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David Baxter

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Long Thought Inflexible, Personality Disorders Show Evidence Of Change
October 5, 2004
Binghamton University

Personality disorder symptoms are supposed to be stable, enduring, and persistent across the lifespan, however researchers at Binghamton University, State University of New York, and Harvard report evidence that such disabling psychiatric conditions are flexible and appreciable change over time is possible.

One of the cardinal assumptions in psychiatry and psychology has long been that individuals who have personality disorders will be the way they are for their lifetime and that treatment offers little real hope of change. In fact, the official diagnostic nomenclature used in modern psychiatry (the DSM-IV of the American Psychiatric Association), describes these disorders as "inflexible" and "stable over time." Results from a landmark longitudinal study, which has followed a large number of young adults over time, now call into question the assumption that personality disorders never change.

The Longitudinal Study of Personality Disorders, under the direction of Professor Mark F. Lenzenweger at Binghamton University, State University of New York, has recently discovered that individuals who have personality disorder symptoms will show significant declines in their symptoms with the passage of time. "On average, our subjects showed a decline of 1.4 personality disorder features per year," noted Lenzenweger.

What is particularly fascinating about this finding is that the change is not explained by exposure to conventional treatments or the presence of another form of mental disorder, such as anxiety, depression, or other illnesses. The subjects in the study were examined carefully for personality disorder features at three time points over a four year period and a complex statistical procedure known as growth curve analysis helped to detect the changes that were happening in the subjects. The nature of the study design helped to assure that any observed change in the personality disorder features was not due to artifacts or shortcomings that plague other studies.

Personality disorders are conditions that reflect serious disturbances in social and occupational functioning and the nature of the disturbance is part and parcel of a person's personality. The personality disorders do not represent episodic disturbances, unlike other forms of mental illness such as schizophrenia, bipolar illness, or major depression. They are relatively common among the public, with approximately 10% of the population affected (a fact also discovered previoulsy in Lenzenweger's laboratory), and they make up a large proportion of those individuals seen for treatment by practicing mental health professionals. "Although the disorders are common, with 1 in 10 people affected, the good news is that we now know the disorders can change with time," states Lenzenweger. The recent emergence of specialized treatments for the personality disorders coupled with these new findings creates new hope for those affected with the conditions.

Common personality disorders are borderline personality disorder, which is characterized by unstable personal relations as well as self-destructive and impulsive behavior. Narcissistic personality disorder is characterized by grandiose self-importance and disregard for others. There are ten well-defined personality disorders according to the American Psychiatric Association.

The report by Lenzenweger and his colleagues, Matthew Johnson (Binghamton University) and John B. Willett (Harvard), will appear in this month's Archives of General Psychiatry. The study was sponsored, in part, by the National Institute of Mental Health (NIMH).
 

ThatLady

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Out of curiosity, Dr. Baxter, has an increase in diagnosis of Borderline Personality Disorder been noticed amongst the professional community, to your knowledge? I feel we are seeing more of this particular disorder. Perhaps, however, it is simply that we are recognizing it more and becoming better at separating it from Bipolar Disorder. I am most interested in your opinion regarding this issue. :)
 

David Baxter

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ThatLady said:
Out of curiosity, Dr. Baxter, has an increase in diagnosis of Borderline Personality Disorder been noticed amongst the professional community, to your knowledge? I feel we are seeing more of this particular disorder. Perhaps, however, it is simply that we are recognizing it more and becoming better at separating it from Bipolar Disorder. I am most interested in your opinion regarding this issue. :)
I suspect that borderline p.d. is being diagnosed more often of late, in part because the nuances of the disorder have perhaps become more clearly defined and in part because of greater attention by researchers and therapists (e.g., Dialectical Behavior Therapy) and perhaps even fiction (Girl Interrupted, Fatal Attarction, etc.). It may also be because, like Schizoaffective Disorder, it's validity as a separate and distinct diagnosis was for a time questioned.
 

ThatLady

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That has been my take on the issue, as well. I often see psychiatrists diagnosing Bipolar Disorder in hospital patients, being treated for physical illness, when the symptoms, to me, are classic for Borderline Personality Disorder. Yet, that problem has appeared to be decreasing lately and I wanted to see if my perception was in error. I, for one, am glad to see this problem being more frequently recognized and addressed.
 

free

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well, since i have been diagnosed with quite a few personality disorders, and no longer meet the criteria for any of them, i guess people can change!
 

ThatLady

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People change daily, free. We err, we learn, we grow. Such is the process of living. :eek:)
 

free

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true, but it is the magnitude and depth of change that has amazed me.
 

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