Are Psychologists All Mad?

A fun little study from 2008 looked at rates of self-reported mental illness in mental health professionals: Psychologists' And Social Workers' Self-Descriptions Using DSM-IV Psychopathology

The authors did an anonymous survey of clinical psychologists and social workers in Israel.  They found that

The sample of 128 professionals included 63 psychologists and 65 social workers. The presence of Axis I traits (i.e. mental illness) was reported by 81.2%, the three most frequent traits being mood, obsessive-compulsive disorder, and eating disorder. Axis II traits (personality disorders) were reported by 73.4% of subjects, the three most frequent conditions being narcissistic, avoidant, and obsessive-compulsive personality traits.

Take a look:

There were few differences between the two professions although for what it's worth, social workers were more likely to report psychosis and substance abuse problems, while clinical psychologists were more narcisstic, with a full 40% of them admitting to having narcisstic traits. On that note the authors (perhaps unwisely) comment:

While speculative, it may be suggested that narcissistic traits include some important factors in motivating individuals to choose to enter the mental health care profession. In a psychotherapeutic relationship, the  ability to influence and understand another person's psyche may include features of  "narcissistic gratification".

Ouch!

The problem with all this, though, is that it's not clear what reporting "DSM-IV psychopathology" means; people rated their symptoms on a 5 point scale where 1 = "no evidence of the disorder" and 5 is "greatest severity". Most of the reported symptoms were low in severity, but we don't know what "low" is relative to.

If you said that your narcissism was rated "2" out of 5, you might just mean that you have some narcissistic traits sometimes. That's how I'd interpret the question, anyway.

But in that case, what exactly are you saying? Not much. You're not saying you're very narcissistic. You're not saying you're more narcissistic than average: you might well think that most other people would also score a "2", or even higher. You're not actually saying "I am narcissistic" at all, just admitting that you're not wholly un-narcissistic... and who of us can really say that?

The same goes for all the questions. I think this study would have been much more interesting if they'd just asked people whether, in their clinical judgement, they meet criteria for the disorder. Or whether, if they had to assess a patient who was just like them, what would they diagnose them with? Because criteria are what professionals use on their patients, not 5 point scales.

Nachshoni, T., Abramovitch, Y., Lerner, V., Assael-Amir, M., Kotler, M., and Strous, R. (2008). Psychologists' And Social Workers' Self-Descriptions Using DSM-IV Psychopathology Psychological Reports, 103 (1), 173-188 DOI: 10.2466/pr0.103.1.173-188