a pervasive pattern of maladaptive traits and behaviours
beginning in early adult life
it usually has its first manifestations in childhood and is clearly evident
in adolescence
it is not diagnosed before early adult life because these maladaptive traits
are very common in childhood and adolescence, but most individuals age-out
of these traits before early adulthood
leading to substantial personal distress and/or social dysfunction, and
disruption to others
is of long duration, typically lasting at least several years
Mild Personality Disorder: There are notable problems in many interpersonal relationships and the performance of expected
occupational and social roles, but some relationships are maintained and/or
some roles carried out. Mild personality disorder is typically not associated with substantial harm to self or
others.
Moderate Personality Disorder: There are marked problems in most interpersonal relationships and in the performance of expected
occupational and social roles across a wide range of situations that are
sufficiently extensive that most are compromised to some degree. Moderate
personality disorder often is associated with a past history and future expectation of harm to self or others, but
not to a degree that causes long-term damage or has endangered
life.
Severe Personality Disorder: There are severe problems in interpersonal functioning affecting all areas of life. The
individual's general social dysfunction is profound and the ability and/or
willingness to perform expected occupational and social roles is absent or
severely compromised. Severe personality disorder usually is associated with
a past history and future expectation of severe harm to self or
others that has caused long-term damage or has endangered
life.
Onset:
Histrionic Personality Disorder occurs in 1.8% of Americans. Typical features of
histrionic personality disorder are attention seeking and emotional
instability.
For this diagnosis to be given, the individual must be at least in early
adulthood. This disorder is only diagnosed when these behaviors become
persistent and very disabling or harmful to others.
Treatment:
There is insufficient (randomized controlled trial) evidence
to prove the effectiveness of any psychological intervention or medication
for adults with this disorder. Lacking such evidence, it would be prudent to
only offer crisis intervention or short-term psychotherapy, rather than
long-term psychotherapy.
Prognosis:
Histrionic Personality Disorder can persist for a lifetime.
Individuals with this disorder would have a significant impairment
in the behaviors that are displayed in
red
:
Most of the time and in most situations:
In general, do you have difficulty making
and keeping friends?
Would you normally
describe yourself as a loner?
In general, do you trust
other people? (No)
Do you normally lose your
temper easily?
Are you normally an
impulsive sort of person?
Are you normally a
worrier?
In general, do you depend
on others a lot?
In general, are you a
perfectionist?
Answer "Yes" or "No" to each of these 8
questions.
7-Question Well-Being Screening Test (By P. W. Long MD,
2020)
Individuals with this disorder would have a
significant impairment in the behaviors that are displayed in
red
:
Agreeableness: I was kind and honest. (Instead was
attention seeking) Conscientiousness:I was diligent and self-disciplined. Openness/Intellect: I showed good problem-solving and curiosity. Sociality: I was
gregarious, enthusiastic, and assertive. Emotional
Stability: I was emotionally stable and calm. Physical Health: I
was physically healthy. Role Functioning: I functioned well socially and at school/work. (Instead had significant impairment in
social, academic, or occupational functioning.)
How often
in the past week did you do each of these 7
behaviors:
Self-diagnosis of this disorder is often inaccurate. Accurate diagnosis of this disorder
requires assessment by a qualified practitioner trained in psychiatric diagnosis and
evidence-based treatment.
However, if no such professional is available, our free computerized diagnosis is usually
accurate when completed by an informant who knows the patient well. Computerized
diagnosis is less accurate when done by patients (because they often lack insight).
Example Of Our Computer Generated Diagnostic Assessment Of President
Trump
Histrionic Personality Disorder 301.50
This diagnosis is based on the following findings:
Is uncomfortable in situations in which he was not the center of attention
(still present)
Inappropriate sexually seductive or provocative behavior. (still present)
Has a style of speech is excessively impressionistic and lacking in detail
(still present)
Shows self-dramatization, theatricality and exaggerated expression of emotion
(still present)
Is suggestible (i.e., easily influenced by others or circumstances) (still
present)
Considers relationships to be more intimate than they actually are (still
present)
Treatment Goals:
Goal: stop always trying to be the center of attention.
If this problem persists: He will alienate people by her constant demands for
attention. When not the center of attention, he will continue to do something
dramatic (e.g., make up stories, create a scene) to draw the focus of attention
to himself.
Goal: stop being inappropriately sexually provocative or seductive.
If this problem persists: He will alienate same-sexed friends because of his
sexually provocative behavior towards his friend's romantic partners.
Goal: stop expressing strong opinions without supporting evidence.
If this problem persists: He will alienate others with his strong opinions that
are expressed with dramatic flair, but without supporting facts and details.
Goal: stop being so suggestible.
If this problem persists: His opinions and feelings will continue to be easily
influenced by others and by current fads. He must stop being overly trusting,
especially of strong authority figures who will magically solve his problems.
Goal: be less dramatic and theatrical.
If this problem persists: He will embarrass others by her excessive public
display of emotions. Others will accuse him of faking his feelings because his
emotions seem to be turned on and off too quickly to be deeply felt.
Goal: stop considering relationships to be more intimate than they actually
are.
If this problem persists: He will continue to think that mere acquaintances are
actually close friends, or believe that casual relationships are more
romantically intimate than they actually are.
