No wonder I am having such troubles with the VA! I just finished reading a report about us and our results after taking the MMPI-2 that was written way back in 1983 and then repeated in 1985. It stated that because we as MTF's test similarly to borderline personality disordered patients we should be considered as BPD spectrum patients ourselves. My psychiatrist was trained in this era and he seems to be treating me like he agrees with this crap study.
Has anyone else run into this line of thinking from the so called hellping professions?
Huggs
Emily
I haven't had an issue at all with my Doctors..
Nor does someone I know who is getting their treatment the same place you are... (They are not a member here..)
That's why the UofM sexual health part of the dept of family medicine and community heath,
doesn't use the test at all for any type of what may or not, be gender dysphoria.
The test is flawed and if they would just read up on whats really been going forward with gender identities,...
They just may turn the corner like most every one else in the proffesion.
Ativan
I am being treated in the addiction medicine clinic. I don't know what would happen if I was in the mood clinic it might be different.
I know that I don't have borderline personality according to past providers. I only have one symptom of nine according to the DSM-IV and that is suicidality. But, mine is under control because I ask for help when ever I start feeling out of control. I agree that I have depression. But the diagnosis of BPD just isn't appropriate for me.
I have been told that the Program in Human Sexuality at the U of Minnesota uses the MMPI-2 with all clients.
I requested that I be tested using the Structured Clinical Interview for DSM and it was denied because I tested normal on the MMPI-2. The psychologist who gave me the test didn't support the BPD diagnosis, but the psychiatrists think they are smarter than everyone else.
Huggs
Emily
What is needed to appeal and/or obtain a second opinion?
I'm not sure I like the MMPI test. I took it once and had it's results run twice. It says that I fit into a group that is at risk of substance abuse, and that my results for a male says I have feminine interests but as a woman, it says I have masculine interests.
Quote from: Emily Ray on October 20, 2011, 09:38:57 PM
I have been told that the Program in Human Sexuality at the U of Minnesota uses the MMPI-2 with all clients.
PHS uses two 1 hour interview/therapy like sessions during diagnosis where they ask questions and give "homework" questions (most notably the pedophile/sex offender questionnaire).
Usually they then recommend group sessions along with regular therapy sessions before referral to U of MN physicians for hrt (although that policy might have changed since I was there). MMPI comes into play before they will make a recommendation for surgery
Quote from: Emily Ray on October 20, 2011, 09:38:57 PM
I am being treated in the addiction medicine clinic. I don't know what would happen if I was in the mood clinic it might be different.
I know that I don't have borderline personality according to past providers. I only have one symptom of nine according to the DSM-IV and that is suicidality. But, mine is under control because I ask for help when ever I start feeling out of control. I agree that I have depression. But the diagnosis of BPD just isn't appropriate for me.
I have been told that the Program in Human Sexuality at the U of Minnesota uses the MMPI-2 with all clients.
I requested that I be tested using the Structured Clinical Interview for DSM and it was denied because I tested normal on the MMPI-2. The psychologist who gave me the test didn't support the BPD diagnosis, but the psychiatrists think they are smarter than everyone else.
Huggs
Emily
Any competent professional doesn't use objective assessments to make any diagnosis, let along suggest comorbid diagnoses, I can assure you that much (key word being competent). It's people who use assessments improperly and treat people with diagnoses they aren't specialized in that give all of us clinical psychologists a bad name.
The MMPI-2 gives information as to what types of people test similarly, but
NOT to suggest that, for instance, MTF individuals are borderline. Any "professional" making that assumption is not going to help you and you should find a new provider! The reason the MMPI-2 provides information as to what individuals test similarly is to direct the provider to rule out one or the other, NOT to suggest dual-diagnosis. For example, a lot of symptoms of depression are similar to symptoms of mania; it all depends on the person. Professionals need to know when assessments will fail at differentiating between similar symptomology in order to avoid inappropriate treatment; in this case, giving anti-depressants to someone with mania.
PHS at UMN uses the MMPI-2 as an efficient way to gather general information about a client; it's just how things happen in the present-day reality of managed care. My advisor did his post-doc at PHS and I've got a fair amount of experience with PHS, and really the MMPI-2 and similar assessments are used as a way to save patients $. It helps a provider put their radar up for potential depression, anxiety, personality issues, and things of the like, so they know what is and isn't appropriate for a particular client. Any competent professional uses that information as
informational only, and then goes on to create an
individualized treatment plan.
Unfortunately, there are a lot of really awful standards and practices put in place by corporations and insurance providers. Programs like PHS have the unfortunate task of being the medium between their patients and the awful "system." It's very tempting to blame the provider or the program (not saying you're doing this), but the patient always has the right to question practices and seek a second opinion, and should see those rights as responsibilities in their own treatment. If somebody comes to me with a problem that I don't specialize in, of course I want to help them, but I can only do so much if it's not my specialty. I can't kick a patient to the curb if they won't heed my advice to find a different, more specialty-competent provider.
EDIT: I'm not necessarily advocating for PHS or the MMPI-2, here, I'm just pointing out their rationale.
