I opened by talking about the general nature of Personality Disorders. There are 10 of them, many of which have obvious titles, some of which are not so evident.
1. Paranoid (they're out to get me)
2. Antisocial (criminals and the assorted lot)
3. Borderline (extreme example.. Fatal Attraction movie)
4. Narcissistic (grandiose, lacking in empathy, think Congress)
5. Avoidant (believe they are inept, fear being embarrassed)
6. Dependent (lack of self-confidence, excessive need to rely on others)
7. Obsessive Compulsive (needs control, strives for perfectionism--as opposed to
A few are not so obvious such as Histrionic (excessive emotion and attention-seeking/hysteria) and Schizoid (detached, no desire to have sexual or social relationships, lacks emotional response, indifferent to social norms).
Personality Disorders are enduring patterns of both behavior and the "inner experiences" that deviate substantially from the person's culture. The disorder typically involves problems in accurately perceiving themselves and others, the nature of emotional expression, the ability to control impulses and the quality of relationships with others.
Personality Disorders are diagnosed in adulthood (after age 18), but they don't just "pop up". The beginning stages of these personality disorders begin in childhood, but because there are so many "variations" of healthy development, it's necessary to wait for many years to see if the pattern is "ingrained". .
The Personality Disorder I discussed today is the one I see as being most closely related to the kids I talked about last week...the neglected kids. These are the ones who are basically ignored by and isolated by their peers...their classmates, teammates. These kids seem to be "out of step" with their peers and the kids see it. A peer group is basically, a thermometer of a kid's social and emotional health. If a kid doesn't belong to any group, it could signal a problem; if a kid belongs to an unhealthy group, it's definitely a problem.
- Incidental events in their lives are perceived as having special meaning. Things they observe are relevant to their lives in ways that make no sense.
- They have "odd beliefs" (magical thinking) that influence their behavior. These odd beliefs could be superstitions, bizarre fantasies or preoccupations.
- They can have unusual experiences regarding perception including "bodily illusions" such as not having control over body parts or feeling that they don't have a body at all.
- They have "odd thinking" or ways of expressing themselves. Their speech can be excessively "elaborated" or extremely simple and awkward. They make connections that others may not make including over-generalizations about people. If a woman has long fingernails, she's evil.
- They have a "flat" or restricted affect. They are not as responsive to others in terms of humor, affection, sadness, disappointment or anger. Their responses are not consistent with the event or the people around them.
- They don't have close friends or close relationships outside of the family.
- Their appearance is "odd". You can't "put their finger on it", but clearly "something" is "up". They dress oddly (shirts buttoned all the way up, wear long sleeves in warm weather), wear clothing that is atypical of their peers (waistband pants), shoes that don't tie.
- They have excessive social anxiety that does not reduce with familiarity of the people. This anxiety is associated with paranoia and is not as much related to negative judgments about themselves.
Of course, anyone with an autistic child can appreciate that some of these behaviors are associated with autism. This is why, when I diagnose a Schizotypal Personality Disorder, I see a great deal of symptoms related to autism as well as to schizophrenia.
Though I have no professional or personal experience with the Sandy Hook Elementary School shooter, I was immediately impressed by news accounts that the shooter's mother (his name will not be mentioned) explained to her other son that the shooter was "autistic". When this information was released, my voice mail system was flooded with worried calls regarding extended family of my autistic clients. My response? In 40 years of working with children have I ever known an autistic child or teen to plot to harm anyone. I told them that there was "something else". That "something else" was likely Schizotypal Personality Disorder.
If a person has been diagnosed with Schizophrenia, Bipolar Disorder, Depression with Psychotic Features, other psychosis or Autism Spectrum Disorder, they don't quality for a Schizotypal Personality Disorder diagnosis. If Schizotypal symptoms are seen before the onset of Schizophrenia, it's described as "premorbid". These conditions can occur in sequence.
If there has been a medical condition (head trauma, viral infection) or substance abuse, Schizotypal can not be diagnosed. [Sorry, just a little "techno'-info".]
All three of the perpetrators shared many of the same features of their early social development and their out of control emotions about being excluded or victimized erupted into rage.
I was surprised to learn that upwards of 2% of the American population may be impacted by Schizotypal Personality Disorder.
Go to your child's school and request an assessment in writing. Don't let them put you off by saying they have to work through interventions first. That's bunk. The federal law says that as a parent, you can request an assessment in writing and the district has to provide you with an assessment plan within 15 days. Once you sign the plan, testing has to be completed and an Individualized Education Plan (IEP) meeting must be held within 90 days. This is a good way to get basic data. REMEMBER: SCHOOLS DO NOT DO DIAGNOSTIC ASSESSMENTS, THEY DO "ELIGIBILITY" ASSESSMENTS. This means they do just enough testing to determine if your child is eligible for a program.
Don't let them scare you, bully or intimidate you. Collect this basic data and get some of your questions answered.
As a parent, you can't live with the consequences of not taking action now.
Do the best you can. TTFN,