The Case of Autumn Asphodel Overcoming Mental Disorders

While gathering videos on youtube about Personality Disorders that we put together as a playlist of a lecture by Dr. Rhoda Hahn we came across the video of Autumn Asphodel.

We asked permission to use this video as a case study of her own account of the mental health issues she gone through from childhood to her gender transition from male to female.

Her video is enlightening, giving a face and practical example to the theories described and lectured by Dr. Hahn. The theories becomes clearer with the personal and authentic account of  Ms. Asphodel experiences of the various symptoms of psychological disturbances she went through.

The thread of comments are equally interesting and worthy of further probing as to the mental health of the commentors.

The video was uploaded and published on Dec 21, 2013. She describe her video below:

The story of my past (childhood, teenage years, middle and high school) and the struggle I had at becoming my true self, through the mental disorders and trauma. It was a difficult journey as I struggled with my gender identity as a male to female and endured severe trauma from a very early age, including abandonment.

(This was the most difficult video I have done. A big thank you to anyone who watches the entire thing!)

Below is the outline and timing of the topics (running time - 38 mins):

0:54 - Childhood Years
8:32 - Preteen & Teen Years
12:04 - Middle School - Abuse
14:27 - Middle School - Anger
16:51 - High School - Abuse
24:25 - High School - Anger & Delusions
29:28 - High School - Aftermath
32:30 - Present Day


As a case study, we like you readers to reflect on the following and share with us your answers:

1) Identify her struggles during her childhood, teens and adulthood?

2) What were the psychopathology or abnormal behaviors she experienced?

3) Give examples of symptoms or dysfuntions that she manifested through her life?

4) Visit the you tube link ( https://www.youtube.com/all_comments?v=8dn0aYm3Mik ) and read through the comments. What lessons can you learn from those  comments?

5) In your assessment is Autumn telling the truth or lies? Why?

Frequently Asked Question: 3 Certificates of Good Moral Character

Implementing Rules and Regulations of Republic Act No. 10029, Known as the "Psychology Act of 2009"

Rule 5 - Licensure Examination

Sec 13-A. Documentary Requirements to the Licensure Examination of Psychometricians

e) Three (3) certificates of good moral character, preferably from school, employer, church, barangay captain duly signed by the issuing authority and duly notarized under oath.

Source - http://prc.gov.ph/uploaded/documents/BoardofPsychology-IRR.pdf

Personality Disorders:Video Playlist and DSM Description

Image source - http://unitycounsellingservice.co.uk/wp-content/uploads/2014/07/RDHTTVOV12_P111.jpg

Note the link of the video playlist below was uploaded in 2009, before the DSM 5 publication. So largely what is being discussed are those of  DSM4-TR.

 


Personality Disorders & DSM 4

Personality disorders
Cluster A (odd)
Paranoid    Schizoid    Schizotypal
Cluster B (dramatic)
Antisocial   Borderline   Histrionic    Narcissistic
Cluster C (anxious)
Avoidant   Dependent   Obsessive–compulsive
Not specified
Depressive    Passive-aggressive  Sadistic    Self-defeating    Psychopathy

Personality disorders are a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition and inner experience, exhibited across many contexts and deviating markedly from those accepted by the individual's culture. These patterns develop early, are inflexible and are associated with significant distress or disability.^[1] The definitions may vary some according to other sources.^[2][3]

Official criteria for diagnosing personality disorders are listed in the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, and in the mental and behavioral disorders section of the International Statistical Classification of Diseases and Related Health Problems, published by the World Health Organization. The DSM-5 published in 2013 now lists personality disorders in exactly the same way as other mental disorders, rather than on a separate 'axis' as previously.^[4]

The Diagnostic and Statistical Manual of Mental Disorders (currently the DSM-5) provides a definition of a General personality disorder that stress such disorders are an enduring and inflexible pattern of long duration that lead to significant distress or impairment and are not due to use of substances or another medical condition. DSM-5 lists ten personality disorders, grouped into three clusters. The DSM-5 also contains three diagnoses for personality patterns that do not match these ten disorders, but nevertheless exhibit characteristics of a personality disorder.^[18]

Cluster A (odd disorders)

