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DSM-5 to Ignore Narcissists – Part 3 May 22, 2011

Posted by alwaysjan in Narcissistic Personality Disorder.
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How could you not love an article that begins with a psychiatrist lamenting, “Where are we going to put the narcissists?”

Psychiatric Diagnoses Get a Rethinking appeared in the Los Angeles Times today. It’s a very interesting read. It seems that psychiatrists, sipping drinks from coconut shells at the American Psychiatric Association’s five-day conference, have been duking it out over the proposed changes to the DSM-V due out in 2013.

Dr. Allen Frances, chairman of the DSM -IV Task Force (sounds so military, almost special-opish!) and one of the most vocal critics of proposed changes pointed out that many advances in brain imaging and molecular biology have given professional insight into the workings of the brain, but there is still much to learn (before throwing out the baby with the bathwater). The bold type is my take on this whole mess.

If you go to DSM5.org, you’ll find the suggested changes listed. The American Psychiatric Association has opened up the changes for public comments. I put in my two cents during the first public comment session last year. The second public session began this month and runs through June 15th. Speak now or forever hold your peace!

I’ve been following the proposed changes in my blog posts DSM-V to Ignore Narcissists? and DSM-V to Ignore Narcissists?-Part 2

DSM-V to Ignore Narcissists – Part 2 April 21, 2011

Posted by alwaysjan in Narcissistic Personality Disorder.
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“There are three kinds of lies: lies, damned lies and statistics.”
Mark Twain

Since writing DSM-V to Ignore Narcissists?, I came across an interesting article, The Mathematics of Narcissism , on Slate.  It offers a statistical rationale for eliminating Narcissistic Personality Disorder from the DSM-V due out in 2013.

I should mention that when I took a statistics class for my master’s degree two summers ago, I woke up every morning weeping. My poor husband hadn’t seen me like that since the first year we were married!  I don’t mind looking at bar graphs, line plots, and pie charts. I just didn’t want to fall into the abyss of Excel spreadsheets. I survived the course and even earned an A, but it was like pulling teeth- slowly and one at a time. Even so, I was able to follow this article, though it would have helped if there were pie charts in color.

The changes proposed for the DSM-V have been years in the making. They address the fact that many of the current ten personality disorders overlap, so instead of “clustering” personality disorders, the DSM-V is going with “dimension reduction.” Oh dear, I’m having statistical PTSD as I type this! If it’s any consolation to those who’ve had a close encounter with a narcissist, the proposed changes are extremely controversial and seem to please no one, least of all psychiatrists.

Personality disorders are being scrapped and replaced with six axes of personality traits, though no single one will be designated as the Axis of Evil. The axes are:
1) negative emotionality
2) introversion
3) antagonism
4) disinhibition
5) compulsivity
6) schizotypy

So, come 2013, there will still be narcissism, but no narcissists. Those formerly diagnosed with NPD will score high on four facets of antagonism;  callousness, manipulativeness, narcissism, and histrionism. So how will this help those who’ve had a close encounter with a narcissist?  It won’t. But read the article and see what you think.

If it’s any consolation, psychopathy, which was eliminated from the DSM-IV, is back. Dexter, take note!

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