"Histrionic Personality Disorder is characterized by shallow and labile affectivity,
self-dramatization, theatricality, exaggerated expression of emotions, suggestibility,
egocentricity, self-indulgence, lack of consideration for others, easily hurt feelings, and
continuous seeking for appreciation, excitement and attention" (ICD10). It is "a pervasive
pattern of excessive emotionality and attention seeking, beginning by early adulthood and
present in a variety of contexts" (DSM-5)
In terms of the "Big-6"
Dimensions of Mental Health this disorder is characterized by
antagonism
(attention seeking). This leads to substantial personal distress and/or social
dysfunction, and disruption to others. This is not diagnosed before early adulthood because
these maladaptive traits are very common in childhood and adolescence, but most individuals
age-out of these traits before early adulthood. This disorder is of long duration, typically
lasting at least several years.
The diagnosis requires having 5 (or more) of the following:
Is uncomfortable in situations in which he or she is not the center of attention.
Interaction with others is often characterized by inappropriate sexually seductive
or provocative behavior.
Displays rapidly shifting and shallow expression of emotions.
Consistently uses physical appearance to draw attention to self.
Has a style of speech that is excessively impressionistic and lacking in detail.
Shows self-dramatization, theatricality, and exaggerated expression of emotion.
Is suggestible (i.e., easily influenced by others or circumstances).
Considers relationships to be more intimate than they actually are.
Like all personality disorders, Histrionic Personality Disorder is an enduring pattern of
inner experience and behavior that deviates markedly from the expectations of the
individual's culture, is pervasive and inflexible, has an onset in adolescence or early
adulthood, is stable over time, and leads to distress or impairment.
Individuals with this disorder may have difficulty achieving emotional intimacy in romantic
relationships. Without being aware of it, they often act out a role (e.g., "victim" or
"princess"). They may seek to control their partner through emotional manipulation or
seductiveness on one level, whereas displaying a marked dependency on them at another level.
Individuals with this disorder often have impaired relationships with same-sex friends
because of their sexually provocative behavior or their demands for constant attention. They
crave novelty, stimulation, and excitement and have a tendency to become bored with their
usual routine. Often old relationships are neglected to make way for the excitement of new
relationships. Although they often initiate a job or project with great enthusiasm, their
interest may lag quickly.
Complications
The actual risk of suicide is not known, but individuals with Histrionic Personality
Disorder are at increased risk for attention seeking suicidal gestures or threats.
Comorbidity
Some other disorders frequently occur with this disorder:
No laboratory test has been found to be diagnostic of this disorder.
Prevalence
The frequency of Histrionic Personality Disorder is equal in males and females, and this
disorder is present in about 1.8% of the general population (and 10%-15% of psychiatric
outpatients).
Controlled Clinical Trials Of Therapy
Click here for a list of all the controlled clinical trials of
therapy for this disorder.
Psychotherapy
There is insufficient (randomized controlled trial) evidence to prove the effectiveness of
any psychological intervention for adults with this disorder. Lacking such evidence, it
would be prudent to only offer crisis intervention or short-term psychotherapy, rather than
long-term psychotherapy.
Pharmacotherapy
There are currently no medications approved by the FDA to treat this disorder. Vitamins,
nutritional supplements, and special diets are all ineffective for all Personality
Disorders.
Individuals with Histrionic Personality Disorder must be the center of attention and "the
life of the party". They are overly concerned with impressing others by their appearance.
They are highly suggestible, and easily influenced by others and by fads. They are
hypersensitive to criticism. They
are impulsive, excitement seeking, reckless, and seductive.
Lack Of Social Skills In Personality Disorders
There are certain social skills that are essential for healthy social functioning.
Individuals with Histrionic Personality Disorder lack the essential social skills of
genuineness, chastity, and caution. They lack emotional
stability (that is also lacking in individuals with Borderline Personality Disorder)
and cooperation/generosity (that is also lacking in Narcissistic Personality
Disorder).
A Good Life
How does one live a good life?
One approach to answering this question is to study the behavior of individuals who live
troubled lives. Could the opposite of their maladaptive behavior define how to live a
good life?
Consider the troubled lives of people with histrionic personality disorder. Individuals with
histrionic personality disorder are inappropriately attention seeking and seductive.
Could the opposite of the maladaptive behaviors seen in histrionic personality
disorder be a clue to how to live a good life? Many religions teach that we should be sincere and not seductive. This is the opposite of the
inappropriately attention seeking
and seductive behavior seen in histrionic personality disorder.
Histrionic Personality Disorder
The Opposite Of Histrionic Personality Disorder
Inappropriate attention seeking:
Sincerity:
Shows self-dramatization, theatricality and exaggerated expression of emotion
Does not show self-dramatization, theatricality, or exaggerated expression of emotion
Is uncomfortable in situations in which she was not the center of attention
Is comfortable in situations in which she is not the center of attention
Consistently uses physical appearance to draw attention to herself
Does not consistently use physical appearance to draw attention to herself
Displays rapidly shifting and shallow expression of emotions
Does not display rapidly shifting and shallow expression of emotions
Has a style of speech is excessively impressionistic and lacking in detail
Does not have a style of speech that is excessively impressionistic and lacking in detail
Considers relationships to be more intimate than they actually are
Does not consider relationships to be more intimate than they actually are
Is suggestible (i.e., easily influenced by others or circumstances)
Is not suggestible, i.e., not easily influenced by others or circumstances
Inappropriate sexually seductive or provocative behavior.
Does not show inappropriate sexually seductive or provocative behavior
Parental Behaviors Which Increase The Risk Of Developing A Personality Disorder
Research has shown that genetic, environmental, and prenatal factors all play important roles in the development
of personality disorder. Research has also shown that low parental affection and harsh
parenting increase the risk of a child later developing a personality disorder.