• Paranoid personality disorder: characterized by a pattern of irrational suspicion and mistrust of others, interpreting motivations as malevolent
• Schizoid personality disorder: lack of interest and detachment from social relationships, and restricted emotional expression
• Schizotypal personality disorder: a pattern of extreme discomfort interacting socially, distorted cognitions and perceptions

Cluster B (dramatic, emotional or erratic disorders)

• Antisocial personality disorder: a pervasive pattern of disregard for and violation of the rights of others, lack of empathy
• Borderline personality disorder: pervasive pattern of instability in relationships, self-image, identity, behavior andaffects often leading to self-harm and impulsivity
• Histrionic personality disorder: pervasive pattern of attention-seeking behavior and excessive emotions
• Narcissistic personality disorder: a pervasive pattern of grandiosity, need for admiration, and a lack of empathy

Cluster C (anxious or fearful disorders)

• Avoidant personality disorder: pervasive feelings of social inhibition and inadequacy, extreme sensitivity to negative evaluation
• Dependent personality disorder: pervasive psychological need to be cared for by other people.
• Obsessive-compulsive personality disorder (not the same as obsessive-compulsive disorder): characterized by rigid conformity to rules, perfectionism and control

Other personality disorders

• Personality change due to another medical condition – is a personality disturbance due to the direct effects of a medical condition
• Other specified personality disorder – symptoms characteristic of a personality disorder but fails to meet the criteria for a specific disorder, with the reason given
• Personality disorder not otherwise specified

Signs and symptoms

In the workplace

Depending on the diagnosis, severity and individual, and the job itself, personality disorders can be associated with difficulty coping with work or the workplace - potentially leading to problems with others by interfering with interpersonal relationships. Indirect effects also play a role; for example, impaired educational progress or complications outside of work, such as substance abuse and co-morbid mental diseases, can plague sufferers. However, personality disorders can also bring about above-average work abilities by increasing competitive drive or causing the sufferer to exploit his or her co-workers.^[41][42]

In 2005, psychologists Belinda Board and Katarina Fritzon at the University of Surrey, UK, interviewed and gave personality tests to high-level British executives and compared their profiles with those of criminal psychiatric patients at Broadmoor Hospital in the UK. They found that three out of eleven personality disorders were actually more common in executives than in the disturbed criminals:

• Histrionic personality disorder: including superficial charm, insincerity, egocentricity and manipulation
• Narcissistic personality disorder: including grandiosity, self-focused lack of empathy for others, exploitativeness and independence.
• Obsessive-compulsive personality disorder: including perfectionism, excessive devotion to work, rigidity, stubbornness and dictatorial tendencies.^[43]

According to leading leadership academic Manfred F.R. Kets de Vries, it seems almost inevitable these days that there will be some personality disorders in a senior management team.^[44]

Relationship with other mental disorders

The disorders in each of the three clusters may share some underlying common vulnerability factors involving cognition, affect and impulse control, and behavioral maintenance or inhibition, respectively, and may have a spectrum relationship to certain syndromal mental disorders:^[45]

• Paranoid or schizotypal personality disorders may be observed to be premorbid antecedents of delusional disorders orschizophrenia.

• Borderline personality disorder is seen in association with mood and anxiety disorders and with impulse control disorders, eating disorders, ADHD, or a substance use disorder.

• Avoidant personality disorder is seen with social anxiety disorder.

Diagnosis

The DSM-IV lists General diagnostic criteria for a personality disorder, which must be met in addition to the specific criteria for a particular named personality disorder. This requires that there be (to paraphrase):^[46]

• An enduring pattern of psychological experience and behavior that differs prominently from cultural expectations, as shown in two or more of: cognition (i.e. perceiving and interpreting the self, other people or events); affect (i.e. the range, intensity, lability, and appropriateness of emotional response); interpersonal functioning; or impulse control.
• The pattern must appear inflexible and pervasive across a wide range of situations, and lead to clinically significant distress or impairment in important areas of functioning.
• The pattern must be stable and long-lasting, have started as early as at least adolescence or early adulthood.
• The pattern must not be better accounted for as a manifestation of another mental disorder, or to the direct physiological effects of a substance (e.g. drug or medication) or a general medical condition (e.g. head trauma).

