“Ok this guy is actually right about Torres, but I still have to pontificate about the non-existent harms of armchair diagnosis rather than just admit it”
(what harms? This particular individual isn’t going to get any worse because I gave him an entirely accurate diagnosis, and while psychiatric diagnoses are invariably more fuzzy clusters than precise categories, there’s absolutely no reason not to engage in justified pattern-matching when you have sufficient evidence, which we really do in this case. No one goes around saying “Will MacAskill has a PhD and has written multiple well-received books”, we just say “Will MacAskill is a smart guy”, even though “smart” is also a pretty fuzzy category!)
Being smart isn’t stigmatized. Having borderline personality disorder definitely is.
There is a tendency in broader society to use armchair diagnosis to demean and belittle people with whom one disagrees. That increases stigma for people who do have mental health conditions.
A person’s medical conditions are private, so speculating as to what conditions they may have is ordinarily an invasion of that privacy.
There’s even a rule of medical ethics for psychiatrists that they—who are arguably qualified to be handing out armchair diagnoses—not to do so. While I don’t always agree with that rule where the opinion is offered to voters considering the mental health of a candidate for president (which was the original context), I think it quite sound here.
As potentially relevant here, the differential includes particularly bipolar spectrum disorders, but also major depression, schizophrenia, attention-deficit/hyperactivity disorder, and posttraumatic stress disorder.
If one of the ways a person is acting unusually is holding grudges against people they once thought highly of (or against movements they were formerly a part of), I’d also consider NPD and pathological narcissism for the differential diagnosis (the latter has a vulnerable subtype that has some overlap with BPD but is separate construct). I’m adding this to underscore your point that a specific diagnosis is difficult without a lot of context.
I also agree with not wanting to add to the stigma against people with personality disorders. A stigma means some commonly held association that is either wrong or unfairly negative. I think the risk with talking about diagnoses instead of specific symptoms is that this can unfairly harm the reputation of other people with the same diagnosis. BPD in particular has 9 symptom criteria, of which people have to only meet 5 in order to be diagnosed. So, you can have two people with BPD who share 1 symptom out of 9.
Another way in which talk about personality disorders can be stigmatizing is if the implication or connotation is something like “this person is irredeemable.” To avoid this connotation (if we were to armchair-diagnose people at all), I would add caveats like “untreated” or “and they seem to lack insight.” Treatment success for BPD without comorbid narcissism is actually high, and for NPD it’s more difficult but I wouldn’t completely give up hope.
Edit: Overall, I should say that I still agree with the comments that sometimes it can make sense to highlight that a person’s destructive behavior makes up a pattern and is more unusual than what you see in conflicts between people without personality disorders. However, I don’t know if it is ever necessary for forum users to make confident claims about what specific type of cluster b personality disorder (or other, related condition) someone may have. More generally, for the reasons I mentioned in the discussion around stigma, I would prefer if this subject was handled with more care than SuperDuperForecasting was giving it. I overall didn’t downvote their initial comment because I think something in the vicinity of what they said is an important hypothesis to put out there, but SuperDuperForecasting is IMO hurting their own cause/camp in the way they were talking about it.
“Ok this guy is actually right about Torres, but I still have to pontificate about the non-existent harms of armchair diagnosis rather than just admit it”
(what harms? This particular individual isn’t going to get any worse because I gave him an entirely accurate diagnosis, and while psychiatric diagnoses are invariably more fuzzy clusters than precise categories, there’s absolutely no reason not to engage in justified pattern-matching when you have sufficient evidence, which we really do in this case. No one goes around saying “Will MacAskill has a PhD and has written multiple well-received books”, we just say “Will MacAskill is a smart guy”, even though “smart” is also a pretty fuzzy category!)
Being smart isn’t stigmatized. Having borderline personality disorder definitely is.
There is a tendency in broader society to use armchair diagnosis to demean and belittle people with whom one disagrees. That increases stigma for people who do have mental health conditions.
A person’s medical conditions are private, so speculating as to what conditions they may have is ordinarily an invasion of that privacy.
I have no idea what your professional qualifications are, but differential diagnosis of mental disorders is actually not easy. As potentially relevant here, the differential includes particularly bipolar spectrum disorders, but also major depression, schizophrenia, attention-deficit/hyperactivity disorder, and posttraumatic stress disorder.
There’s even a rule of medical ethics for psychiatrists that they—who are arguably qualified to be handing out armchair diagnoses—not to do so. While I don’t always agree with that rule where the opinion is offered to voters considering the mental health of a candidate for president (which was the original context), I think it quite sound here.
If one of the ways a person is acting unusually is holding grudges against people they once thought highly of (or against movements they were formerly a part of), I’d also consider NPD and pathological narcissism for the differential diagnosis (the latter has a vulnerable subtype that has some overlap with BPD but is separate construct). I’m adding this to underscore your point that a specific diagnosis is difficult without a lot of context.
I also agree with not wanting to add to the stigma against people with personality disorders. A stigma means some commonly held association that is either wrong or unfairly negative. I think the risk with talking about diagnoses instead of specific symptoms is that this can unfairly harm the reputation of other people with the same diagnosis. BPD in particular has 9 symptom criteria, of which people have to only meet 5 in order to be diagnosed. So, you can have two people with BPD who share 1 symptom out of 9.
Another way in which talk about personality disorders can be stigmatizing is if the implication or connotation is something like “this person is irredeemable.” To avoid this connotation (if we were to armchair-diagnose people at all), I would add caveats like “untreated” or “and they seem to lack insight.” Treatment success for BPD without comorbid narcissism is actually high, and for NPD it’s more difficult but I wouldn’t completely give up hope.
Edit: Overall, I should say that I still agree with the comments that sometimes it can make sense to highlight that a person’s destructive behavior makes up a pattern and is more unusual than what you see in conflicts between people without personality disorders. However, I don’t know if it is ever necessary for forum users to make confident claims about what specific type of cluster b personality disorder (or other, related condition) someone may have. More generally, for the reasons I mentioned in the discussion around stigma, I would prefer if this subject was handled with more care than SuperDuperForecasting was giving it. I overall didn’t downvote their initial comment because I think something in the vicinity of what they said is an important hypothesis to put out there, but SuperDuperForecasting is IMO hurting their own cause/camp in the way they were talking about it.