Re: OT DID & idolect

--- In conlang@yahoogroups.com, Tristan McLeay <conlang@T...> wrote:
> [snip]
>  Schizophrenia is diagnosed only if a particular set of
> patterns involving defects in the perception or expression of
> reality are met.
DSM-IV
http://cebmh.warne.ox.ac.uk/cebmh/elmh/nelmh/schizophrenia/diagnosis/d
sm/page1.html
says
"Diagnostic criteria

A. Characteristic symptoms: Two (or more) of the following, each
present for a significant portion of time during a 1-month period (or
less if successfully treated):

delusions
hallucinations
disorganized speech (e.g., frequent derailment or incoherence)
grossly disorganized or catatonic behavior
negative symptoms, i.e., affective flattening, alogia, or avolition
Note: Only one Criterion A symptom is required if delusions are
bizarre or hallucinations consist of a voice keeping up a running
commentary on the person's behavior or thoughts, or two or more
voices conversing with each other.

B. Social/occupational dysfunction: For a significant portion of the
time since the onset of the disturbance, one or more major areas of
functioning such as work, interpersonal relations, or self-care are
markedly below the level achieved prior to the onset (or when the
onset is in childhood or adolescence, failure to achieve expected
level of interpersonal, academic, or occupational achievement).

C. Duration: Continuous signs of the disturbance persist for at least
6 months. This 6-month period must include at least 1 month of
symptoms (or less if successfully treated) that meet Criterion A
(i.e., active-phase symptoms) and may include periods of prodromal or
residual symptoms. During these prodromal or residual periods, the
signs of the disturbance may be manifested by only negative symptoms
or two or more symptoms listed in Criterion A present in an
attenuated form (e.g., odd beliefs, unusual perceptual experiences).

D. Schizoaffective and Mood Disorder exclusion: Schizoaffective
Disorder and Mood Disorder With Psychotic Features have been ruled
out because either (1) no Major Depressive Episode, Manic Episode, or
Mixed Episode have occurred concurrently with the active-phase
symptoms; or (2) if mood episodes have occurred during active-phase
symptoms, their total duration has been brief relative to the
duration of the active and residual periods.

E. Substance/general medical condition exclusion: The disturbance is
not due to the direct physiological effects of a substance (e.g., a
drug of abuse, a medication) or a general medical condition.

F. Relationship to a Pervasive Developmental Disorder: If there is a
history of Autistic Disorder or another Pervasive Developmental
Disorder, the additional diagnosis of Schizophrenia is made only if
prominent delusions or hallucinations are also present for at least a
month (or less if successfully treated).

Differential diagnosis

Some disorders have similar or even the same symptom. The clinician,
therefore, in his/her diagnostic attempt has to differentiate against
the following disorders which he/she needs to rule out to establish a
precise diagnosis.

Psychotic Disorder Due to a General Medical Condition, delirium, or
dementia;
Substance-Induced Psychotic Disorder;
Substance-Induced Delirium;
Substance-Induced Persisting Dementia;
Substance-Related Disorders;
Mood Disorder With Psychotic Features;
Schizoaffective Disorder;
Depressive Disorder Not Otherwise Specified;
Bipolar Disorder Not Otherwise Specified;
Mood Disorder With Catatonic Features;
Schizophreniform Disorder;
Brief Psychotic Disorder;
Delusional Disorder;
Psychotic Disorder Not Otherwise Specified;
Pervasive Developmental Disorders (e.g., Autistic Disorder);
Childhood presentations combining disorganized speech (from a
Communication Disorder) and disorganized behavior (from Attention-
Deficit/ Hyperactivity Disorder);
Schizotypal Disorder;
Schizoid Personality Disorder;
Paranoid Personality Disorder.
"


> [snip]
> And yes, there are multiple types of schizophrenia:
DSM-IV
http://cebmh.warne.ox.ac.uk/cebmh/elmh/nelmh/schizophrenia/diagnosis/d
sm/page1.html
says
"Subtypes

1. Paranoid Type
A type of Schizophrenia in which the following criteria are met:

Preoccupation with one or more delusions or frequent auditory
hallucinations.
None of the following is prominent: disorganized speech, disorganized
or catatonic behavior, or flat or inappropriate affect.