The ICD-10 'clinical descriptions and diagnostic guidelines' introduces its specific personality disorder diagnoses with some general guideline criteria that are similar. To quote:^[47]

• Markedly disharmonious attitudes and behavior, generally involving several areas of functioning; e.g. affectivity, arousal, impulse control, ways of perceiving and thinking, and style of relating to others;
• The abnormal behavior pattern is enduring, of long standing, and not limited to episodes of mental illness;
• The abnormal behavior pattern is pervasive and clearly maladaptive to a broad range of personal and social situations;
• The above manifestations always appear during childhood or adolescence and continue into adulthood;
• The disorder leads to considerable personal distress but this may only become apparent late in its course;
• The disorder is usually, but not invariably, associated with significant problems in occupational and social performance.

The ICD adds: "For different cultures it may be necessary to develop specific sets of criteria with regard to social norms, rules and obligations."

Source - http://en.wikipedia.org/wiki/Personality_disorder 


Personality Disorders & DSM 5

Personality disorders are associated with ways of thinking and feeling about oneself and others that
significantly and adversely affect how an individual functions in many aspects of life. They fall within
10 distinct types: paranoid personality disorder, schizoid personality disorder, schizotypal personality
disorder, antisocial personality disorder, borderline personality disorder, histrionic personality, narcissistic personality disorder, avoidant personality disorder, dependent personality disorder and obsessive-compulsive personality disorder.

DSM-5 moves from the multiaxial system to a new assessment that removes the arbitrary boundaries
between personality disorders and other mental disorders. A hybrid model that included evaluation of impairments in personality functioning (how an individual typically experiences himself or herself as well as others) plus five broad areas of pathological personality traits. Although this hybrid proposal was not accepted for DSM-5’s main manual, it is included in Section III for further study. Using this alternate methodology, clinicians would assess personality and diagnose a personality disorder based on an individual’s particular difficulties in personality functioning and on specific patterns of those pathological traits.

The hybrid methodology retains six personality disorder types:
• Borderline Personality Disorder
• Obsessive-Compulsive Personality Disorder
• Avoidant Personality Disorder
• Schizotypal Personality Disorder
• Antisocial Personality Disorder
• Narcissistic Personality Disorder

Each type is defined by a specific pattern of impairments and traits. This approach also includes a diagnosis of Personality Disorder—Trait Specified (PD-TS) that could be made when a Personality Disorder is
considered present, but the criteria for a specific personality disorder are not fully met. For this diagnosis,
the clinician would note the severity of impairment in personality functioning and the problematic
personality trait(s). This hybrid dimensional-categorical model and its components seek to address existing issues with the categorical approach to personality disorders.

Source - http://www.dsm5.org/Documents/Personality%20Disorders%20Fact%20Sheet.pdf

Symptom, Diagnosis and Dysfunction

A symptom (from Greek σύμπτωμα, "accident, misfortune, that which befalls",^[1] from συμπίπτω, "I befall", from συν- "together, with" and πίπτω, "I fall") is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality. A symptom is subjective,^[2] observed by the patient,^[3] and cannot be measured directly,^[4] whereas a sign is objectively observable. For example, paresthesia is a symptom (only the person experiencing it can directly observe their own tingling feeling), whereas erythema is a sign (anyone can confirm that the skin is redder than usual). Symptoms and signs are often nonspecific, but often combinations of them are at least suggestive of certain diagnoses.

Types of Symptoms 

1) Chronic, relapsing or remitting,  asymptomatic. 

2) Constitutional or general symptoms are those that are related to the systemic effects of a disease (e.g., fever, malaise, anorexia, and weight loss). They affect the entire body rather than a specific organ or location.

3) The terms "chief complaint", "presenting symptom", "iatrotropic symptom", or "presenting complaint" are used to describe the initial concern which brings a patient to a doctor. The symptom that ultimately leads to a diagnosis is called a "cardinal symptom".

4) Non-specific symptoms are those self-reported symptoms that do not indicate a specific disease process or involve an isolated body system. For example, fatigue is a feature of many acute and chronic medical conditions, whether physical or mental, and may be either a primary or secondary symptom. Fatigue is also a normal, healthy condition when experienced after exertion or at the end of a day.

