You liken yourself to this association as if you were the spokesperson for them.
What? How in the world have I likened myself to the APA simply by sharing their position? I am, quite clearly, representing myself as a non-expert who defers to the consensus expert position in the field.
In your posts you go well beyond citing the standard to interpreting it with such unqualified statements as "Dr. G cannot possibly know anything of diagnostic value about Trump's thought processes, behavior outside the view of cameras, his functioning level, his interpersonal relationships, his probability of actually being dangerous to anyone"
Talk about an out-of-your-depth proclamation.
That is not you citing Dr F, or you pointing out which things in the diagnostic exam are missing and providing examples.
That is me summarizing the positions of the APA, Dr. F and other experts that have been cited throughout this thread. It's also just a little bit of "no ****, Sherlock" thinking: Part of diagnosing a personality disorder is understanding the subject's inner experience. How can you know anything about the way another person actually thinks and feels if you've never even met them or spoken with them? You can't! That's the purpose of the interview tools, questionnaires and other validated diagnostic tools and that's exactly what is missing when you don't examine the patient in person.
That is you applying what you read on the Net to the public positions of well qualified psychiatrists on Trump's mental status.
When those "well qualified" psychiatrists are not using any validated method of diagnosis, then it's appropriate to call them out on that.
I can give my qualified opinion, my education and license back that up and I cited a number of references showing how diagnosing simple psychiatric conditions are indeed within the scope of family practice.
You can chose not to buy it. I'm fine with that.
I know full well what the scope of family practice is. It does not include diagnosis and treatment of complex mental conditions like NPD. Sure, a family doc/nurse may strongly suspect that one of their patients suffers from NPD and they may even be right; after all, they know the patient and treat them. But anything other than minor depression, anxiety, etc -and especially complex and controversial issues like personality disorders- should be referred to a psychiatrist for complete evaluation and treatment. In any case, those are patients that the family practice doc/nurse knows and interacts with. How can they say anything about someone they don't know?
I cite other professionals with much greater experience and education than I have who support my position. You can side with Dr F, no problem.
When those professionals are not following any validated standard and haven't presented any evidence to support them, I think the choice is easy.
But keep in mind what Dr F's argument is. It's not that he can't assess Trump's extreme narcissism. Dr F just doesn't think Trump is impaired by the condition.
Right. He can be narcissistic and not be "dangerously mentally ill."
You try to argue with ad homs dissing nurse practitioners
That's ridiculous. I haven't dissed Family Nurse Practitioners by pointing out the limits of their training and experience. It's not an ad hom to point out that someone's credentials are not as all-encompassing as they think they are.
and equating dissenting medical opinions to the global warming deniers who happen to have credentials. In this case it's not the same thing, at all.
In both cases we have a minority of experts in the field who disagree with the mainstream position. In order to accept the position of the minority, they need strong evidence that the majority is wrong. It's exactly the same thing.
You are trying to apply a standard you read on the Net, but instead of just citing it, you try to argue it's application and the lack of qualifications one needs to argue that application are evident.
Good thing they aren't really my arguments. All I'm doing is citing the relevant standards which have been formulated by the professional organization who wrote the DSM-V. You accept the authority of the DSM-V, even if it has some flaws. Therefore, there's no reason for you not to accept the authority of the organization that created it. It's their argument that no diagnosis should be rendered without a personal examination.
Source
“There’s been an increasing flurry of activity in both the lay and professional literature that suggested that APA’s position was unclear, and some felt it appropriate to comment professionally on public figures,” said Ezra Griffith, M.D., a professor emeritus and senior research scientist in psychiatry at Yale University School of Medicine and chair of APA’s Ethics Committee.
...
Psychiatric evaluations must consider the need for consent and confidentiality, said Griffith. Basing a diagnosis of some political figure seen on television violates the way psychiatry should be practiced.
“There is no direct interaction, no consent, no confidentiality, no examination, and no access to collateral information,” he said. Opinions drawn from such circumstances are thus both unethical and factually uncertain.
That is the prevailing position of the major professional organization of psychiatrists. If you want to argue against that, you are going to need more than just, "I and some psychiatrists disagree with that."
You really should take a step back and consider maybe the in-person exam you are trying to apply to any and every situation doesn't apply.
Why wouldn't it apply in this situation? Simply because you think there's enough evidence? That's clearly not the position of the APA. They seem to think that it's always needed because they specifically state that such diagnoses are unreliable. If you think that it would be reliable in this case, then you need to present evidence showing that this kind of diagnosis is reliable. You won't find it.
That's dogma, not science.
Following a standard of care that is based on the science as it is currently understood is not "dogma." It's just competent, professional practice.
And you still fail to recognize the difference between a case where the amount of evidence for a disorder is as overwhelming as this case. You can't find any expert arguing the in-person exam is needed to make the diagnosis in the case of Trump. They are only arguing 'should'.
Why would they argue it "should" be done if they didn't think it "needs" to be done? There is no standard that says,"Well, if you have a lot of TV footage and anecdotes about the subject, you can go ahead and diagnose them with a complex mental illness."
The arguments are it's unethical to speak up. And one shouldn't diagnose someone from a distance for ethical reasons, not for diagnostic reasons, at least not in the case of Trump.
That is an incorrect summation of the argument. One of the reasons that it's unethical to diagnose someone you haven't examined is that it isn't based on the standard of care:
1. When a psychiatrist comments about the behavior, symptoms, diagnosis, etc. of a public figure without consent, that psychiatrist has violated the principle that psychiatric evaluations be conducted with consent or authorization.
2. Offering a professional opinion on an individual that a psychiatrist has not examined is a departure from established methods of examination, which require careful study of medical history and first-hand examination of the patient. Such behavior compromises both the integrity of the psychiatrist and the profession.
3. When psychiatrists offer medical opinions about an individual they have not examined, they have the potential to stigmatize those with mental illness.
Those "established methods of examination" exist for a reason. I don't need to know that reason to understand that, if the majority of experts think it's important then it's probably important.