"Low affection" was defined as: low parental affection, low parental time spent with the child, poor parental
communication with the child, poor home maintenance, low educational aspirations for the child, poor parental
supervision, low paternal assistance to the child's
mother, and poor paternal role fulfillment. "Harsh parenting" was defined as: harsh punishment, inconsistent
maternal enforcement of rules, frequent loud arguments between the parents, difficulty controlling anger toward
the child, possessiveness, use of guilt to control
the
child, and verbal abuse.
(USE SLIDER ON RIGHT SIDE OF THE ABOVE PAGE TO SEE FULL CHECKLIST)
This disorder is characterized by pathological personality traits in the following domains:
Antagonism
, characterized by:
Attention seeking: Excessive attempts to attract and be the
focus of the attention of others; admiration seeking.
Question: "Do you really like to be the center of attention? Do you like to show
off if you get the chance? Do you really want to be admired by others?"
"Continually seeks excitement and being the center of attention." (ICD-10)
"Is uncomfortable in situations in which he or she is not the center of attention."
(DSM-5)
"Self-dramatization, theatricality, or exaggerated expression of emotions."
(ICD-10) "Shows self-dramatization, theatricality, and exaggerated expression
of emotion." (DSM-5)
"Shallow and labile affectivity. (ICD-10) "Displays rapidly shifting and
shallow expression of emotions." (DSM-5)
"Inappropriately seductive in appearance or behavior." (ICD-10) "Interaction
with others is often characterized by inappropriate sexually seductive or
provocative behavior." (DSM-5)
"Considers relationships to be more intimate than they actually are." (DSM-5)
"Overly concerned with physical attractiveness." (ICD-10) "Consistently uses
physical appearance to draw attention to self." (DSM-5)
"Suggestibility, easily influenced by others or by circumstances." (ICD-10)
"Is suggestible (i.e., easily influenced by others or circumstances)."
(DSM-5)
"Has a style of speech that is excessively impressionistic and lacking in detail."
(DSM-5)
Histrionic
Personality Disorder F60.4 - ICD10 Description, World Health Organization
Histrionic Personality Disorder is characterized by shallow and labile affectivity,
self-dramatization, theatricality, exaggerated expression of emotions, suggestibility,
egocentricity, self-indulgence, lack of consideration for others, easily hurt feelings, and
continuous seeking for
appreciation, excitement and attention.
A. The general criteria of personality disorder must be met:
Evidence that the individual's characteristic and enduring patterns of inner
experience and behavior
deviate markedly as a whole from the culturally expected and accepted range (or
'norm').
The deviation must manifest itself pervasively as behavior that is inflexible,
maladaptive, or otherwise
dysfunctional across a broad range of personal and social situations (i.e. not
being limited to one specific
'triggering' stimulus or situation).
There is personal distress, or adverse impact on the social environment, or
both, clearly attributable to the
behavior.
There must be evidence that the deviation is stable and of long duration, having
its onset in late childhood
or adolescence.
The deviation cannot be explained as a manifestation or consequence of other
adult mental disorders.
Organic brain disease, injury, or dysfunction must be excluded as possible cause
of the deviation.
B. At least four of the following must be present:
Self-dramatization, theatricality, or exaggerated expression of emotions.
(E.g., "I show my feelings for everyone to see.")
Suggestibility, easily influenced by others or by circumstances.
(E.g., "I'm too easily influenced by what goes on around me.")
Shallow and labile affectivity.
(E.g., "My feelings are like the weather; they are always changing.")
Continually seeks excitement and being the centre of attention.
(E.g., "I like being the center of attention.")
Inappropriately seductive in appearance or behavior.
(E.g., "I have a reputation for being a flirt.")
Overly concerned with physical attractiveness.
(E.g., "I like to dress so that I stand out in a crowd.")
Comments: Egocentricity, self-indulgence, continuous longing for
appreciation, lack of consideration for others,
feelings that are easily hurt, and persistent manipulative behavior complete the
clinical picture, but are not required
for the diagnosis.
Are emotionally dramatic and prone to express emotion in exaggerated and theatrical ways.
Their reactions tend to be based on emotion rather than reflection, and their cognitive
style tends to be glib, global, and impressionistic (e.g., missing details, glossing over
inconsistencies, mispronouncing names).
Their beliefs and expectations seem cliche or stereotypical, as if taken from storybooks or
movies, and they seem naive or innocent, seeming to know less about the ways of the world
than would be expected.
Are sexually seductive or provocative. They use their physical attractiveness to an
excessive degree to gain attention and notice, and they behave in ways that seem to
epitomize gender stereotypes. They may be flirtatious, preoccupied with sexual conquest,
prone to lead people on,
or promiscuous.
Become involved in romantic or sexual "triangles" and may be drawn to people who are
already attached or sought by someone else.
Have difficulty directing both tender feelings and sexual feelings toward the same person,
tending to view others as either virtuous or sexy, but not both.
Are suggestible or easily influenced, and idealize and identify with admired others to the
point of taking on their attitudes or mannerisms.
Fantasize about ideal, perfect love, yet tend to choose sexual or romantic partners who are
emotionally unavailable, or who seem inappropriate (e.g., in terms of age or social or
economic status).
Become attached quickly and intensely; however, beneath the surface, they often fear being
alone, rejected, or abandoned.
(Editor's Note: These behaviors would be considered "normal" in 14-year-olds just
"discovering" the opposite sex. Most adolescents mature out of their personality disorders
within 2 years.