2. Catatonic Type
A type of Schizophrenia in which the clinical picture is dominated by
at least two of the following:

motoric immobility as evidenced by catalepsy (including waxy
flexibility) or stupor
excessive motor activity (that is apparently purposeless and not
influenced by external stimuli)
extreme negativism (an apparently motiveless resistance to all
instructions or maintenance of a rigid posture against attempts to be
moved) or mutism
peculiarities of voluntary movement as evidenced by posturing
(voluntary assumption of inappropriate or bizarre postures),
stereotyped movements, prominent mannerisms, or prominent grimacing
echolalia or echopraxia

3. Disorganized Type
A type of Schizophrenia in which the following criteria are met:

All of the following are prominent:
disorganized speech
disorganized behavior
flat or inappropriate affect
The criteria are not met for Catatonic Type.

4. Undifferentiated Type
A type of Schizophrenia in which symptoms that meet Criterion A are
present, but the criteria are not met for the Paranoid, Disorganized,
or Catatonic Type.

5. Residual Type
A type of Schizophrenia in which the following criteria are met:

Absence of prominent delusions, hallucinations, disorganized speech,
and grossly disorganized or catatonic behavior.
There is continuing evidence of the disturbance, as indicated by the
presence of negative symptoms or two or more symptoms listed in
Criterion A for Schizophrenia, present in an attenuated form (e.g.,
odd beliefs, unusual perceptual experiences).
Associated features

Learning Problem
Hypoactivity
Psychosis
Euphoric Mood
Depressed Mood
Somatic or Sexual Dysfunction
Hyperactivity
Guilt or Obsession
Sexually Deviant Behavior
Odd/Eccentric or Suspicious Personality
Anxious or Fearful or Dependent Personality
Dramatic or Erratic or Antisocial Personality
"

> [snip]
> The diff between positive and negative symptoms is that positive
> ones are ones experienced in schizophrenia that normal people don't
> have (e.g. hallucinations), and negative ones are ones *not*
> experienced in schizophrenia that normal people *do* have (e.g. a
> flat affect).
A medium-recent article I read said the "negative" signs and symptoms
were probably actually more diagnostic -- or at least more
characteristic -- than the "positive" signs and symptoms.

Or, at least, that was the case among the particular abilities they
were discussing; the abilities to detect and "fill in" a pattern.

One test they performed, for instance, was to take a photograph of
some object (e.g. a wristwatch), glue it to a sticky-board, cut it
into many pieces, then remove some of the pieces.  It turned out that
all types of schizophrenics needed a larger minimum of pieces left in
to detect that it was a wristwatch, than all types of non-
schizophrenic people (whether mentally healthy or otherwise).

So, the specific "negative symptoms" they had in mind were, inability
to detect and/or fill-in a pattern most "normal, healthy" people
could detect and fill-in.

The specific "positive symptoms" they had in mind were, the tendency
to detect and/or fill-in a pattern under circumstances in which
most "normal, healthy" people would detect no pattern; and to "fill
it in" in a manner that most "normal, healthy" people would eschew.

Thus a paranoid schizophrenic, for instance, can detect proof that he
or she is being stalked by the CIA, out of evidence that a "normal"
person would think does not form a pattern; or, at most, forms an
innocuous one.

> One interesting thing is that for some inexplicable reason,
> Catatonic Schizophrenia is not often seen in more developed
> societies. It used to be common in the West, but as our society has
> developed it's become rare; whereas it's still seen in less
> developed societies.
That's interesting.

>
> Hope this was interesting
> [snip]
I thought so.

>> I wondered if people with DID do exhibit differences in idiolect
>> in their different personae.
>> [snip]
> [snip]
> Actually, come to think of it, I have a vague recollection of a
> mention of someone who had an American accent in one personality,
> and an Australian one in another
When I used to go with my parents to Charismatic meetings, there was
a certain woman who preached in a Scottish accent, but had a South-of-
-the-Mason-Dixon-line, West-of-the-Mississippi U.S.American accent
when not in the pulpit.

Sorry I can't remember her name.

I don't know if she suffered from any disorder at all (except that
some psych(iatr,olog)ists consider _all_ religious behaviour
pathologicial -- e.g. the MMPI, but not the DSM).

Anyway, I witnessed this first-hand.

> [snip]
> --
> Tristan.
Thanks, Tristan.

Tom H.C. in MI