The Statistics-Do You Believe Them?

They have said for some of the pd's that they affect between 1 to 3% of the population, right...of cluster b.
So, if we were to take these four:

1) HPD
2) BPD
3) NPD
4) ASPD

and say that each had a ball park average of 2%...it comes out to

8% of our population is cluster b.

If we maxed out the stats the numbers would be far worse.
This is a lot of people (and since cluster b behaviors and traits overlap so much you know there are a lot of odds of bumping into the wrong type of person if you catch my drift), and some estimate that the numbers are either higher or much higher.

Do you think the numbers are accurate or not? If you do, do you think the numbers are working in 'worldwide' (Latin America, Africa, etc...), or that they are mainly stats given to represent the ballpark average figures of just the United States?

I suppose, in part, that the figures could not include other countries (not accurately...the US may think of nearly the entire population of some communist countries as cluster b-seeing how they're governments function and allow/dictate others to function).
Imagine a lot of HPD wife's in a Muslim country (do you think that's happening ). Who knows...

Well the real question is where did these statistics come from? How were they arrived at? By who? How long ago? Etc.

I buy it, sure.

I think 8% is easily believable and perhaps even a low estimate. I seem to have managed to come into contact with a disproportionate number, assuming that what I observe as dysfunctional translates to disordered, and I suspect it does.

In the United States it's estimated that 30-50% of the prison population is ASPD, with roughly 5% of the population incarcerated in state and federal prisons (504 per 100,000 population in 2008).

An often cited 2001 study from Oslo University estimates 13.4% of the general population of Oslo based on structured interviews using DSM III criteria. The breakdown, irrespective of comorbidity is: paranoid, 2.4%; schizoid, 1.7%; schizotypal, 0.6%; antisocial, 0.7%; sadistic, 0.2%; borderline, 0.7%; histrionic, 2.0%; narcissistic, 0.8%; avoidant, 5.0%; dependent, 1.5%; obsessive-compulsive, 2.0%; passive-aggressive, 1.7%; self-defeating, 0.8%.

This table aggregates ten studies and shows fairly consistent results with respect to the pooled total, and great variance between individual studies in both individual PDs and overall totals. But seven out of the ten indicate totals above 8% and of the three below eight percent it's a max of 2.1% below.

http://salparadise.net/images/prevalence-personality-disorders.gif

(image settings on this forum are max of 480px... let's ask to have it changed, which is easy to do)

They are probably very low estimates, since most people are not aware they have a problem.
I know someone who goes into an asylum regularly to see his father and he tells me of the past respectable people he meets there. Vice-rector of a university, printing-press big shot, and others. Those people, did well throughout their lives and had the honors of society, but eventually, they collapsed. Of course, at the time of their zenith, nobody would have figured they had a problem.

Yes, but if these people were successful in career, and seemingly well-adjusted to life in general, then they would most likely not be suffering from a personality disorder, at least by accepted criteria. By definition personality disorders are patterns that exist from adolescence or early adulthood... "an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it".

This is not to say that a person can't have a personality disorder and be high-functioning or successful in certain ways, but the chances that a personality disorder would essentially remain unnoticed until the later years and then become so problematic that the person would need to be institutionalized is probably low. I think the reason for institutionalization is more likely to be the later onset of something else (schizophrenia, major depression, etc.) whether or not a PD also exists.

There are two huge problems in trying to estimate the prevalence of PDs... a) definition and establishment consistent thresholds, and b) subjectivity in assessment of individuals. While the DSM criteria is generally accepted as the standard definition, it still leaves a huge amount of judgement to practitioner in both regards. The context of the assessment is also highly variable... in private practice it's less likely that a patient will be diagnosed with a PD and often something like anxiety disorder or mild depression is used in leu of accurate diagnosis to comply for insurance purposes while not alienating the patient, giving the patient an excuse to not be responsible for their behaviors, and not diminishing hope for effective treatment and a positive outcome (keeping them in therapy).

The DSM is the APA's official book of standards, and the APA is recognized as the official professional organization for the field of psychology, but that doesn't mean you can apply hard edges to inherently intangible concepts and ideas by creating a bureaucracy, calling it authoritative, and printing a book. Does the nature of psychology actually change when they update the DSM or is it only the APA's official interpretation that changes? There are a lot of divergent ideas about the mind and emotions even within the established community of psychologists. Particularly interesting is the concept of 'Borderline.' James F. Masterson M.D. and Otto Kernberg both have expanded concepts compared to the DSM and both are quite illuminating regardless of how any person or group decides to define the term. By their definitions (which don't need hard edges) the percentage of people with BPD would be huge.

I wonder what the numbers would look like if we simply subtract from the total population all of those who are leading healthy, productive, lives, deal well with normal stressors, have good reality testing, satisfying relationships, and would describe their existence as meaningful, enjoyable and satisfying?

mr.johnnymac wrote:Imagine a lot of HPD wife's in a Muslim country (do you think that's happening ). Who knows...

I think in Muslim countries HPD has long been eliminated from the gene pool.

mr.johnnymac wrote:So, if we were to take these four:

1) HPD
2) BPD
3) NPD
4) ASPD

and say that each had a ball park average of 2%...it comes out to

8% of our population is cluster b.

Don't think this is right. The same person can be counted for more than one PD, so it could be less than 8%. In fact, 8% would be the maximum if each person was limited to only one PD, which, unfortunately, is not the case. Comorbidities are quite common. Probably the norm, or close to it in fact.

As for worldwide, I know that NPD is almost never DX'ed outside of the US. I suspect that American culture makes AsPD more common than in other countries. Probably HPD and BPD too, so yeah, the whole cluster B is probably overrepresented in the US, but NPD is, undoubtedly the most overrepresented.

santa fe wrote:Yes, but if these people were successful in career, and seemingly well-adjusted to life in general, then they would most likely not be suffering from a personality disorder, at least by accepted criteria.

They would not have been diagnosed, which does not mean they had nothing. The people that suffer are generally the people around them. If someone is successful and has influence, people are ready to put up a lot with their immaturity. There is this guy right now where I live that has a trial right now. He was a successful surgeon and killed his wife and children. They are trying to determine his mental fitness at the time. If you read his story, you can tell he was a textbook narcissist.

santa fe wrote:I wonder what the numbers would look like if we simply subtract from the total population all of those who are leading healthy, productive, lives, deal well with normal stressors, have good reality testing, satisfying relationships, and would describe their existence as meaningful, enjoyable and satisfying?

That's the thing. Probably very high, if I go from what people are saying and how they are acting. It also has to be agreed by their entourage that they have satisfying relationships.

OneLiner wrote:They would not have been diagnosed, which does not mean they had nothing. The people that suffer are generally the people around them.

I think we're off in two different directions here- it's not about a formal diagnoses or effect on others. I'm simply saying that PDs are relatively stable throughout life, and if a person is able to live with the PD through most of their life and be successful on some level, it's not likely that they'd later have to be institutionalized because of the personality disorder- more likely something new in addition to it.

OneLiner wrote:If someone is successful and has influence, people are ready to put up a lot with their immaturity. There is this guy right now where I live that has a trial right now. He was a successful surgeon and killed his wife and children. They are trying to determine his mental fitness at the time. If you read his story, you can tell he was a textbook narcissist.

Narcissism may be unique among the cluster b disorders in that it could be disguised behind a facade of high confidence, with ruthlessness and self-focus carefully managed. If the person believes their own grandiose fantasy, as long as they continue to perform accordingly and subordinates support their role of superior, it may be sustainable. Then when faced with aging, mortality and narcissistic injury for the first time at an older age I guess it could be pretty rough.