Thus the question is: why do these maladaptive adolescent behaviors persist into adulthood
in Histrionic Personality Disorder?)
TRIGGER: what did you do that could have triggered this problem?
GOAL: what life skill(s) do you have to work on? (from checklist)
Example Of Setting Goals In Interviewing A Person With Histrionic Personality Disorder
In The Past Week:
WHO: was your problem?
"My boyfriend."
EVENT: what did he/she do?
"I was just talking to this guy at a party, and my boyfriend got all jealous."
RESPONSE: how did you respond to that event?
"I stormed out of the party. I wish now that we hadn't made such a scene."
OUTCOME: did your response help?
"No, I over-reacted. It wasn't worth upsetting everyone at the party."
TRIGGER: what did you do that could have triggered this problem?
"My boyfriend knows that I like to flirt. I just got a little carried away that night."
GOAL: what life skill(s) do you have to work on? (from checklist)
"I want to work on: (1) Sincerity ("being genuine - not overly theatrical or attention
seeking"), and (2) Chastity ("avoidance of casual sex ["one night stands"] AND absence of
intense desire for illicit sex")."
NOTE: When each of the following presentations finish; you must exit by manually
closing its window in order to return to this webpage.
The Healthy Social Behavior Scale lists social behaviors that research has found to be
associated with healthy social relationships. You can keep score (totaling its 4-point scale answers) on a
separate piece of paper to monitor your progress.
The Mental Health Scale lists behaviors and symptoms that research has found to be associated
with mental health (or disorder). You can keep score (totaling its 4-point scale answers) on a separate
piece of paper to monitor your progress.
The Life Satisfaction Scale lists the survey questions often used to measure overall
satisfaction with life. You can keep score (totaling its 4-point scale answers) on a separate piece of paper
to monitor your progress.
This website uses these 5 major
dimensions of human behavior (i.e., Agreeableness, Conscientiousness, Openness/Intellect,
Extraversion/Sociability, and Emotional Stability) to describe all mental disorders. This website
adds one more dimension, "Physical Health", to create the "Big 6" dimensions of mental health.
The behaviors of the "Five Factor Model of Personality" represent five adaptive functions that are vital to
human survival. For example, when one individual approaches another, the individual must: (1) decide whether
the other individual is friend or foe [
"Agreeableness"
], (2) decide if this represents safety or danger [
"Emotional Stability"
], (3) decide whether to approach or avoid the other individual [
"Extraversion/Sociability"
], (4) decide whether to proceed in a cautious or impulsive manner [
"Conscientiousness"
], and (5) learn from this experience [
"Openness/Intellect"
].
"In physical science a first essential step in the direction of learning any subject is to find
principles of numerical reckoning and practicable methods for measuring some quality connected
with it. I often say that when you can measure what you are speaking about
and express it in numbers you know something about it; but when you cannot measure it,
when you cannot express it in numbers, your knowledge is of a meagre and unsatisfactory
kind: it may be the beginning of knowledge, but you have scarcely, in your
thoughts, advanced to the stage of science, whatever the matter may be."
Lord Kelvin (1824 – 1907)
The best summary on bad
research is given by Laura Arnold in this TEDx lecture. If you read
nothing else about research, you owe it to yourself to watch this short video
- it is excellent!
The active placebo effect: 2300 years ago, the Greek Stoic philosophers taught that it is
not the objective event, but our subjective judgment about the event, that
determines our behavior. The active placebo effect bears witness to this ancient wisdom.
Randomized Controlled Trial:
Ask: Was the trial randomized? Was the randomization procedure
described and was it appropriate?
The best research design is to have research subjects randomly assigned to an
experimental or control group. It is essential that confounding factors be controlled for by
having a control group or comparator condition (no intervention, placebo, care as usual
etc.).
Representative Sample:
Ask: Do the research subjects represent a normal cross-section of the
population being studied?
Many psychological research studies using university students are flawed because their
subjects are not representative of the normal population since they are all W.E.I.R.D.
(White, Educated, Intelligent, Rich, and living in a Democracy).
Single Blind Trial:
Ask: Was the treatment allocation concealed?
It is essential that the research subjects are kept "blind" as to whether they are in
the experimental or control group (in order to control for any placebo effects).
Double Blind Trial (Better Than Single Blind Trial):
Ask: Were blind outcome assessments conducted?
In a double blind study, neither the research subjects nor the outcome assessors know
if the research subject is in the experimental or control group. This controls for both the
placebo effect and assessor bias.
Baseline Comparability:
Ask: Were groups similar at baseline on prognostic indicators?
The experimental and control groups must be shown to be comparable at the beginning of
the study.
Confounding Factors:
Ask: Were there factors, that weren't controlled for, that could have
seriously distorted the study's results?
For example, research studies on the effectiveness of mindfulness cognitive therapy in preventing
depressive relapse forgot to control for whether the research subjects were also
simultaneously receiving antidepressant medication or other psychological treatments for
depression.
Intervention Integrity:
Ask: Was the research study protocal strictly followed?
The research subjects must be shown to be compliant (e.g., taking their pills,
attending therapy) and the therapists must be shown to be reliably delivering the
intervention (e.g., staying on the research protocol).
Statistical analysis:
Ask: Was a statistical power calculation described?
The study should discuss its statistical power analysis; that is whether the study size
is large enough to statistically detect a difference between the experimental and control
group (should it occur) and usually this requires at least 50 research subjects in the
study.
Ask: Are the results both statistically significant and
clinically significant?
