"Enclosed please find a supplemental addition to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)....."
"301.75 Identiopathic Personality Disorder
Diagnostic Features
The essential feature of Identiopathic Personality Disorder is a pervasive pattern of acute, inflexible mimetic attachment to an exaggerated and overly demonstrative identification of oneself with perceived subversive ideology. This pattern typically begins in early adulthood (though increasing reports of onset as early as age 10 are becoming significant) and persists well into the 30s and beyond, and is present in a variety of contexts.
This pattern has also been referred to as Identiopathy, Subsociopathy, and Inverted Self-Aggrandizing Psychosis.
Individuals with Identiopathic Personality Disorder can only perceive, relate to, or think about their environment or themselves through the filter of a perceived collective truth, specifically one which is—or appears to be—at odds with, or subversive of, received dominant cultural truths (Criterion 1). In a parody of Paranoid Personality Disorder, with which it is often mistaken, their attraction to oversimplified formulations of the world tend to make them wary and dismissive of ambiguous situations. This tendency resembles Paranoid Personality Disorder, as these individuals often behave as fanatics and form tightly knit groups with others who share "their" belief system. Unlike individuals with Paranoid Personality disorder, their understanding about the nature of the world is not in the least abstract or fantastical, but is extremely concrete and literal (Criterion 2).
Individuals with this disorder experience severe subjective distress regarding an overly rigid certainty on issues relating to identity, including long-term goals, lifestyle, friendship patterns, moral values, and group loyalty. They have a pattern of immediate demonstrative and intense relationships based predominantly on the notion of shared vision and struggle (e.g., social, political, personal). These relationships, though believed to be enduring, tend to be unstable over time. Beneath the sense of camaraderie lies a thinly veiled hierarchy based on a competitive mastering of the group identity (e.g., A exuberantly tells B, "I too once thought that until C called me on it..."). They demand consistency from themselves, others, and their environment, and are unable to accept or reconcile conflicting beliefs and desires. These relationships also tend to have an undercurrent of distrust which grows out of a fear that the individuals involved will prove inadequate to the demands of the group identity. As a result, these individuals often experience low-grade feelings of trepidation and one-up-myn-ship (Criterion 3).
Individuals with Identiopathic Personality Disorder cling to their identities in order to authenticate their existence in a manner that can be readily observed and taken note of by others. In doing so, the individual solemnifies his sense of self (Criterion 4). Identiopathic Personality disorder is often initially misdiagnosed as Borderline Personality Disorder, since in both we see a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and a chronic feeling of emptiness. However, whereas individuals with Borderline Personality Disorder suffer from a markedly and persistently unstable self-image or sense of self, in the Identiopathic Personality Disorder the sense of self is, although deeply flawed, unfortunately quite stable. Individuals with this disorder may perceive themselves as possessing superior intellectual powers and a vast capacity for empathy, causing them to have an unreasonable expectation of deference or automatic compliance with their values and beliefs (Criterion 5); they often appear haughty and arrogant, and believe they can only be understood by, or should only associate with, other "special people" (e.g., individuals believed to be like-minded, more knowledgeable and unique, or relevant to "the cause"). These individuals may interpret a lack of deference or directed difference of opinion to be a personal attack, and may quickly assume a combative and defensive stance. This is because their sense of self is inextricable from a rigid belief system. Because this enduring personality trait, which is exhibited in a wide range of social and personal contexts, deviates markedly from the expectations of dominant culture, individuals with this disorder tend to suffer distress and/or impairment in social and occupational settings."
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