Change Over Time
Experts have long believed that personality
disorders -- types of mental illness in which people have trouble
functioning with others -- were relatively inflexible, and endured
throughout a person's life.
Now, new research contradicts that
belief, showing that these disorders actually appear to shift
over time, with many people improving at a steady rate.
Each personality disorder typically
has around 8 or 9 symptoms, lead author Dr. Mark F. Lenzenweger
stated. His team found that, on average, people lose 1.4 symptoms
of their personality disorders each year, or more than 5 symptoms
over 4 years.
These changes occurred in both
men and women, regardless of whether they were receiving treatment
or had additional mental illnesses.
Consequently, after a few years,
some people diagnosed with a personality disorder may no longer
have one, Lenzenweger noted. For example, one woman entered the
study with borderline personality disorder, and finished the study
disorder-free, he said.
In an interview, Lenzenweger explained
that people with personality disorders have "maladaptive personalities,"
and tend to have ongoing problems in every aspect of their lives.
For instance, people with narcissistic personality disorder always
see themselves as entitled, believe the world revolves around
them, and apply this logic at home, work and everywhere they go.
In contrast, people with depression
or anxiety -- not considered personality disorders -- have episodes
of extreme symptoms, he noted.
Despite the fact that many people
with personality disorders tend to improve gradually over time,
treatment is still important, Lenzenweger stressed. Not everybody
included in the study experienced a decrease in symptoms -- some
even developed more symptoms -- and people with personality disorders
often need help to deal with their life and relationships, he
"The 'wait and see' attitude probably
wouldn't be good for most people," he said.
Personality disorders are surprisingly
common, with one study placing the rate as high as 13 percent
of certain populations.
People with an obsessive-compulsive
personality disorder, for example, may be overly rigid, tending
to plan everything out and believing that everyone else should
do the same. Paranoid personality disorders are ascribed to people
who are generally suspicious of others and overly careful. Those
with borderline personality problems, in contrast, can be excessively
impulsive, and often uncertain about their decisions.
Experts have long assumed that
personality disorders do not change. To investigate this assumption,
Lenzenweger and his team followed 250 people with a personality
disorder for 4 years, noting if their symptoms shifted. Their
findings appear in the Archives of General Psychiatry.
The results show that personality
disorders are "not necessarily engraved in stone, the way it's
been taught for generations," concluded Lenzenweger, who is based
at the State University of New York at Binghamton.
He said he and his colleagues plan
to continue to follow study participants, and investigate further
why their disorders appear to change over time.
SOURCE: Archives of General Psychiatry,
Reference Source 89
October 15, 2004