5) Positive symptoms are symptoms that most individuals do not normally experience but are present in the disorder. It reflects an excess or distortion of normal functions (i.e., experiences and behaviours that have been added to a person’s normal way of functioning.^[8] Examples are hallucinations, delusions, and bizarre behavior.^[5]

6) Negative symptoms are functions that are normally found in healthy persons, but that are diminished or not present in affected persons. Thus, it is something that has disappeared from a person’s normal way of functioning.^[8] Examples are social withdrawal, apathy, inability to experience pleasure and defects in attention control.^[6]

Symptom versus Sign

A symptom can more simply be defined as any feature which is noticed by the patient. A sign is noticed by other people. It is not necessarily the nature of the sign or symptom which defines it, but who observes it.

A feature might be a sign or a symptom, or both, depending on the observer(s). For example, a skin rash may be noticed by either a healthcare professional as a sign, or by the patient as a symptom. When it is noticed by both, then the feature is both a sign and a symptom.

Some features, such as pain, can only be symptoms, because they cannot be directly observed by other people. Other features can only be signs, such as a blood cell count measured in a medical laboratory.

Source http://en.wikipedia.org/wiki/Symptom

DIAGNOSIS

Diagnosis is the process of identifying a disorder by examining its signs and symptoms, an identification of a disorder by such a process (Oxford Dictionary of Psychology, 2009).

A diagnosis is a label to a set of symptoms that tend to occur with one another (Hoeksema).  

The diagnosis of a psychological disorder requires evaluation by a trained mental‐health professional and usually an interview, administration of a variety of personality tests (and in some cases, neuropsychological tests), and gathering of background (including medical) information about the individual. The mental‐health professional arrives at a diagnosis by comparing this information to that in the Diagnostic and Statistical Manual of Mental Disorders (DSM), which uses a system devised by the American Psychiatric Association to classify psychological disorders (http://www.cliffsnotes.com/sciences/psychology/psychology/abnormal-psychology/diagnosis-of-psychological-disorders).

DYSFUNCTION

Dysfunction means abnormality or deviation from the norms of social behavior in a way regarded as maladaptive or impaired. 

It is a deficit in the ability to perform tasks. It is often a result of effects of symptoms but there is not always a direct correlation (Cara and MacRae, 2005). 

Ateneo de Naga University Holds Regional Orientation on the Licensure Examination for Psychologists and Psychometricians

College of Arts and Sciences, Psychology Department and The Graduate School of Ateneo de Naga University in partnership with The Psychological Association of the Philippines (PAP) and the Professional Regulatory Board of Psychology will hold a Regional Orientation on the Licensure Examination for Psychologists and Psychometrician on 9 August 2014  at 8 AM - 5PM at the Arrupe Convention Center, Ateneo de Naga University, Ateneo Avenue, Naga City. 

For inquiries call:
Office of the Psychology Department
472-2368/ 472-2631 / 473-9773 loc 2591

Image Source -https://www.facebook.com/148851815387/photos/a.10150469570850388.363899.148851815387/10152144356460388/?type=1&theater

Link source - PAP - https://www.facebook.com/148851815387/photos/a.10150469570850388.363899.148851815387/10152144356460388/?type=1 

Related link: http://psychometricpinas.blogspot.com/2014/06/psychology-first-profession-to-offer.html

Infographics: Stigma and Mental Health

Source - http://www.visualistan.com/2014/06/stop-stigma-realities-of-mental-health.html

Poll: Handa ka na ba para sa 2014 Psychometrician Licensure Exam?

Image source - http://sd.keepcalm-o-matic.co.uk/i/keep-calm-only-99-days-to-go.png

99 days to go before the 2014 Psychometrician Licensure Exam, are you ready? Still reading and reviewing? What are your review strategies? For most of us doing self-review have you covered most of the subjects?

It is advised to focus your attention on the TOS and familiarize yourself with outcome-based assessment - here and here. 

We hope soon we can post sample of our outcome-based quizzes.

So until then, we hope to see you all the exam date and of course the oath taking of Psychometrician Board Passers!