Continuing our discussion..
The very notion of personality disorders is controversial . When we say someone has a disordered personality it comes across to some as a personal insult, yet we look at autism quite differently.
At core is the definition of chronic persistent use of maladaptive defense mechanisms, and we delegate intervention to longer term psychotherapy.
Another consideration – maybe this has been resolved and I just do not know enough child psychiatry – you will need to tell me.
We know (believe) that temperaments are manifest in very early childhood and have biological underpinnings. It would seem to me that as various temperaments mater, they may progress to different types fo personality disorders. Thus if biologically based, then biological psychiatrists (my training) should have studied these conditions. I know of only 2 groups that did pursue it.
Long ago I worked on a DSM III validity study of personality disorders. The main finding was the dx is not stable if made in context of symptomatic Axis I disorder. However, even with personality traits, we as psychiatrists must learn how to navigate the emotions and behaviors.
I attach an old article by George Vaillant with some perspective.
JT
Joseph (Joe) E. Thornton, M.D., DFAPA
Clinical Associate Professor, Psychiatry
University of Florida College of Medicine
joethornton@ufl.edu
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