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10-16-2006, 03:58 AM | #1 | |||
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Gender Bias in Diagnosing Personality Disorders
Sam Vaknin October 15, 2006 Ever since Freud, more women than men sought therapy. Consequently, terms like "hysteria' are intimately connected to female physiology and alleged female psychology. The DSM (Diagnostic and Statistical Manual, the bible of the psychiatric profession) expressly professes gender bias: personality disorders such as Borderline and Histrionic are supposed to be more common among women. but the DSM is rather even-handed: other personality disorders (e.g., the Narcissistic and Antisocial as well as the Schizotypal, Obsessive-Compulsive, Schizoid, and Paranoid) are more prevalent among men. Why this gender disparity? There are a few possible answers: Maybe personality disorders are not objective clinical entities, but culture-bound syndromes. In other words, perhaps they reflect biases and value judgments. Some patriarchal societies are also narcissistic. They emphasize qualities such as individualism and ambition, often identified with virility. Hence the preponderance of pathological narcissism among men. Women, on the other hand, are widely believed to be emotionally labile and clinging. This is why most Borderlines and Dependents are females. Upbringing and environment, the process of socialization and cultural mores all play an important role in the pathogenesis of personality disorders. These views are not fringe: serious scholars (e.g., Kaplan and Pantony, 1991) claim that the mental health profession is inherently sexist. Then again, genetics may be is at work. Men and women do differ genetically. This may account for the variability of the occurrence of specific personality disorders in men and women. Some of the diagnostic criteria are ambiguous or even considered "normal" by the majority of the population. Histrionics "consistently use physical appearance to draw attention to self." Well, who doesn't in Western society? Why when a woman clings to a man it is labeled "codependence", but when a man relies on a woman to maintain his home, take care of his children, choose his attire, and prop his ego it is "companionship" (Walker, 1994)? The less structured the interview and the more fuzzy the diagnostic criteria, the more the diagnostician relies on stereotypes (Widiger, 1998). Quotes from the Literature Quote:
Gender differences in the structure of narcissism: a multi-sample analysis of the narcissistic personality inventory - Brian T. Tschanz, Carolyn C. Morf, Charles W. Turner - Sex Roles: A Journal of Research - Issue: May, 1998 Quote:
Butler, D., & Gels, F. L. (1990). Nonverbal affect responses to male and female leaders: Implications for leadership evaluations. Journal of Personality and Social Psychology, 58, 48-59. Quote:
Reproduced with Author's permission Sam Vaknin (samvak.tripod.com) is the author of Malignant Self Love - Narcissism Revisited and other books.He served as a columnist for online publications such as Central Europe Review, Global Politician, PopMatters, United Press International (UPI) (as Senior Business Correspondent), editor in The Open Directory and Suite101 and, until recently, the Economic Advisor to the Government of Macedonia.
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