Many medical research findings are statistically significant (with a p-value
<0.05), but they are not clinically significant because the difference between the
experimental and control groups is too small to be clinically relevant.
For
example, the effect of a new drug may be found to be 2% better than placebo.
Statistically (if the sample size was large enough) this 2% difference could be
statistically significant (with a p-value <0.05). However, clinicians would say
that this 2% difference is not clinically significant (i.e., that it was too
small to really make any difference).
Statistically, the best way to test for
clinical significance is to test for effect size (i.e., the size of the
difference between two groups rather than confounding this with statistical
probability).
When the outcome of interest is a dichotomous variable, the
commonly used measures of effect size include the odds ratio (OR), the relative risk
(RR), and the risk difference (RD).
When the outcome is a continuous
variable, then the effect size is commonly represented as either the mean difference
(MD) or the standardised mean difference (SMD) .
The MD is the difference in
the means of the treatment group and the control group, while the SMD is the MD
divided by the standard deviation (SD), derived from either or both of the groups.
Depending on how this SD is calculated, the SMD has several versions such, as
Cohen's d, Glass's Δ, and Hedges' g.
Clinical Significance: With Standard Mean Difference, the general rule of
thumb is that a score of 0 to 0.25 indicates small to no effect, 0.25-0.50 a
mild benefit, 0.5-1 a moderate to large benefit, and above 1.0 a huge benefit.
It is a convention that a SMD of
0.5
or larger is a standard threshold for clinically meaningful
benefit.
The statistical summary should report what percentage
of the total variance of the dependent variable (e.g., outcome) can be explained by
the independent variable (e.g., intervention).
In clinical studies, the study
should report the number needed to treat for an additional beneficial outcome (NNTB), and
the number needed to treat for an additional harmful outcome (NNTH).
Number Needed To Benefit (NNTB): This is defined as the number of
patients that need to be treated for one of them to benefit compared with a
control in a clinical trial. (It is defined as the inverse of the absolute risk
reduction.) Note: Statistically, the NNTB depends on which control group is used for comparison - e.g.,
active treatment vs. placebo treatment, or active treatment vs. no
treatment.
Number Needed To Harm (NNTH): This is defined as the
number of patients that need to be treated for one of them to be harmed compared
with a control in a clinical trial. (It is defined as the inverse of the
absolute increase in risk of harm.)
Ask: Does the researcher accept full responsibility for the
study's statistical analysis?
The researcher should not just hand over the study's raw data to a
corporation (that may have $1,000 million invested in the study) to do the
statistical analysis.
Completeness of follow-up data:
Ask: Was the number of withdrawals or dropouts in each group
mentioned, and were reasons given for these withdrawals or dropouts?
Less than 20% of the research subjects should drop out of the study. The intervention
effect should persist over an adequate length of time.
Handling of missing data:
Ask: Was the statistical analysis conducted on the intention-to-treat
sample?
There must be use of intention-to-treat analysis (as opposed to a completers-only
analysis). In this way, all of the research subjects that started the study are included in
the final statistical analysis. A completers-only analysis would disregard those research
subjects that dropped out.
Replication of Findings:
Ask: Can other researchers replicate this study's results?
The research study's methodology should be clearly described so that the study can be
easily replicated. The researcher's raw data should be available to other researchers to
review (in order to detect errors or fraud).
Fraud:
Ask: Is there a suspicion of fraud?
In a research study, examine the independent and dependent variables that are always
measured as a positive whole number (e.g., a variable measured on a 5-point Likert-type
scale ranging from "1 = definitely false to 5 = definitely true" etc.). For
each of these variables, look at their sample size (
n
), mean (
M
) and standard deviation (
SD
) before they undergo statistical analysis. There is a high suspicion of fraud in a
study's statistics:
If the M is mathematically impossible (online calculator): This is
one of the easiest ways to mathematically detect fraud. The mean (
M
) is defined as "the sum (
Sum
) of the values of each observation divided by the total number (
n
) of observations". So:
M
=
Sum
/
n
. Thus: (
Sum
) = (
M
) multiplied by (
n
). We know that, if a variable is always measured as a positive whole number,
the sum of these observations always has to be a whole number. For these variables
to test for fraud: calculate (
M
) multiplied by (
n
). This calculates the
Sum
which MUST be a positive whole number. If the calculated
Sum
isn't a positive whole number; the reported mean (
M
) is mathematically impossible - thus the researcher either cooked the data or
made a mistake. A recent study of 260 research papers published in highly
reputable psychological journals found that
1 in 2 of these research papers reported at least one
impossible value
, and 1 in 5 of these research papers reported multiple impossible values. When
the authors of the 21 worst offending research papers were asked for their raw data
(so that its reliability could be checked) - 57% angrily refused. Yet such release
of raw data to other researchers is required by most scientific journals. (Here is
an example of a research paper filled with mathematically impossible
means.)
If the SD is
mathematically impossible (online calculator): When researchers fraudulently
"cook" their data, they may accidently give their data a mean and standard deviation
that is mathematically impossible.
If the
SD/M is very small
(i.e., the variable's standard deviation is very small compared to the mean
suggesting data smoothing).
If the
SD's are almost identical
(i.e., the variables have different means but almost identical standard
deviations).
If the 4th digit of the values of the variables aren't uniformly distributed - since
each should occur 10% of the time (Benford's
Law).
If the researcher is
legally prevented from publishing negative findings
about a drug or therapy because that would violate the "nondisclosure of trade
secrets" clause in the research contract (i.e., it is a "trade secret" that the drug
or therapy is ineffective - hence this can not be "disclosed"). Approximately half of all registered clinical trials fail to
publish their results.
