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This research summary
suggests that millions of average adult
Americans are psychologically "wounded"
- i.e. their wise
Most clinicians and media professionals don't acknowledge this yet, and call
the symptoms of these wounds ''personality
disorders'' - a form of ''mental illness.''
See my comments after this summary. The links and hilights
are mine. - Peter Gerlach, MSW
+ + +
CHICAGO – Almost one in five
young American adults has a personality disorder that interferes with
everyday life, and even more abuse
alcohol or drugs, researchers reported Monday in the most extensive
study of its kind.
The disorders include problems such as obsessive or compulsive tendencies
and anti-social behavior that can sometimes lead to violence. The study
also found that fewer than 25
percent of college-aged Americans with mental problems get treatment.
One expert said personality disorders may be over-diagnosed. But others said
the results were not surprising since previous, less rigorous evidence has
suggested mental problems are common on college campuses and elsewhere.
Experts praised the study's scope —
face-to-face interviews about numerous disorders with more than 5,000 young
people ages 19 to 25
— and said it spotlights a problem college administrators need to address.
Study co-author Dr. Mark Olfson
of Columbia University and New York State Psychiatric Institute called the
widespread lack of treatment particularly worrisome. He said it should alert
not only "students and parents, but also deans and people who run college
mental health services about the need to extend access to treatment."
Counting substance abuse, the study found that
nearly half of young people surveyed
have some sort of psychiatric condition, including students and non-students.
Personality disorders were the second
most common problem behind drug or alcohol abuse as a single category. The
disorders include obsessive, anti-social and paranoid behaviors that are not
mere quirks but actually interfere with ordinary functioning.
The study authors noted that recent tragedies such as fatal shootings at
Northern Illinois University and Virginia Tech have raised awareness about
the prevalence of mental illness on college campuses.
They also suggest that this age group might be particularly vulnerable.
"For many, young adulthood is characterized by the pursuit of greater
educational opportunities and employment prospects, development of personal
relationships, and for some, parenthood," the authors said. These
circumstances, they said, can result in stress that triggers the start or
recurrence of psychiatric problems.
The study was released Monday in
Archives of General Psychiatry. It was based on interviews with 5,092
young adults in 2001 and 2002.
Olfson said it
took time to analyze the data, including weighting the results to
extrapolate national numbers. But the authors said the results
would probably hold true today.
The study was funded with grants from the National Institutes of Health, the
American Foundation for Suicide Prevention and the New York Psychiatric
Dr. Sharon Hirsch, a University of Chicago psychiatrist not involved in the
study, praised it for raising awareness about the problem and the high
numbers of affected people who don't get help.
Imagine if more than 75 percent of diabetic college students didn't get
treatment, Hirsch said. "Just think about what would be happening on our
The results highlight the need for mental health services to be housed with
other medical services on college campuses,
to erase the stigma and make it more
likely that people will seek help, she said.
In the study,
trained interviewers, but not psychiatrists, questioned
participants about symptoms. They used an assessment tool similar to
criteria doctors use to diagnose mental illness.
Dr. Jerald Kay, a psychiatry professor at Wright State University and
chairman of the American Psychiatric Association's college mental health
committee, said the assessment tool is considered valid and more rigorous
than self-reports of mental illness. He was not involved in the study.
Personality disorders showed up in similar numbers among both students and
non-students, including the most common one,
obsessive compulsive personality disorder. About 8 percent of young
adults in both groups had this illness, which can include an extreme
preoccupation with details, rules, orderliness and perfectionism.
Kay said the prevalence of personality disorders was higher than he would
expect and questioned whether the condition might be over-diagnosed.
All good students have a touch of "obsessional" personality that helps them
work hard to achieve. But that's different from an obsessional disorder that
makes people inflexible and controlling and interferes with their lives, he
Obsessive compulsive personality disorder differs from the better known OCD,
or obsessive-compulsive disorder, which features repetitive actions such as
hand-washing to avoid germs.
OCD is thought to affect about 2
percent of the general population. The study didn't examine OCD separately
but grouped it with all anxiety disorders, seen in about 12 percent of
college-aged people in the survey.
The overall rate of other disorders was also pretty similar among college
students and non-students.
Substance abuse, including drug
addiction, alcoholism and other drinking that interferes with school or
work, affected nearly one-third of those in both groups.
Slightly more college students than non-students were problem drinkers — 20
percent versus 17 percent. And slightly more non-students had drug problems
— nearly 7 percent versus 5 percent.
In both groups, about 8 percent had phobias and 7 percent had
Bipolar disorder was slightly more common in non-students, affecting almost
5 percent versus about 3 percent of students.
This Associated Press summary of a
2002 psychiatric research report is misleading
in several ways.
It doesn't define
it promotes the outdated concept that
"personality (mental) disorders" are illnesses, which fosters the
presumption that sufferers are "sick" and should be medicated. I propose
that they are
which is less tainted and more accurate.
the article suggests that "college mental
health services" should be more accessible to students, and that college
administrators should give more attention to this health problem to
combat how few affected students seek help. It offers no suggestion for
that the real explanation for not seeking help for "mental problems" are
(a) widespread ignorance about
"mental problems," and (b) denial among young people and their parents
the article (and original clinical report?)
offers no suggestion aboutwhy these young people have
"personality (and other) disorders." It implies that college
administrators are responsible for providing help, rather than young
adults and their parents.
The study did not try to assess how many parents of affected young
adults had significant "personality disorders" or suggest a
cause-and-effect correlation. Over
36 years clinical experience suggests a high
psychologically-wounded parents and troubled kids.
The study's authors suggest that the stress
of living independently contributes to the scope of these "psychiatric
problems." This unrelated study suggests that "mental
illness" can begin by age 14, and this one concludes American kids begin drinking "at an early age.".
This study implies that "substance abuse" is
a "psychiatric condition," rather than a reflexive self-medicating
strategy to mute intolerable
this report implies that
significant obsessions and compulsions are "mental disorders"
(illnesses), rather than symptoms of birthfamily dysfunction and
inherited psychological wounds.
this article's headline suggests one fifth
of Americans aged 19 to 25 have (a type of mental problem), but the
body of the summary says "almost half" of respondents had "some sort of
psychiatric condition." So readers may underestimate the scope of this
My experience suggests that
typical psychologically-wounded people are prone to reality distortions,
including minimizing, exaggerating, and denying. This suggests
that the data from this study based on personal interviews is probably
understating the real frequency of psychological "disorders" (wounds) in
this summary doesn't specify whether the
"trained interviewers" sought evidence of psychological wounds -
excessive shame, guilts, fears, reality distortions, trust disorders,
an inability to bond and empathize. In my
36-year experience as a family therapist and
inherited wounds are common among people
who survived early-childhood abandonment, neglect, and abuse
12/2/08 Google search on "personality disorders" revealed
that these research findings were widely summarized and generalized in the US and international media.