Tag Archives: Personality disorder

June 17, 2012 · 4:51 pm

Psychology and the Sandusky trial: Assessing Histrionic Personality Disorder


A short news article (found here) tells that Jerry Sandusky is to be evaluated for a personality disorder today by a prosecution psychologist. Jerry is on trial for some 50 counts of child sexual abuse. The article says that the defense team plans to argue that Jerry has Histrionic Personality Disorder and that explains his verbal and written behavior with the boys who are accusing him of abuse–rather than see those same behaviors as attempts to groom the boys.

Just how will a psychologist go about determining the presence of HPD? In a non-forensic setting, a psychologist would attempt to determine the presence of a personality disorder by gathering several kinds of data

However, there is a problem with the forensic (criminal court) setting. The problem is this: if the defense believes such a diagnosis will help their case, it stands to reason that they could easily coach their client to answer questions (whether interview or objective testing) in such a way as to ensure a positive diagnosis. It doesn’t take a rocket scientist to figure out how to present or which questions need to be answered in a particular way to meet the criteria for HPD, or any other diagnosis.

So, what is a forensic psychologist to do? Check for malingering. Some who try to fake a particular diagnosis tend to overdo the fake. The MMPI-II, for example, has some capacity to assess for those who answer in a particular way in an attempt to fake mental illness. There are a few other tests that work very hard in assessing malingering. Even so, it will be one psychologist’s clinical judgment against another’s.

Does it matter?

Not really. What is on trial is whether Sandusky committed acts of child sexual abuse. Either he did or didn’t. The only way the HPD diagnosis will work is if the jurors believe that Sandusky is only misunderstood–that he never touched a child in a sexual way but was over-emotional in his attempts to garner the kids attention. It is possible that Sandusky does meet criteria for HPD and abused the boys. The diagnosis will not protect him from the consequences of crimes he may have committed.

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February 16, 2011 · 9:57 am

More on Narcissism


Hadn’t read my Monitor on Psychology (Feb 2011 edition) til this morning and saw that the cover story is on the possible rise of narcissism in young folk these days. Now, this magazine is popular and doesn’t go too deep into reporting on research…and I haven’t followed up on the studies to read them for myself, but…

  • one study has 80% of middle school students scoring higher on self-esteem in ’06 than ’88
  • Another shows an increase in the lifetime prevalence of NPD
  • However, no nationally representative samples comparisons have been done to really shed light on whether a rise is truly taking place
  • One meta study of 85 studies (between ’82 and ’06) suggests an increase of narcissism among college students

The article goes on to muse about whether materialism and social networking lead the way toward narcissism but also wonders whether the decrease in availability to easy credit will lower the self-promoting trend a bit.

In an ironic twist, it appears that the DSM 5 may not include NPD as a diagnosis. Rather. It will include a more general diagnosis (see below taken from the DSM5.0rg site). Strangely, one of the “types” is NOT narcissism.

The essential features of a personality disorder are impairments in identity and sense of self and in the capacity for effective interpersonal functioning. To diagnose a personality disorder, the impairments must meet all of the following criteria:

A.    A rating of mild impairment or greater in self and interpersonal functioning on the Levels of Personality Functioning.

B.    Associated with a “good match” or “very good match” to a personality disorder type or with a rating of “quite a bit like the trait” or “extremely like the trait” on one or more personality trait domains.

C.    Relatively stable across time and consistent across situations.

D.    Not better understood as a norm within an individual’s dominant culture.

E.    Not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma).

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February 14, 2011 · 5:59 am

Resources about narcissism?


Cover of "The Drama of the Gifted Child"

Cover of The Drama of the Gifted Child

A few weeks ago I was asked about resources on the topic of narcissism, things a person struggling with some of the features might read to better understand their inner world. I didn’t have any really great “lay” materials on the topic so I’m going to poll the audience. A perfect entry for Valentine’s Day when we celebrate those people who make us feel special!

Narcissism is an ugly word if it is used about you, as in, “you’re so narcissistic!” This usually means someone sees us as being self-centered.

The truth is…most of us have a touch of it at times. We desire affirmation, we fantasize about being recognized for our achievements, we want to be special (or at least seen that way), we have times of feeling entitled and may even manipulate the feelings of others to get what we want. Our focus on self may limit our empathy towards others. We may be haughty. All of have some of these features some of the time. Some of us have these features most of the time.

Having these feelings doesn’t mean we are personality disordered. But, our willingness to acknowledge and work on being more other centered MAY reveal whether we meet diagnostic criteria. Meaning, if you can admit to the problem and improve your capacity for empathy then you probably aren’t meeting criteria for a personality disorder.

What causes narcissism?

The simple Christian answer is sinful self-focus. But since ALL of us are sinners and flawed…can we be more specific why some people seem to struggle more with the problem, why some have an enduring bent  or a fixed pattern of relating to the world? One theory suggests that narcissistic features arise out of a lack of mirroring which results in a deep fear that we aren’t special…or worse, are worthless. There is likely some truth to this. However, it seems that some narcissism is encouraged in a me-first culture.

Resources?

So, what resources do you know that get at some of these experiences, desires, feelings of narcissism that could help a person be more aware of their impact on others.

Here’s a few reads I know about:

1. Drama of the Gifted Child, by Alice Miller. A classic psychodynamic read about our emotions. She does a nice job illustrating the fears/cravings of narcissism and borderline features and how we all have a touch of these. Not necessarily helpful in what to do about the experience but good to delve into the experiences of depression, grandiosity, denial, and self-contempt and what these do for us.

2. Re-inventing Your Life, by Jeffrey Young. In particular, look at chapter 16. In fact, if you follow the link, you can search “entitlement” in the “search inside” box on the left and once you get results, scroll down to the one on p. 314. You can read a bit of the chapter to see how the authors do a good job describing the common symptoms of narcissism.

3. Anatomy of Secret Sins, by Obadiah Sedgwick. Well, not exactly about narcissism but definitely about uncovering our true self-centeredness. Sedgwick lived between 1600 and 1658! Excellent read on the problem of self-deception.

If you try to search for books on this topic, you will discover (not surprisingly) most are written to those who either have to live with the person or are trying to get free of them. Few are written to the person with the problem.

Any resources you might add to the list?

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