If the
researcher refuses to release his raw data to fellow
researchers
(so that they can check its validity). In order to be published in most
scientific journals, a researcher must promise to share his raw data with fellow
researchers. Thus a researcher's refusal to do so is almost a sure indicator of
fraud.
If the
research study's data contradicts the study's own conclusions
- surprisingly, this often occurs.
Calling Bullshit In The Age of
Big Data - "Bullshit is language, statistical figures, data graphics, and other forms of
presentation intended to persuade by impressing and overwhelming a reader or listener, with a
blatant disregard for truth and logical coherence." Reading the syllabus of this university
course should be required reading for every student of mental health. This syllabus is
absolutely fantastic!
This website uses these 5 major
dimensions of human behavior to describe all mental disorders. (This website adds one more
dimension, "Physical Health", to create the "Big 6" dimensions of mental health.)
The behaviors of the "Five Factor Model of Personality" represent five adaptive functions that are vital to
human survival. For example, when one individual approaches another, the individual must: (1) decide whether
the other individual is friend or foe [
"Agreeableness"
], (2) decide if this represents safety or danger [
"Emotional Stability"
], (3) decide whether to approach or avoid the other individual [
"Extraversion/Sociability"
], (4) decide whether to proceed in a cautious or impulsive manner [
"Conscientiousness"
], and (5) learn from this experience [
"Openness/Intellect"
].
What Are The 6 Major Dimensions of Histrionic Personality Disorder?
THE POSITIVE SIDE OF THE "BIG 6" DIMENSIONS OF MENTAL HEALTH
THE NEGATIVE SIDE OF THE "BIG 6" DIMENSIONS OF MENTAL HEALTH
THIS DISORDER
Agreeableness Being kind and honest.
Antagonism Being unkind or dishonest.
Antagonism
Conscientiousness Being diligent and self-disciplined.
Disinhibition Being distractible, impulsive or undisciplined.
Openness/Intellect Showing good creativity, problem-solving, and learning ability
Impaired Intellect Showing decreased creativity, problem-solving, or learning ability.
Extraversion Being gregarious, assertive and enthusiastic.
Detachment Being detached, unassertive, and unenthusiastic.
Emotional Stability Being emotionally stable and calm.
Emotional Distress Being emotionally unstable/distressed.
Physical Health Being physically fit and healthy.
Physical Symptoms Being physically unfit or ill.
The Following Will Only Discuss The Dimensions of Mental Illness That Are Abnormal
In This Disorder
The problems that are
characteristic of this disorder are highlighted with this pink background color
.
AGREEABLENESS VS. ANTAGONISM
AGREEABLENESS
(Helping Others)
Description:
Agreeableness is synonymous with compassion and politeness. Compassion reflects empathy, sympathy,
and caring for others. Politeness reflects respect for others. Individuals with high
Agreeableness do not hold grudges, are lenient in judging others, are willing to
compromise and cooperate with others, and can easily control their temper. The
Agreeableness dimension measures the behaviors that are central to the concept of
JUSTICE and equality (fair, honest, and helpful behavior - living in harmony with
others, neither harming nor allowing harm). Basic human rights are enshrined in the UN Universal Declaration of Human Rights. Individuals with
high Agreeableness avoid manipulating others for personal gain, feel little
temptation to break rules, are uninterested in lavish wealth and luxuries, and feel no
special entitlement to elevated social status. High Agreeableness is associated with
better: longevity, helping others, giving to charity, job [team] performance, and marital
success. (This dimension appears to measure the behaviors that differentiate friend
from foe.)
Descriptors:
Honest, humble, compassionate, polite, cooperative, nonaggressive.
Chimpanzees:
The Agreeableness-Antagonism dimension of human behavior can be traced back to our
chimpanzee ancestory. Chimpanzee communities, like every social species, organize themselves
according to status (video). In such status hierarchies, the dominant members
actively protect their privileged status within the community by using domineering,
antagonistic behavior towards subordinate members. This antagonistic, competitive behavior
by high-status dominant members of the community is in contrast to the agreeable,
cooperative behavior of the low-status, subordinant members. In humans, this same
antagonistic behavior is used by those seeking to dominate others.
Evolution:
The brains of social species evolved to allow cooperation
and altruism which require coordinating one’s goals with those of others. The core
features of Agreeableness are empathy and fairness. In more intelligent species,
there appears to be an almost instinctual sense of empathy and fairness (video). Language Characteristics: Pleasure talk, agreement, compliments,
empathy, few personal attacks, few commands or global rejections, many self-references, few
negations, few swear words, few threats, many insight words.
Research:
Higher scores on Agreeableness are associated with deeper relationships. Are you a giver or taker? (video). *MRI research found that Agreeableness was associated
with increased volume in regions that process information about the intentions and mental
states of other individuals.
"I am helpful and unselfish with others."
"I have a forgiving nature."
"I am generally trusting."
"I am considerate and kind to almost everyone."
"I like to cooperate with others."
"I don't find fault with others."
"I don't start quarrels with others."
"I am not cold and aloof."
"I am not rude to others."
"I feel other's emotions."
"I inquire about others' well-being."
"I sympathize with others' feelings."
"I take an interest in other people's lives."
"I like to do things for others."
"I respect authority."
"I hate to seem pushy."
"I avoid imposing my will on others."
"I rarely put people under pressure."
