Immature personality disorder

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Immature personality disorder
Specialty Psychiatry
Symptoms
  • Lack of stamina [1]
  • Poor adaptation capabilities [1]
Diagnostic method Based on reported symptoms
Differential diagnosis anxiety disorder, autism, phobia, conversion disorder, [2] histrionic personality disorder, dependent personality disorder, passive-aggressive personality disorder

Immature personality disorder was a type of personality disorder diagnosis. It is characterized by lack of emotional development, low tolerance of stress and anxiety, inability to accept personal responsibility, and reliance on age-inappropriate defense mechanisms. [3] It has been noted for displaying "an absence of mental disability", [3] and demonstrating "ineffectual responses to social, psychological and physical demands." [4]

Contents

History

The definition borrowed by the first edition of the DSM (see Diagnosis) was originally published in the Army Service Forces's Medical 203 in 1945 under Immaturity Reactions. It had five subtypes:

Diagnosis

DSM

Immature personality (321), as "Personality trait disturbance", only appeared in the first edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), separately from personality disorders. The DSM defines the condition as follows: [2]

"This category applies to individuals who are unable to maintain their emotional equilibrium and independence under minor or major stress because of disturbances in emotional development. [...] This classification will be applied only to cases of personality disorder in which the neurotic features (such as anxiety, conversion, phobia, etc.) are relatively insignificant, and the basic personality maldevelopment is the crucial distinguishing factor. Evidence of physical immaturity may or may not be present."

Some of its subtypes became separate conditions (see History). In DSM-II "immature" became a type specifier for Other personality disorder (301.89), [5] : 44  and remained unchanged in the DSM-III. [6] : 330  [lower-alpha 1] The condition does not appear in later editions.

ICD

The International Classification of Diseases (ICD) also listed the condition as Immature personality (321) in the ICD-6 [8] and ICD-7. [9] The ICD-8 introduced Other personality disorder (301.8) [10] which became the main diagnosis adding "immature" as a type specifier. This classification was shared by the ICD-9 (301.89) and ICD-10 (F60.8). The specifier was removed in ICD-11.

Mechanics

Early explanations

The underlying mechanism of the disorder was originally explained either as fixation (certain character patterns persisting from childhood to adult life), or as a regressive reaction due to severe stress (reversion to an earlier stage of development). [7]

Poor emotional control "require[s] quick mobilization of defense, usually explosive in nature, for the protection of the ego." In case of dependency "there is a predominant child-parent relationship." The "morbid resentment" of the aggressive type is the result of a "deep dependency" hidden by reaction formation. [7]

Later developments

IPD involves a weakness of the ego, which limits the ability to restrain impulses or properly model anxiety. [3] [ better source needed ] They fail to integrate the aggressive and libidinal factors at play in other people, and thus are not able to parse their own experiences. [3]

It can be caused by a neurobiological immaturity of brain functioning, or through a childhood trauma, or other means. [3]

Prevalence

Determining the prevalence of the disorder in the general population would be difficult because it has not had a separate diagnosis since World War II. As part of Other personality disorder it can be estimated to be a fraction of 1.6% in the United States [11] and 2.4% in Denmark. [12]

A Russian study of military age persons in the Tomsk region between 2016 and 2018 reported that mental and behavioral disorders were detected in 93 out of 685 recruits. 3.6% (25 of them) could be diagnosed with immature personality disorder. [13]

In law and custom

In the 1980s, it was noted that immature personality disorder was one of the most common illnesses invoked by the Roman Catholic Church in order to facilitate annulment of undesired marriages. [14]

In 1978, David Augustine Walton was tried in Barbados for killing two passersby who had offered his mother and girlfriend a ride following an argument, and pleaded diminished capacity resulting from his immature personality disorder; he was nevertheless convicted of murder. [15]

In 1989, a former employee of the Wisconsin Department of Transportation had his claim of discrimination dismissed, after alleging that his employment had been terminated due to his Immature Personality Disorder alongside a sexual fetish in which he placed chocolate bars under the posteriors of women whose driving capabilities he was testing. [16]

A 1994 Australian case regarding unemployment benefits noted that while "mere personal distaste for certain work is not relevant, but a condition (such as immature personality disorder) may foreclose otherwise suitable prospects". [17]

A 2017 study indicated that an individual with immature personality disorder (among other people with personality disorders) was allowed to die through Belgian euthanasia laws that require a medical diagnosis of a life-long condition that could impair well-being. [18]

Notes

  1. ↑ "Other Personality Disorder should be used when the clinician judges that a specific Personality Disorder not included in this classification is appropriate, such as Masochistic, Impulsive, or Immature Personality Disorder. In such instances the clinician should record the specific Other personality Disorder, using the 301.89 code."

Related Research Articles

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Antisocial personality disorder, sometimes referred to as dissocial personality disorder, is a personality disorder characterized by a limited capacity for empathy and a long-term pattern of disregard for or violation of the rights of others, starting before one was 15 years old. Other notable symptoms include impulsivity, reckless behavior, a lack of remorse after hurting others, deceitfulness, irresponsibility, and aggressive behavior.

