Does anybody know what Personality Disorder Not Otherwise Specified means?

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[EMC2010]

Does anybody know what Personality Disorder Not Otherwise Specified means?  It's hard for me to interpret the information I've read on the web aboutit.  It sounds confusing.

[blackandwhite]

EMC2010,

I'm not surprised you find it unclear; it seems pretty unclear even to many professionals. "NOS" has been a catch bin diagnosis. It can represent elements of a personality disorder are present but not enough of one particular disorder to diagnosis it (but several elements from several different disorders). Or it may indicate more than one disorder is present, a mix.

The profession in general is looking at revising how personality disorders are diagnosed, as nobody seems terribly satisfied with the current way its done. This article, Research led by Michigan State University psychologist Christopher Hopwood proposes a new way to classify personality disorders, might be informative.

B&W

[EMC2010]

Thanks for the reply.  I read the article you posted the website of.  I think a new way should be devised in regard to diagnosing personality disorders...or to rename them.

I read a book by Judith Lewis Herman, M.D> called Trauma and Recovery and she writes in her book that when clinicians call somebody a borderline it is nothing than a sophisticated insult.  She is a smart lady who advocates in her profession people who have had trauma.  There is a reason why people are the way they are...I recognize this and try to be patient with friends who happen to be diagnosed borderline or something else.  It gets frustrating and there have been serious issues with friends but I always try to say to myself...hey, she's had it hard.  So she has some behaviors.  I can overlook things sometimes when I know a friend is troubled.  On the other hand I sometimes have to protect myself...I have an anxiety disorder so I'm sure I'm not an easy friend sometimes either.

[GENERAL ANNOUNCEMENT]

GENERAL ANNOUNCEMENT This board is intended for general questions about BPD and other personality disorders, trait definitions, and related therapies and diagnostics. Topics should be formatted as a question. Please do not host topics related to the specific pwBPD in your life - those discussions should be hosted on an appropraite [L1] - [L4] board. You will find indepth information provided by our senior members in our workshop board discussions (click here).

[Skip]

It's a really good question.  In the DSM and ICD-10 there are general criteria for personality disorders over all.  Then there are specific classifications for personalty disorders.  Patient must meet both the general and specific criteria.  If a patient meets the general criteria, but not one of the specific criteria it becomes Personality Disorder Not Otherwise Specified.

The background is that four specific personality disorders were dropped from the DSM-III - Sadistic personality disorder, Self-defeating personality disorder, Depressive personality disorder, and Passive–aggressive personality disorder - and patients with these symptoms are covered by  Personality Disorder Not Otherwise Specified.

I don't know the work of Judith Lewis Herman, MD.  But I see that she is a professor at Harvard.  Harvard has one of the worlds top rated inpatient programs for BPD. Not sure of the connection.

Skippy

[EMC2010]

Hi,

Judith Lewis Herman also has a women's clinic in MA.  She treats women who have trauma issues there.  I worked for a law firm and my boss went to Harvard Law School.  She got a magazine called Harvard Law Review and there was an article called Rowers on the RIver Styx and it was about the work Dr. Herman does.  This was almost 20 years ago.  The article was about people with DID, PTSD, etc..how women are not believed about their abuse, etc...it was a pretty big article.  I suspected I had PTSD and I was afraid to tell my psychiatrist.  I thought he would diagnose me w/schizophrenia.  I was seeing and hearing things in my head which were flashbacks.  I took a chance and wrote to Dr. Herman and asked her for a referral in my state to someone who treats PTSD.  She sent me back a note with the name of a doctor who I was with for 9 years.  This doctor used to live in Boston.  She changed my dx from bipolar disorder to PTSD and I got good treatment.  Unfortunately, after nine years of therapy and some relief from PTSD, a few years after I stopped therapy the flashbacks came back and continue to this day.  I am treated for PTSD at a clinic in my area twice a week now.

Dr. Herman wrote a book called Father Daughter Incest that sort of put her on the "celebrity" list of MD's who treat trauma victims...

I was grateful for the referal.  That was back in 1991.  Seems like a lifetime ago.  I think in a lot of ways healing from mental illness is a lifelong endeavor.