ANTAGONISM
(Harming Others)
Description:
Antagonism is synonymous with being very self-centered and lacking empathy. They
find it hard to forgive, are critical of others' shortcomings, are stubborn in defending their
point of view, and readily feel anger when provoked. They will flatter others to get what they
want, break rules for personal profit, and feel a strong sense of self-importance.
ICD-11 Description:
The core feature of the Antagonism (or Dissociality) trait domain is disregard for
the rights and feelings of others. Common manifestations of Antagonism (or Dissociality)
include: self-centeredness (e.g., sense of entitlement, expectation of others’ admiration,
positive or negative attention-seeking behaviors, selfishness); and lack of empathy (i.e.,
indifference to whether one’s actions hurt others, which may include being deceptive,
manipulative, and exploitative of others, being mean and physically aggressive, callousness in
response to others' suffering, and ruthlessness in obtaining one’s goals).
Descriptors:
Dishonest, arrogant, callous, rude, manipulative, aggressive.
Language Characteristics: Problem talk, dissatisfaction, little
empathy, many personal attacks, many commands or global rejections, few self-references, many
negations, many swear words, many threats, little politeness, few insight words.
Video Example:
Here is an example of a very antagonistic person - President
Trump at a Mississippi political rally. Screening Questions:
"It’s no big deal if I hurt other peoples’ feelings."
"I crave attention."
"I often have to deal with people who are less important than me."
"I use people to get what I want."
"It is easy for me to take advantage of others."
"Others see me as irresponsible."
Attention Seeking
"I like to draw attention to myself."
"I crave attention."
"I do things to make sure people notice me."
"I do things so that people just have to admire me."
"My behavior is often bold and grabs peoples' attention."
The Man Who Saved The World
The world barely avoided being annihilated in 1983. On 26 September 1983, the nuclear
early warning system of the Soviet Union erroneously reported an incoming attack against
Russia by American intercontinental missiles. Russia has a "launch on warning" policy
whereby it launches its missiles against America on the first warning of an incoming
American missile attack.
Fortunately this missile attack warning was correctly identified as a false alarm by Stanislav
Petrov, lieutenant colonel of the Soviet Air Defence Forces. Petrov's decision to
disregard the erroneous radar warnings is credited with having prevented a retaliatory
nuclear attack on the United States and its NATO allies that could have resulted in
large-scale nuclear war.
Stanislav Petrov had the courage to disobey his military orders (to "launch on warning")
because of his personal knowledge and convictions. He knew that launching a large-scale
nuclear war would annihilate humanity, and he knew that the Russian early warning system
could not be trusted.
9 Times the World Was at the Brink of Nuclear War — and Pulled Back
Due to human error, there have been nine times that the world was at the brink of nuclear war — but
pulled back. Accidental false alerts which could trigger a nuclear war are not a
rare occurrence. Given how incompetent our nuclear "launch on warning" system is - it is
a miracle that we haven't already annihilated all life on earth.
The 2 Men Who Could End The World
America and Russia possess 93% of the world's nuclear weapons. Thus Valdimir Putin and President Trump are
the only two people on earth who could single-handedly start a nuclear World War III and thus annihilate all life on our
planet.
The problem now is that the leaders of Russia and America have severe personality
flaws that make them incapable of appreciating the enormity of harm that they may
cause.
Both Vladimir
Putin and President Trump have Antisocial, Narcissistic, and Paranoid
Personality Disorders.
Being Hot-Headed:
Easily angered; quick to take offense; unable to take criticism, blame or
rejection.
Histrionic Personality Disorder
Attention Seeking:
Trying to be the center of attention; being overly dramatic or flamboyant.
Tony Schwartz wrote "The Art of the Deal" for Donald Trump, and spent 18 months in Donald Trump's office
observing him in order to write this Donald Trump biography. In 2016, immediately before the
presidential election, Tony Schwartz gave a scathing lecture entitled "The Truth About Trump" at Oxford
University. Every American who voted for President Trump should watch this Oxford lecture
video.
P.S. In
the past 2 years, Canada has accepted more than 40,000 Syrian refugees.
Not one of these Syrian refugees has attempted a terrorist attack in Canada or
America.
A Counterargument To President
Trump's Xenophobia:
(Interview with Jack Ma, a Chinese businessman worth US$ 35 billion) "In the past 30 years, America
has had
13 wars spending US$ 14.2 trillion
. What if they spent a fraction of that money building up [America's] infrastructure, and
helping white collar and blue collar workers? ... You are supposed to spend money on your own
people. The money has gone to Wall Street. And what happened?
In 2008, the financial crisis wiped out US$ 19.2 trillion
in USA alone, and
destroyed 34 million jobs globally
. What if that money wasn't spent on Wall Street? What if that money was spent on middle America
and the rest of the United States developing the industry there? So it's not the other countries
stealing jobs from America, it is your strategy [over-spending on war and on Wall Street]. You did
not distribute your money in the proper way."
The "Five Factor Model of Personality" as Shown In DogsAll animals have
personalities - that is, consistent individual differences in behavior. Within
virtually any population, some individuals are consistently more active, more aggressive, or
are more willing to engage in risk-taking behavior. Thus the same "Big 5 Factors" of
personality found in humans can be found in dogs.
AGREEABLENESS VS. ANTAGONISM
Agreeableness ("Friend")
Dog is friendly towards unfamiliar people.
Dog is friendly towards other dogs.
When off leash, dog comes immediately when called.
Dog willingly shares toys with other dogs.
Dog leaves food or objects alone when told to do so.
Antagonism ("Foe")
Dog is dominant over other dogs.