And to Michelle:
It depends on how much you trust your current provider. You could ask your current provider, but if you're already dissatisfied, you may have to do the legwork yourself.
I think that this study might be on to something. I fit the description for borderline personality disorder perfectly. ;D
but thats just me
I don't want to pick on PHS at the UofM. I think the could be doing things better, but they are leagues ahead of where I was going for treatment at the VAMC Minneapolis.
Fionabell,
If any of the symptoms that are used to diagnos BPD can be explained by an Axis 1 diagnosis then you can't use it to diagnos BPD. Many of the symptoms used to describe BPD are also present with Gender Dysphoria. I even have ADHD and severe depression that can make the picture even more confusing to a doctor who rarely ever sees a trans patient and has not had proper training to determine the differences. Why it is important to know the cause? Because we treat the cause not the symptom. For us that means bringing the body in line with what we believe we should be. For those with BPD it means DBT therap
Y. DBT therapy is never, ever going to make me happy about a life in this body. I will only find relief through surgery.
Huggs
Emily
Quote from: Emily Ray on October 20, 2011, 07:15:28 PM
No wonder I am having such troubles with the VA! I just finished reading a report about us and our results after taking the MMPI-2 that was written way back in 1983 and then repeated in 1985. It stated that because we as MTF's test similarly to borderline personality disordered patients we should be considered as BPD spectrum patients ourselves. My psychiatrist was trained in this era and he seems to be treating me like he agrees with this crap study.
Has anyone else run into this line of thinking from the so called hellping professions?
Huggs
Emily
Quote
Could you provide the references?
Here is recent study, no correlation -Jen61
Psychiatr Prax. 2008 Apr;35(3):135-41. Epub 2007 Aug 2.
[Borderline personality disorder and transsexualism].
[Article in German]
Seikowski K, Gollek S, Harth W, Reinhardt M.
Source
Universität Leipzig, Klinik für Dermatologie, Venerologie und Allergologie, Andrologische Abteilung. Kurt.Seikowski@medizin.uni-leipzig.de
Abstract
OBJECTIVE:
The study addresses the question whether, as often assumed, the symptoms of borderline personality disorders occur more frequently in transsexuals or not.
METHODS:
We examined 164 transsexuals. The subjects completed the following questionnaires: The Borderline-Personality Inventory (BPI), the Freiburg Personality Inventory (FPI) and the Questionnaire for Assessment of One's Own Body (FbeK).
RESULTS:
In 80 % of all the examined transsexuals, there was evidence of symptoms of neither a borderline personality disorder nor of other personality disorders. If borderline symptoms occurred, they were predictable from the variables depressivity, low composure, low sociability and lack of confidence in relation to the external appearance.
CONCLUSIONS:
The data obtained refute the often-assumed increased relationship between borderline personality disorders and transsexuality. It should be assumed that a borderline personality disorder is primarily a psychiatric illness, while transsexuality is a disorder of gender identity in which secondary borderline symptoms may arise in some cases
I don't know how I came accros this article, but it goes to show how much stigma ther is against the LGBT community by the psychiatric profession. In this study they looked at 145 lgbt patients who we're dual diagnosed 94% were borderline. This study was published in july of this year in the American Journal of Addiction. I know with absolute certainty my Doctors at the VA read this study. One of them is the Director of the addiction medicine fellowship program. Now I don't know what went wrong in that study, but something obviously did. It goes against all that we know about psychiatric prevalence of diagnosis for there to be 135 out of 145 people diagnosed with borderline personality disorder. In the sources I have read only 2% of the general population has BPD.
http://onlinelibrary.wiley.com/doi/10.1111/j.1521-0391.2011.00155.x/abstract (http://onlinelibrary.wiley.com/doi/10.1111/j.1521-0391.2011.00155.x/abstract)
Huggs
Emily
I thought the general drug addicts have more than this disorder anyway. Not all of us here do not do those drugs. I hope the VA didn't use that study!
Joelene
what's dbt therapy?
shrinks from my local UK gender clinic last year refused to testify that TSism isn't a mental illness.
If they keep us labelled mentally ill then they can defraud the NHS by charging for unnecesary assessmnets and letters.
DBT is Dialectical Behavioral Therapy. It is a recent offshoot of Cognitive Behavioral Therapy. It is used primarily as a treatment for Borderline Personality Disorder. It has been very effective as a treatment for BPD and if you think that you might benefit from DBT I think you should look into it. For me it was the wrong diagnosis and wrong treatment. The primary difference between DBT and GT that I can determine is the position they take on our behaviors, thoughts and feelings. GT believes in affirming our thoughts about ourself, our transgender behaviors, and cross gender feelings. DBT believes that if we learn new skills and new ways of interpersonal relationships we will gain emotional regulation. In doing so they have to get you to believe that your old skills are the source of the problem. For me, my skills are not the problem, my body is! The sooner I can get that changed the sooner I can go on to live to the best of my ability in my prefered gender. This isn't rocket science!
Huggs
Emily