Public Affairs: Questioning that study on personality disorders

Ainsley Deer, Contributor

Sometime ago, I read the research findings of psychiatrist Fred Hickling and psychologist Vanessa Paisley, as reported in The Gleaner recently. The article stated that nearly one million adult Jamaicans suffer from personality disorders. According to the authors, this rate of personality disorder in the Jamaican population is significantly higher than the rate of six to 15 per cent identified internationally.

The authors went on to suggest that their findings explain the high risk of behavioural dysfunction in the Jamaican population and would account for our high rates of murder and violence, rape, other sexual atrocities, and crimes such as theft and praedial larceny. The submission also made reference to the atrocious driving of our motorists, hooligan behaviour of our children in schools, and the crass disregard for truth in our society.

As an occupational psychologist and researcher myself, rather than blindly accepting the findings and pronouncements of the psychiatrist (Hickling) and psychologist (Paisley), and, in the process, labelling nearly half the population of Jamaica as being psychologically challenged, I proceeded to ask myself some questions pertaining to the article, namely:

Why is it that when we as 'mentally ill' people (adults and children alike) leave Jamaica and go abroad the majority of us do so well in whatever field of endeavour we find ourselves despite racial and socio-economic challenges? This applies even to those who choose to live a life of crime.

How do we compare with other nations who have had a similar history of slavery and colonisation? In fact, how do we compare with our Ame-rican neighbours?

Was the social-economic background of the sample skewed in one direction or another?

Were the samples measured against a Jamaican norm, or did we use an instrument that was developed in another culture, which could bring its statistical reliability and validity into question?

Do we not all have some degree of mental illness, and if so, how do we differ from cultures that are similar to ours and other cultures that, although unlike ours, display extreme manifestations of mental disorder? A case in point is the frequently reported cases of random killings among the American school population.

How do we measure against the Japanese, in whose culture 50 years ago mental institutions were a cultural taboo? Today, suicide and mental facilities are commonplace.

Jamaica, for the last 40-plus years, has been exposed to enormous social and economic pressures. Sustained pressures of the kind we have been experiencing will eventually affect the individual/ nation physically, emotionally, and behaviourally. To what extent might the behavioural dysfunction referred to by the authors be a function of the sustained pressures under which this nation has been placed by those in authority and our decision makers?

What are the racial/ethnic dimensions of these results? Since crimes of theft, murder, praedial larceny, and violence are more prevalent lower down the social ladder where most of Jamaica's blacks reside, are we to conclude from the findings that most black Jamaicans are mentally ill?

Although the findings may be applicable to some Jamaicans, how realistic is a number of 1,000,000 of a population of fewer than 3,000,000?

As one writer (Albert Waite, PhD) observes, during the 1960s-'70s, large numbers of Jamaican children entering Britain were labelled educationally subnormal simply because they were tested using research instruments that were normalised on English children. When I entered secondary school in Britain at the age of 11, the then headmaster declared that although I was a "bright" student, he could not place a Jamaican in an 'A' stream because "he had to give us time to catch up". As Dr Waite further pointed out, at the time, it was not recognised that most Jamaican children would not know, for example, what a tube (as in the London Transport) was. So they performed poorly on the educational tests - we had to be given time to 'catch up'. In fact, all the black kids were told by one teacher at high school that we were not university material. That was my sole reason at the time for applying for a place in a university - to prove him wrong.

Dr Waite further made the point that most Jamaicans are expressive in their mannerisms, as one might readily observe in a game of dominoes. If a typical English domino player were to watch a typical Jamaican game, he might readily conclude that the Jamaicans are among Hickling and Paisley's 40 per cent who display personality disorders. Someone once jokingly said to me that an Englishman's definition of a domino game is four black men trying to mash up a square table.

Most Jamaicans who occupy higher socio-economic strata had our beginnings in rather humble settings, and although socially and economically we have evolved into the upper echelons of society, our personalities have not changed significantly. I submit that the very things like our expressiveness, which may be viewed in negative terms by some, are the said factors that may well account for our success in other quarters.

