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Prevalence of DSM-IV Personality Disorders in Patients with Chronic Fatigue Syndrome: A Controlled S

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
"The prevalence of personality disorders in CFS patients (16.3 %) was significantly lower than in psychiatric patients (58.7 %) and was similar to that in the community sample (16.3 %)."

Not a surprise, but it could be useful research evidence.

Ok. I confess. I was about to ask you "Why the hell are you of all people posting another psychological paper?" until I saw the results. :)

Nice job Mr Bob :thumbsup:

edit:

Of course I could say, 'Well, this only relates to CFS patients in the study, and not that ME lot of nutters' but I won't of course :rofl: :D
 

user9876

Senior Member
Messages
4,556
"The prevalence of personality disorders in CFS patients (16.3 %) was significantly lower than in psychiatric patients (58.7 %) and was similar to that in the community sample (16.3 %)."

Not a surprise, but it could be useful research evidence.
So 16% of the population have personality disorders.It makes me wonder when does someone with a personality that a pscyhiatrist doesn't like become disordered.
 
Messages
13,774
However, I also came to realize that, by pursuing this behaviour modification, I was unintentionally reinforcing the medical pathologization of homosexuality.
If this 'insight' had been achieved through therapy, said therapy after at least 5 years would have failed every test of cost effectiveness.

The fact that exaggerating the extent to which cognitive and behavioural interventions can control an abnormal 'condition' will serve to increase the stigmatisation which surrounds those with this condition - it was true for homosexuality, and it's true for CFS. That those taking money for the provision of psychosocial care have forgotten to account for this social aspect to their approach reveals them to be utterly incompetent or else intentionally dishonest.

OK - its a typo. I can be a little childish at times I admit but the combination of psychiatry and TCM tickles me.

It was my typo... and I'd just realised I could touch type! That was the first time I ever typed while reading what I was typing up: it was a bit of a thrill.
 
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13,774
So 16% of the population have personality disorders.It makes me wonder when does someone with a personality that a pscyhiatrist doesn't like become disordered.

This is an interesting and depressing topic. It seems that it is a quacky as you might expect (and figures higher than 16% are often used).
 

Bob

Senior Member
Messages
16,455
Location
England (south coast)
So 16% of the population have personality disorders.It makes me wonder when does someone with a personality that a pscyhiatrist doesn't like become disordered.

It also makes me wonder how many psychiatrists have personality disorders!

That would be an interesting study!

The control group could be ME patients. Let's see which group has a higher proportion of personality disorders!
 

Marco

Grrrrrrr!
Messages
2,386
Location
Near Cognac, France
It also makes me wonder how many psychiatrists have personality disorders!

That would be an interesting study!

The control group could be ME patients. Let's see which group has a higher proportion of personality disorders!


When I was a psych undergrad (confession time) it was generally assumed that anyone progressing on to clinical psychology were drawn to it for 'personal' reasons.

Which of course, if not a malicious slur, is at least a gross overgeneralisation;)
 

SOC

Senior Member
Messages
7,849
So 16% of the population have personality disorders.It makes me wonder when does someone with a personality that a pscyhiatrist doesn't like become disordered.

I once heard a psychologist say something to the effect that mathematicians and engineers were "almost by definition" asperger's or near-asperger's because of their preference for orderliness and logic. In fact, she said that any child exhibiting a preference for these areas should be considered "at the functional end of the autism spectrum". :eek:

I probably don't need to mention that this particular person was very much the flighty, touchy-feely, it's-all-about-emotions type of therapist. Clearly, people not like her have to be disordered, right? :rolleyes:
 

Sing

Senior Member
Messages
1,782
Location
New England
I was surprised when I read this study to find that it concurs with my own experience. I expected to find a biased attack and psych labelling, reversion to psych cause and categorization. But, after many years of ME/CFS plus aging challenges piling on, I do seem to function more in a rut of petty physical management in order to cope. I like to be functional and competent, but with this illness, I have to do a lot of managing even to function at the low end, much less to convey the appearance of functionality during brief appearances, so to speak, with more normal people. It is not my personality to be a petty manager (OCD behavior), but, functions that were once automatic, or are still automatic for healthy people my age, have broken down into many small steps which I have to do consciously, intentionally. As a result of this focus on a lot of petty management and all the limitations and physical issues, I do feel a tendency towards a depressed outlook. I drop this many times a day too, to focus on my other tendencies--towards interest, joy and humor. I feel that many other people have a hard time too in life, and that we are all in this together. Lightening the burden by sharing humor, encouragement and fun, when possible, gives to me as well as to others. Also being willing to take what responsibility I can to help where help is needed--this also gives back as I am doing the giving.

