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Illinois Divorce: Personality Disorders and the New DSM

Personality Disorders affect the quality of marriages, and when the conflict and distortions in a marriage lead to a divorce and custody case, the harmful elements of the personality disorder can be raised and inflamed in the divorce case: intense anger, blaming, targeting, false allegations, parental alienation.

As Bill Eddy (expert and author of Splitting) has described, probably the most prevalent personality disorder in family court is Borderline Personality Disorder (BPD) — more commonly seen in women. BPD may be characterized by wide mood swings, intense anger even at benign events, idealization (such as of their spouse — or attorney) followed by devaluation (such as of their spouse — or attorney). Also common is Narcissistic Personality Disorder (NPD) — more often seen in men. There is a great preoccupation with the self to the exclusion of others. This may be the vulnerable type, which can appear similar to BPD, causing distorted perceptions of victimization followed by intense anger (such as in domestic violence or murder, for example the San Diego case of Betty Broderick). Or this can be the invulnerable type, who is detached, believes he is very superior and feels automatically entitled to special treatment.

It is then notable that the study committee on the DSM-5 is considering doing away with the NPD diagnosis, along with four other traditional DSM diagnoses. The committee seems to feel that the new DSM should create a “menu” of traits, and require the clinician to focus on the traits, rather than naming the cluster of traits as a specific diagnosis.

Diagnosis is helpful in psychology, as these diagnostic terms give a framework for treatment and can be helpful in assessing, for example, the fitness of a parent in a custody case. How these traits affect the ability of a parent to co-parent is an important consideration in a custody case.

The new DSM is due to be published in 2013. It will be interesting to see how the debate over the elimination of NPD and other disorders is continued by clinicians over the next few years. I will continue to track these debates and developments, recognizing that the advancements (and reversals) made in the field of psychology are important to the understanding of parenting qualities that meet the best interests of children in contested divorce and custody cases.