Tuesday, August 21, 2007

A Bad Joke

Please check out the link in the previous post. It reveals that when the DSM confused psychopathy with antisocial personality disorder in the diagnostic criteria, it labelled most of the prison polulation as psychopaths. Which is grossly wrong. Most of the prison population does meet the diagnostic criteria for APD, but the Psychopathy Checklist is the accepted standard for diagnosing pychopathy, and only about 40% of violent criminals imprisoned meet the criteria for psychopathy. Violent criminals.

Why did the DSM suddenly say Antisocial PD = psychopathy, thereby making millions of people (like car thieves) suddenly psychopaths? Why? That's obscurantism.

Look at the diagnostic criteria for NPD. Vague. Does it keep mere (non-malignant) narcissists from being diagnosed with NPD? Not at all.

Why the fuzziness? The fruit of fuzziness?

One issue in the diagnostic assessment bias literature is errors in applying the diagnostic criteria (Rabinowitz & Efron, 1997). In one demonstration of this bias, Morey and Ochoa (1989) asked 291 psychiatrists and psychologists to complete a symptom checklist for a client whom they had diagnosed with a personality disorder. When the checklists were later correlated with the DSM criteria, nearly three of four clinicians had made mistakes in applying the diagnostic criteria. Kappa coefficients of agreement between clinicians' checklists and the DSM criteria varied from 0.09 to .59, indicating a poor-to-modest level of agreement (Babbe, 1998). These results demonstrate the pervasiveness of errors in applying diagnostic criteria.

Errors in applying the DSM criteria were also reported by Davis, Blashfield, and McElroy (1993). They asked 42 psychologists and 17 psychiatrists to read and diagnose case reports containing different combinations of the DSM-III-R criteria for Narcissistic Personality Disorder (NPD; APA, 1987). They found that 94% of the clinicians made mistakes applying the diagnostic criteria, and nearly one out of four clinicians made a diagnosis of NPD even if fewer than half the DSM criteria were met.

Rubinson, Asnis, Harkavy, and Freidman (1988) found clinicians making more mistakes of omission than of commission in applying the DSM criteria. Researchers sent 113 questionnaires to a random sample of clinicians asking them what criteria they used to make a diagnosis of Major Depression. The 54 questionnaires returned indicated that clinicians' most often erred by failing to use all the diagnostic criteria in their diagnostic decision making.

— Jerry McLaughlin, "Reducing diagnostic bias," 01-07-02, Journal of Mental Health Counseling

Read the rest. Those statistcs are way out there in Bizarre Land. In other words, they diagnose by the seats of their pants, apparantly DIVINING their diagnosis. Whatever PD is most popular this year gets diagnosed most. The most prevalent PD is "other" on the diagnostic checklist. And most diagnoses cover all bases by diagnosing more than one PD.

This is a joke. Not only is the seriousness of malignant narcissism and psychopathy watered down, but people who are not really malignant narcissists or psychopaths are are labeled as such and thus made to seem heartless predators when they are not.

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2 Comments:

At 3:21 AM, Anonymous Anonymous said...

Hello Kathy,

I've learned that generaly in earlier days in Europe psychopathy was diagnosd where in America APD was diagnosed due to cultural differences and because the diagnose 'psychopath' became a kind of very negative 'name-calling' word, something like 'idiot' which was a diagnostic label also back then.
It's like calling a raper a sexual pervert. It still is a raper but somehow it sounds nicer..
The distinction between psychopathy and APD is virtualy gone, at least in Holland. Only APD is used now and I also think that's a mistake. The real psychopaths now get treated conform the criteria of APD which gives them to much credit and room to be even better psychopaths, while people with APD get treated too much like psychopaths.
'Anti-social' doesn't say much at all also. People can be very anti-social whitout being wicked and predatory like psychopaths.
I agree that it's a mistake that the diffirence between psychopathy ('ill psyche' say's at least more than 'anti-social'..) and APD is gone. Maybe it's a solution when the old criteria for psychopathy get used for APD. Then it's only a new word for an old and well known kind of realy bad people and all that other 'anti-social' people wouldn't meet the criteria anymore.
I even think people with NPD will be recognised better then and many of them will be regarded as psychopaths who act-out their psychopathy just in a differant way. Cause in fact they have the same basic disorder; they feel good by hurting people when they get the change. It's their drug as you call it. And that I think is the most central and dangerous drive of their behaviour.
And in fact a strange thing is happening already for years. We can see all forms of psychopathy appear on our televisionscreen and in movies every day for many ours. I guess people have projected it into a virtual reality so they can have the illussion that it's not in the real world. That they can control it that way. It seems they donn't want to know the truth that it's real in the real world. It's a cultural kind of schizofrenia that happened by it (through the media)that keeps the people asleep.
This influance must not be underestimated I think.
Media should be used to inform and educate people and that's what almost dissapeared over the years.
People are kept asleep.

greetings, Gerard

 
At 3:34 AM, Anonymous Anonymous said...

Hello Kathy,

I've learned that generaly in earlier days in Europe psychopathy was diagnosd where in America APD was diagnosed due to cultural differences and because the diagnose 'psychopath' became a kind of very negative 'name-calling' word, something like 'idiot' which was a diagnostic label also back then.
It's like calling a raper a sexual pervert. It still is a raper but somehow it sounds nicer..
The distinction between psychopathy and APD is virtualy gone, at least in Holland. Only APD is used now and I also think that's a mistake. The real psychopaths now get treated conform the criteria of APD which gives them to much credit and room to be even better psychopaths, while people with APD get treated too much like psychopaths.
'Anti-social' doesn't say much at all also. People can be very anti-social whitout being wicked and predatory like psychopaths.
I agree that it's a mistake that the diffirence between psychopathy ('ill psyche' say's at least more than 'anti-social'..) and APD is gone. Maybe it's a solution when the old criteria for psychopathy get used for APD. Then it's only a new word for an old and well known kind of realy bad people and all that other 'anti-social' people wouldn't meet the criteria anymore.
I even think people with NPD will be recognised better then and many of them will be regarded as psychopaths who act-out their psychopathy just in a differant way. Cause in fact they have the same basic disorder; they feel good by hurting people when they get the change. It's their drug as you call it. And that I think is the most central and dangerous drive of their behaviour.
And in fact a strange thing is happening already for years. We can see all forms of psychopathy appear on our televisionscreen and in movies every day for many ours. I guess people have projected it into a virtual reality so they can have the illussion that it's not in the real world. That they can control it that way. It seems they donn't want to know the truth that it's real in the real world. It's a cultural kind of schizofrenia that happened by it (through the media)that keeps the people asleep.
This influance must not be underestimated I think.
Media should be used to inform and educate people and that's what almost dissapeared over the years.
People are kept asleep.

greetings, Gerard

 

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