<span class="mw-page-title-main">Obsessive–compulsive personality disorder</span> Personality disorder involving orderliness

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<span class="mw-page-title-main">Dependent personality disorder</span> Personality disorder

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<span class="mw-page-title-main">Avoidant personality disorder</span> Personality disorder

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<span class="mw-page-title-main">Intermittent explosive disorder</span> Behavioral disorder

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Dissociative disorders (DDs) are a range of conditions characterized by significant disruptions or fragmentation "in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior." Dissociative disorders involve involuntary dissociation as an unconscious defense mechanism, wherein the individual with a dissociative disorder experiences separation in these areas as a means to protect against traumatic stress. Some dissociative disorders are caused by major psychological trauma, though the onset of depersonalization-derealization disorder may be preceded by less severe stress, by the influence of psychoactive substances, or occur without any discernible trigger.

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<span class="mw-page-title-main">DSM-5</span> 2013 edition of the Diagnostic and Statistical Manual of Mental Disorders

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References

  1. 1 2 "Personality disorders". medicineworld.org. Archived from the original on June 21, 2022. Retrieved November 26, 2020.
  2. 1 2 Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association. 1952. p. 98,36.
  3. 1 2 3 4 5 Almeida F, Ribeiro P, Moreira D (September 27, 2019). "Immature Personality Disorder: Contribution to the Definition of this Personality" (PDF). Clinical Neuroscience and Neurological Research International Journal. 2 (2). Troy, Michigan: Academic Strive.
  4. ↑ "Personality disorders :From MedicineWorld.Org". medicineworld.org. Archived from the original on 2022-06-21. Retrieved 2020-10-10.
  5. 1 2 Diagnostic and Statistical Manual of Mental Disorders (2nd ed.). American Psychiatric Association. 1968.
  6. 1 2 3 Diagnostic and Statistical Manual of Mental Disorders (3rd ed.). American Psychiatric Association. 1980.
  7. 1 2 3 "Nomenclature of Psychiatric Disorders and Reactions". War Department Technical Bulletin, Medical 203. Army Service Forces. 1945.
  8. ↑ "International Classification of Diseases, Revision 6". 1948.
  9. ↑ "International Classification of Diseases, Revision 7". 1955.
  10. ↑ "Conversion Tables between ICD-8, ICD-9, ICD-10" (PDF). 1994. p. 14.
  11. ↑ Lenzenweger MF, Lane MC, Loranger AW, Kessler RC (15 Sep 2007). "DSM-IV personality disorders in the National Comorbidity Survey Replication". Biological Psychiatry. 62 (6): 553–564. doi:10.1016/j.biopsych.2006.09.019. PMC   2044500 . PMID   17217923.
  12. ↑ Pedersen L, Simonsen E (November 17, 2014). "Incidence and prevalence rates of personality disorders in Denmark—A register study". Nordic Journal of Psychiatry. 68 (8). Abingdon, England: Taylor & Francis: 543–548. doi:10.3109/08039488.2014.884630. ISSN   0803-9488. PMID   24520919. S2CID   207472992.
  13. ↑ Bokhan NA, Evseev VD, Mandel AI (2019). "Structure and prevalence of mental and behavioral disorders in persons of military age in the Tomsk Region in 2016-2018". Siberian Herald of Psychiatry and Addiction Psychiatry. 4 (105): 26–33.
  14. ↑ Severino SK, Mcnutt ER (March 1984). "The Psychiatrist as Expert Witness: The Roman Catholic Church Marriage Tribunal". Journal of the American Academy of Psychiatry and the Law . 12 (1). Bloomfield, Illinois: American Academy of Psychiatry and the Law: 49–66. doi:10.1177/009318538401200106. S2CID   158806167.
  15. ↑ Kok LP, Cheang M, Chee KT (1990). Diminished Responsibility: With Special Reference to Singapore. Kent Ridge, Singapore: NUS Press. pp. 157–158. ISBN   9789971691387.
  16. ↑ "Decision order" (PDF). werc.wi.gov. 1989. Retrieved November 26, 2020.
  17. ↑ Carney T (2003). "Disability and Social Security: Compatible or Not?". Australian Journal of Human Rights. 9 (2). Abingdon, England: Taylor & Francis: 139–172. doi:10.1080/1323238X.2003.11911110. S2CID   158299198.
  18. ↑ Dierickx S, Deliens L, Cohen J, Chambaere K (December 2017). "Euthanasia for people with psychiatric disorders or dementia in Belgium: analysis of officially reported cases". BMC Psychiatry. 17 (1). London, England: BioMed Central: 203. doi: 10.1186/s12888-017-1369-0 . ISSN   1471-244X. PMC   5481967 . PMID   28641576. S2CID   3237745.
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