nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Tuesday, November 30, 2010

Narcissists No Longer Have A Narcissistic Personality (?)

This is the kind of silliness you get when academics start monkeying around with definitions.  The new DSM will eliminate five of the ten personality disorders.

For a long time personality disorders have been a standard, a way to categorize patients into types that allow for better treatment plans.  The DSM (Diagnostic and Statistical Manual of Mental Disorders) has provided the template for the definition of each personality disorder;  obsessive-compulsive, paranoid, schizoid, antisocial, etc.

So, no more narcissistic personality disorder in the upcoming revision of the DSM...along with four others.

Apparently the academics who sit on the committee that makes these decisions decided it was inappropriate to take a "categorical" attitude toward personality disorders (then why did they eliminate only 5 of the 10?), preferring rather to call someone with narcissistic personality as "personality disorder with narcissistic traits."

So, a big uprorar from the clinical psychiatric community (those folks who see patients rather than do research).  See here (NY Times, Nov 29).

The argument comes down to this:  there are people with personality disorders who are relatively pure in the traits they exhibit, but many have a mix.  For instance, a person who is predominantly narcissistic may also have paranoid characteristics (and many of them do).  So, the committee thought it was better to take a step back and emphasize the broad range of elements involved, sort of like a chinese menu:   two from column A, one from column B, and two from column C, all under the general heading of "personality disorder."

Admittedly, psychiatry is different.  In general medicine you don't end up with a diagnosis of "liver disease with cancerous and hepatitis traits."  You have both.  In psychiatry it is possible to define mental health as a mix of issues.

Is all this just a tempest in a teapot?  A mountain out of a molehill?  and other quaint cliches for meaningless drivel?

IMO this is like most deconstructionist efforts (in literature, art, sociology, etc).  It's taking a small and worthy idea, and making it the centerpoint of an overall scheme:  probably too much heavy lifiting to justify the change in perspective.

Will patients be treated any differently?  Doubtful.

Doc D

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