I did a pilot study some years ago to compare Jamaican and British professionals using some 31 constructs of personality. The study utilised a series of questionnaires, based on a deductive model of personality, which can be used to give a self-report measure of a person's typical ways of behaving. The model included occupationally relevant scales of personality conceptually defined, but empirically tested and refined to provide a detailed description of personality, appropriate primarily for use with professional and managerial groups. The scales fall under three headings: relationships with people; thinking style; and feelings and emotions. The 31st scale termed consistency measured the extent to which the respondent answered in a socially desirable manner.

The data were statistically analysed and statistically significant differences were determined between two means if a T-test table shows a value of less than 0.05. Apart from getting a higher consistency score than their British counterparts, the Jamaican sample showed significant differences - had higher scores - in 11 constructs: persuasive, socially confident, democratic, data rational, behavioural (psychologically minded), innovative, forward planning, detail conscious, optimistic, active, achieving. The Jamaican sample also showed statistical differences in a further 10 constructs: controlling, independent, outgoing, caring, artistic, change orientated, conceptual, conscientious, tough minded, competitive. In the latter case, although the Jamaican sample showed statistical difference - had higher scores than their British counterparts - the difference was too small to have any practical value. Interestingly, the British sample showed significant difference - had higher scores - in only three of the 31 constructs. They can be expected to be more traditional, decisive, and display better emotional control.

This study clearly indicates that Jamaican professionals are temperamentally very resilient when compared to their British counterparts. I have no doubt that comparable results may be produced if similar studies are conducted with other more developed societies.

That is why when we are given the opportunity to excel, we do so well despite the odds. Wherever you go around the world, if it is not in academia, we find Jamaicans doing well in music or sports, and those who choose to channel their energies in a negative direction also 'excel' in their chosen field. Our children are no exception.

So why is it that, given all of these admirable temperamental attributes, we cannot seem to lift our country out of its present state of decadence?

I do not believe that it is because we suffer from the mental illness of personality disorder, according to Hickling and Paisley, but it is more because those who are given stewardship over the social, economic, natural, and cultural resources of this country do not create the space for this hidden talent of our people to find expression. But first, we must recognise that we are a special people, and if we are given the opportunity, we will change the world for the better. If not, we will change it for the worse.

We are not mentally ill; we are just angry and frustrated because the space is not being created in our own country and by our own people for us to grow and excel.

Success of relationships

The personality of an individual is the factor that most determines the success of relationships in the workplace (Unterberg, 2003). It is your personality (above your qualifications, training, years of service, skills, technical abilities, etc) that dictates how you prioritise your work, make decisions, complete tasks, follow directives, work with colleagues, comply with policies, and respond to management. No one could dispute the fact that Jamaicans, when given the space to excel, almost invariably do well.

Thus, if 40 per cent of Jamaicans are suffering from personality disorders, how do we account for our success in more developed economies? Perhaps our 'craziness' is working in our favour and/or the space is created to enable the free flow of our creative juices.

The Diagnostic and Statistical Manual of Medical Disorders - Fourth Edition - Text Revision, defines personality disorders as an enduring pattern of perceiving, relating to, and thinking about oneself and the world that impairs social and occupational functioning. Two primary characteristics are extreme difficulties in relationships with others; and problems regulating one's thinking, feelings, and impulses.

In a general sense, this does not hold true for our brothers and sisters who have traded Jamaica for greener pastures. But if, perchance, Hickling and Paisley are correct, we are not alone. According to the latest research, 14.8 per cent (30.8 million) of American adults meet DSM-IV-TR diagnostic criteria for at least one personality disorder (Grant, et al, 2004). This figure suggests double the prevalence of clinical depression and an almost equal rate compared to substance abuse (Lynch & Horton, 2004).

The common dynamic between all personality disorders is a lack of self-awareness. This is not borne out by my own research, according to which, my Jamaican sample was significantly persuasive, socially confident, behavioural, innovative, forward planning, optimistic, and achieving. These are not the traits that one would associate with persons who lack self-awareness.

In light of the foregoing, while I am willing to admit that some Jamaicans may have fallen victim to personality disorders, I doubt that 40 per cent is a realistic percentage. Clearly, more work is needed if we are to embrace the authenticity of the work of Hickling and Paisley. Until then, let us not be too perturbed about personality disorders, as in all appearances, they are working for us.

Ainsley Deer is an occupational psychologist and CEO of Training Dynamics and Consultants. Email feedback to columns@gleanerjm.com and tdc@cwjamaica.com.