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Betsy Saneholtz's avatar

Well said again!! I really appreciate the constructive suggestions at the end. It left me with hope rather than despair.

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Erm's avatar

I found this beautifully thought through and affecting. Thank you.

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Dr Simon Rogoff's avatar

Thanks Erm

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Scapegoat Healing Rebecca LMFT's avatar

Excellent article. As a clinician, if someone presented to you with a high degree of impulsivity and seemed to have a lot of compulsive behaviors, would assessing for NPD at the top of your 'rule out' list or would you look more toward ADHD or similar?

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Dr Simon Rogoff's avatar

Hi Rebecca, thanks for your comment and question. I think the answer depends on alot of context as to what the person wants help with and the history of the problem. In terms of the different personality disorders, BPD (and antisocial pd) is the more impulsive. But it seems increasingly that traits of BPD and NPD and antisocial traits are no respectors of these subcategories in the DSM. People can have traits of different subtypes of PD.

What i would expect in the personality disorder case (npd, bpd), would be more interpersonal aspects. For example, when impulsivity is at its worst, there would normally be an interpersonal trigger event behind it.

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Betsy Saneholtz's avatar

I agree. I saw a comparison of mental health as more of a stove with knobs versus a linear spectrum. We may have a similar set of knobs but they are set at different temperatures/symptoms/degrees for each individual

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Dr Simon Rogoff's avatar

Hi Betsy, yes that works and fits well with the new dimensional approach to personality difficulties. There are 5 personality trait domains - maybe 4 hobs and a grill control!

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Betsy Saneholtz's avatar

🤣💖 Exactly!

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