So, yeah, I know this stuff. But honestly I think that a psych test would show overall what this one did--that I am not "crazy" (Axis II), but veer somewhat towards OCD behavior and depressive features than the healthy do. I do think that if their study design compared us to other ill people, such as those with MS or Parkinsons, responses such as depressive and OCD features would fall into a natural context of both struggle and coping behavior.
 
Messages
13,774
Sorry to continue with an OT, when maybe I should start a new thread, but I was just reading the wikipedia article on the researcher mentioned here:

A challenge to the pathology model of homosexuality started to emerge in the 1950s with the work of Evelyn Hooker (1965), who used various psychometric test to compare homosexual to heterosexual men

This seems interesting:

Evelyn Hooker (September 2, 1907–November 18, 1996) was an American psychologist most notable for her 1957 paper "The Adjustment of the Male Overt Homosexual" in which she administered several psychological tests to groups of self-identified homosexuals and heterosexuals and asked experts to identify the homosexuals. The experiment, which other researchers subsequently repeated, demonstrates that homosexuality is not a mental disorder as there was no detectable difference between homosexual and heterosexual men in terms of mental adjustment.

Her work exposed a false correlation between homosexuality and mental illness that had formed the basis of scientific classification of homosexuality as a disorder, by avoiding the use of a sample group that contained homosexual men with a history of treatment for mental illness. It is of critical importance in refuting cultural heterosexism because it shows that homosexuality is not developmentally inferior to heterosexuality. As homosexuality is not an illness, bias against it is irrational from a scientific point of view.[1]

Hooker used three different psychological tests for her study: the TAT, the Make-a-Picture-Story test (MAPS test), and the Rorschach inkblot test.[2]
There's an awful lot of quackery and politics here. I was going to read her papers, but I'm not sure if there's any need now, as the details don't seem that important. It would be quite funny to test CFS 'experts' on their ability to distinguish the profiles of CFS and (for example) MS patients. The history of the debate about viewing homosexuality as a mental health issue is interesting and terrifying.

Another article mentions this:

Hooker also analyzed the protocols herself using then-popular scoring systems and found a few statistically significant differences, but they didn’t permit reliable differentiation of the two groups.

http://www.psychologicalscience.org...hology-yesterday-and-today-evelyn-hooker.html

It would be difficult to imagine psychological testing of 'personality' or similar which did not tend to elicit some different responses from gay and straight men in this period, as they would tend to face quite different circumstances. And the same is true with CFS patients and healthy controls.
 
Messages
13,774
It is not my personality to be a petty manager (OCD behavior), but, functions that were once automatic, or are still automatic for healthy people my age, have broken down into many small steps which I have to do consciously, intentionally. As a result of this focus on a lot of petty management and all the limitations and physical issues, I do feel a tendency towards a depressed outlook. I drop this many times a day too, to focus on my other tendencies--towards interest, joy and humor. I feel that many other people have a hard time too in life, and that we are all in this together. Lightening the burden by sharing humor, encouragement and fun, when possible, gives to me as well as to others.

Generally, I think that these would be seen as confounding factors in the diagnosis of personality disorders, and this is one of the problems with these sorts of diagnoses. eg: If someone needs to be very controlled because of a health condition, take care with their diet, medication, what they do, etc, then this should not mean that they are more likely to be diagnosed as having an OC personality disorder - although they almost certainly would be. This is one of the reasons why I think it's really important to have an appropriate control group for these sorts of studies, but those who have undue faith in the nature of these diagnoses will be less concerned.
 

Holmsey

Senior Member
Messages
286
Location
Scotland, UK
Do they perform similar studies for all biological illnesses?

In a way I feel like we aremarked "insane" until proven "sane".

With respect to other illnesses, clearly not, there's no need when the pathology of those illnesses is already understood. Whether we like it or not the reason all avenues are still explored is that there is no clear understanding of our condition. We have a growing evidence base for the physical but again, many of those studies throw up physical symptoms which are also seen in psychological conditions so often they're not a clear win. We also get subjected to the same criticism we throw at psychological studies, that the cohort may contain various different illness, so a failure on selection criteria.