Dog is assertive with other dogs (e.g., if in a home with other dogs, when
greeting).
Dog behaves aggressively towards unfamiliar people.
The "Five Factor Model of Personality" In A Social Species
The behaviors of the "Five Factor Model of Personality" serve adaptive functions that are vital to human
survival. For example, when one individual approaches another, the individual must: (1) decide whether
the other individual is friend or foe [
"Agreeableness"
], (2) decide if this represents safety or danger [
"Emotional Stability"
], (3) decide whether to approach or avoid the other individual [
"Extraversion/Sociality"
], (4) decide whether to proceed in a self-controlled or disinhibited manner [
"Conscientiousness"
], and (5) learn from this experience [
"Openness to Experience"
].
Spider Personalities
All animals
have personalities (defined as consistent behavioral differences among individuals). Animals can
consistently differ on: (1) Antagonism (e.g., aggression), (2) Disinhibition (e.g., risk
taking), (3) Intellect (e.g., inventiveness), (4) Extraversion (e.g., assertiveness), and
(5) Emotional Stability (e.g., calmness).
Some social spiders live in colonies of up to
several hundred individuals, and exhibit cooperative behaviours such as prey capture and maternal care.
Researchers have found that spider personalities differ in aggressiveness:
Aggressive spiders are more likely to attack their mirror image than are
shy spiders who are more likely to run away.
In a spider colony, individual spiders differ in degree of boldness
(aggression) vs. shyness (nonaggression). [Aggressive spiders show shorter latencies to attack
prey and to resume movement after a disturbance.] Hunting prey for these social spiders is a
collective effort. The presence of a bold spider causes the shy spiders to become bolder which
increases the effectiveness of their collective hunting effort. A positive feedback loop is
established whereby hunting success increases spider boldness which increases future collective
hunting success. However, when researchers removed these bold "leader" spiders, the collective
hunting by the remaining spiders became less successful. The bold "leader" spiders thus were
shown to have a disproportionately large impact on the group, and so were named "keystone
individuals". Because of their special personality characteristic (boldness) the "leader"
spiders performed a vital function (making the shy spiders bolder) which fascilitated collective
social action.
This research made the very important finding that the spiders modified
each other's personalities. The bold spiders became bolder because of their hunting success.
However their hunting success was entirely dependent upon gaining the collective support of
the shy spiders. Likewise, the shy spiders owed their hunting success to being made bolder
by association with the bold spider. Thus for more successful collective action, the bold
"leader" spider needed to have followers, and the shy "follower" spiders needed to have a
"leader". To make their collective social action more successful, the different spider
personalities had to bring out the "best" in each other.
This statistical model shows that all of the personality disorders are highly correlated - they
are overlapping entities that blend into each other with no clear boundaries. This 3D model
groups personality disorders into two highly interrelated large clusters (named "greed" and
"fear" by PWL).
The fact that these personality disorders are so highly interrelated suggests that it is common
for individuals to have multiple personality disorders.
Section III of the DSM-5 presents an alternative model for
personality disorders. Based on research findings, this model drops four personality disorders:
Schizoid, Paranoid, Dependent, and Histrionic.
The above 3D model shows the statistical
correlations between personality disorders in this alternative DSM-5 model.
Note:
Borderline Personality Disorder plays a central role in this model. It is
correlated to all of the other major personality disorders (except Schizotypal
Personality Disorder). It could be argued that Borderline Personality Disorder may not
be a true personality disorder. Instead, it may more represent chaotic instability - an
advanced stage in which a previous stable personality disorder becomes unstable and goes
from order into chaos. This would explain why Borderline Personality Disorder is usually
diagnosed in combination with another personality disorder.
Thus, it is argued,
instead of diagnosing someone as having both "Paranoid and Borderline Personality
Disorders"; it would be more correct to diagnose "Paranoid Personality Disorder with
Emotionally Unstable Traits".
Chaos theory
states that balanced systems under stress can be pushed into instability. Specifically,
as stress on a stable system is increased, a "tipping point" is reached wherein the
system quickly goes from stability to instability. The following animated graphs
illustrate this mathematical principle. The vertical (y) axis represents the stress
level. As the stress level increases, a tipping point is reached whereafter the system
becomes more unstable. (These animations recycle.)
According to chaos theory, these animations could represent what happens when a
personality disorder is under increasing stress. Initially, the personality disorder
remains stable; then under increasing stress a tipping point is reached wherein the
previously stable personality disorder becomes chaotic. Any further stress makes the
personality disorder even more unstable.
Thus the emotional instability, chaotic
social functioning, and self-harming behavior of Borderline Personality Disorder could
represent a chaotic, unstable state of a previously stable personality disorder.
Primate Evolution
There appears to be three different ways in which primates have evolved socially:
The chimpanzees have evolved to be socially antagonistic, competitive, callous, and
manipulative. Chimpanzees are the only primates (apart from humans) that wage organized
war. Thus chimpanzee social behavior most closely mirrors the antagonistic
behavior of
the antisocial-paranoid-narcissistic-histrionic-borderline cluster of personality
disorders.
In contrast, the bonobos have evolved to be socially anxious, peaceful,
cooperative, and loving. Thus bonobo social behavior most closely mirrors the emotional
distress (anxious) behavior of the avoidant-dependent cluster of personality
disorders.
Another separate evolutionary path was followed by the orangutans. They evolved
to become solitary hermits. Thus orangutan social behavior most closely mirrors the
detached behavior of the schizoid-schizotypal cluster of personality disorders.
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