inductive, and abductive reasoning are analogous.

Thus, Millon's subtypes have value, particularly in a difficult area like personality disorders, but they should be regarded as heuristics or hypotheses, not fact. As an aside, Millon's treatise, Disorders of Personality: Introducing a DSM/ICD Spectrum from Normal to Abnormal, 3rd ed. (John Wiley & Sons, 2011), is important reading for mental health professionals and others interested in the topic.

- Mark D Worthen PsyD (talk) [he/him] 23:37, 10 July 2022 (UTC)

I agree to the letter with your description of the underlying conceptual framework here, but with the caveat that, as an editorial matter, whether the subtypes are to be mentioned in a particular article must, as a matter of policy, hinge more on WP:WEIGHT sources give to his models relative to particular PDs, rather than the weight we might subjectively assign them. In those terms, we really cannot make a blanket decision here, but rather must accept the WP:LOCALCONSENSUS of each article. If the OP's question was meant to inquire whether they should be mentioned in any PD articles at all, then yes, I think it's fair to say the subtype diagnoses will be WP:DUE in at least some. SnowRise ^{let's rap} 06:25, 11 July 2022 (UTC)

Well said! I agree with you 100%. Mark D Worthen PsyD (talk) [he/him] 06:30, 11 July 2022 (UTC)

Thanks for the feedback :) When I get around to it I'll try starting a local consensus per PD on their respective talk pages, for ones that seem at issue. Darcyisverycute (talk) 07:15, 12 July 2022 (UTC)

Neurobiological correlates - hippocampus, amygdala and not prefrontal cortex?

cf #Neurobiological correlates - hippocampus, amygdala - I would think a developmental disorder of the prefrontal cortex would also play a role? Anybody has time to delve into that? Thy, SvenAERTS (talk) 12:32, 18 August 2022 (UTC)

There must be a criticism section somewhere in the academic literature.

The whole world became witness recently of two professional psychotherapists having completely opposing views on the 'spectrum' and 'disorder' of the same individual. Nothing happened against any of them because they could both rely on the generalized nature of the guidelines that can easily mislead in court towards any 'spectrum' or 'disorder' because of the subjectivity and also broad nature of the guidelines. fs 07:49, 13 November 2022 (UTC)