But if we're to genuinely hold the view that this is not a psychological illness then we shouldn't fear these studies, as long as we ensure they are impartially performed and accurately reported then they can only help build the evidence base for our viewpoint. Of course where they divert funds from reciprocal physical studies that's something we should vigorously oppose.

Given this study in particular, for the main test criteria we are seen as entirely normal, for DE we're elevated but I doubt it's lost on anyone reading this that most likely this is a symptomatic of long term debilitating illness and it's impact on general mental well being. As to the OC, I'm not sure where that leads but we shouldn't fear it, not if what we ultimately want is honest understanding.

Best regards, Zee.
 

Bob

Senior Member
Messages
16,455
Location
England (south coast)
But if we're to genuinely hold the view that this is not a psychological illness then we shouldn't fear these studies, as long as we ensure they are impartially performed and accurately reported then they can only help build the evidence base for our viewpoint.

Yes, well, "impartially performed" and "accurately reported" is a bit of a sticking point for us, isn't it?!?

Of course where they divert funds from reciprocal physical studies that's something we should vigorously oppose.
Another major issue.
 
Messages
13,774
With respect to other illnesses, clearly not, there's no need when the pathology of those illnesses is already understood.

That's not quite right. The biopsychosocial approach to medicine has affected other areas. eg: James Coyne has been writing a lot of critical analysis of those claiming that emotional and personality factors can be routinely medicalised and managed to improve the life expectancy of cancer patients - he seems to think that there's a lot of quackery in this area, and much of it seems very similar to that which we've seen with CFS. This sort of BPS stuff does tend to be of a different nature with conditions like cancer, than conditions like CFS though.

But if we're to genuinely hold the view that this is not a psychological illness then we shouldn't fear these studies, as long as we ensure they are impartially performed and accurately reported then they can only help build the evidence base for our viewpoint. Of course where they divert funds from reciprocal physical studies that's something we should vigorously oppose.

I cannot imagine that any subsection of society facing abnormal experiences could be lumped together, and have these sorts of psychological studies done so relentlessly, without some abnormalities coming to light. If the group is one people already wish to view dismissively, then these abnormalities will be used to justify their mistreatment, as they have been in the past.

If there was really clear and good evidence that almost all CFS patients suffered from consistently diagnosable personality disorders, then this would be a line of research worth continuing. Instead we've had two decades worth of studies producing minor and conflicting results - the only impact of which has been to justify bigotry and quackery. I think that we should be afraid of this research, just as gay people, people of minority ethnicity, and many other groups should be.

I'm sympathetic to your viewpoint, and it was one I shared prior to looking more closely at exactly how this research is done, the tools which are used to assess personality, and so on. This whole area is way more quacky than one would assume. Think about it: how would you design a way of assessing people's personality? It's really difficult, and the techniques used are generally no better than the questionnaires one finds in the back of magazines: 'What season suits your personality best?'
 
Messages
15,786
But if we're to genuinely hold the view that this is not a psychological illness then we shouldn't fear these studies, as long as we ensure they are impartially performed and accurately reported then they can only help build the evidence base for our viewpoint. Of course where they divert funds from reciprocal physical studies that's something we should vigorously oppose.

But most psych papers aren't impartially performed. They usually begin by stating an unsupported hypothesis as fact, and go on to base their own hypothesis on that unsupported hypothesis. Then they don't use a proper selection of ME/CFS patients, base all of their observations on purely subjective measurements, and create a conclusion that depends on external and unproven assumptions such as personality types.

This paper is far better than most, yet still throws in the tidbit that their results are consistent with the "maladaptive or self-critical perfectionism" supposedly demonstrated in other studies. Unlike many psych papers, this one actually cites other papers to support that claim, but there is still the basic assumption that those results are trustworthy or meaningful in regards to personality traits, and that it has an effect on our behavior and illness.
 
Messages
85
Thanks Bob.

It's nice for a change to see such results but, I can't help it to think that why do they even bother starting such studies to begin with?
Do they perform similar studies for all biological illnesses?

In a way I feel like we are marked "insane" until proven "sane".


Actually they do do these kinds of studies in other biological diseases - the difference is that they don't use it as a reason to not do biomedical studies. As for why they did this study on personality disorders in CFS, other studies have found that personality disorders are often found more often in individuals with psychosomatic disorders. So this study either shows that theory is incorrect or that CFS is not a psychosomatic disorder as that theory doesn't apply.
 

Marlène

Senior Member
Messages
443
Location
Edegem, Belgium
Given the conflicting findings in this area, future studies using multiple measures to assess personality disorders in CFS are needed to substantiate these findings.

Anyone looked at the names of the writers? Indeed, Van Houdenhove, good old advisor of the social security, belgian government and insurers. He is supposed to be retired but his disciples are paid again to solve the "conflicting findings".

When are going to get paid for their misdiagnosis of existing conditions?
 

Bob

Senior Member
Messages
16,455
Location
England (south coast)
The latest edition of ME Research UK's Breakthrough magazine has an interesting article about this paper.

The magazine is not online yet, so I've typed up this section, myself...

ME Research UK
Breakthrough magazine
Issue 17
Spring 2013


BELGIUM.

Personality disorders not a factor.

CDSM-IV axis II personality disorders involve 'maladaptive personality traits', such as obsessive-compulsive disorder. A study from Belgium reports no increase in such personality disorders in ME/CFS patients compared with people in the community (prevalence 16.3% in each group, in contrast with 58.7% in a comparison group of psychiatric patients). No surprise there then, particularly as the results accord with a previous study in 2009 (prevalence 12% in both patients and controls).

The interesting thing is that both of these 'negative' investigations used the ADP-IV questionnaire to assess personality disorder, whereas other 'positive' studies (reporting moderate differences between ME/CFS patients and controls) have tended to use the PDQ questionnaire which, as the authors point out, gives high rates of false positives and overestimates the prevalence of personality disorder. Such matters are important, particularly when the results of research studies affect the lives of real people, and impact on healthcare professionals' views of the illness!

Source: Kempke et al., Int J Behav Med, 2012

This is the bit that I found interesting, taken from the above quote:

"The interesting thing is that both of these 'negative' investigations used the ADP-IV questionnaire to assess personality disorder, whereas other 'positive' studies (reporting moderate differences between ME/CFS patients and controls) have tended to use the PDQ questionnaire which, as the authors point out, gives high rates of false positives and overestimates the prevalence of personality disorder."



There is plenty of other interesting research news in the Breakthrough magazine, but the magazine is not online yet.
You'll find the full magazine here, when it's placed online:
http://www.meresearch.org.uk/information/breakthrough/
 
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13,774
Sorry for weird OT post, but I just stumbled upon this from a 2001 Sports Medicine Report on CFS, and thought that it might be of interest, and need to get off the PC...

3. Personality, Affect and Cognitive Function
3.1 Personality
There have been suggestions that a particular
type of personality is vulnerable to CFS. In the case
of athletes, some individuals are more discouraged
than others by development of a minor infection or
observation of a small decrement in their current
performance. Nevertheless, the nature of the vul-
nerable personality remains to be defined clearly.
There have been suggestions that those affected
by CFS tend to be perfectionists. However, a com-
parison of 101 cases of CFS with 45 cases of rheu-
matoid arthritis, [77] and a second comparison be-
tween 40 cases of CFS and 31 normal individuals
[78] each failed to confirm the perfectionist stereotype,
with negative attitudes towards psychiatry.[77]

High scores on neuroticism and low scores on
extraversion were found mainly during periods
when patients were ill, suggesting these findings
were a reaction to CFS rather than precipitating
factors.[79]

77. Wood B, Wessely S. Personality and social attitudes in chronic
fatigue syndrome. J Psychosom Res 1999; 47: 385-97
78. Blenkiron P, Edwards R, Lynch S. Associations between per-
fectionism, mood and fatigue in chronic fatigue syndrome: a
pilot study. J Nerv Ment Dis 1999; 187: 566-70
79. Buckley L, MacHale SM, Cavanagh JT, et al. Personality di-
mensions in chronic fatigue syndrome and depression. J Psy-
chosom Res 1999; 46: 395-40

http://aula.acemefide.org/cursos/ph...edicine__Feb2001__Vol._31_Issue_3__p167__.pdf
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
Higher levels of depression? Can they tell the difference between unhappy and depressed? Are they unaware that chronic disease and loss of lifestyle make people unhappy? Sure some of us get depressed, so what?

OCD? When my brain is not working the only way I can function is by picking a task and performing it with serious focus, excluding everything else. OCD? No. When my memory fails me I sometimes have to check things several times. OCD? No.