Hoogbegaafd en ADHD, ADD, Narcisme, OCP, of Antisociaal.

Misdiagnosis and dual diagnoses of gifted children and adults adhd, bipolar, ocd, asperger's, depression, and other diso

Webb, j.t. amend, e.r. webb, n.e. goerss, j. beljan.

Inhoud ADD/ADHD/Hoogbegaafd DSM criteria ADD DSM criteria ADHD Differentiatie ADD/ADHD en hoogbegaafd Narcisme/Hoogbegaafd DSM criteria Narcisme Differentiatie Narcisme en hoogbegaafd. Combinatie Narcisme/Hoogbegaafd Obsessief compulsief/Hoogbegaafd DSM criteria Obsessief compulsief Overeenkomsten Hb/OCP Differentiatie OCP/Hoogbegaafd

Combinatie Hb/Antisociaal DSM criteria Antisociaal (Dit is een extra toevoeging want antisociaal wordt niet in het boek beschreven.)

Combinatie HB/Antisociaal Discussie vragen Inhoudsopgave van het gebruikte boek. Propaganda en prullaria?

ADD/ADHD/Hoogbegaafd

DSM criteria ADD

Het kind heeft onvoldoende aandacht voor details, of maakt achteloos fouten.

Het heeft moeite om aandacht te houden bij dingen die gedaan moeten worden of bij het spelen.

Het lijkt niet te luisteren. Het volgt aanwijzingen niet op of maakt opdrachten

niet af. Het heeft moeite met het organiseren van dingen die

het moet doen. Het gaat dingen uit de weg die het moet doen en die

geestelijke inspanning vragen. Of het heeft een hekel aan dat soort dingen.

Het raakt dingen kwijt die het nodig heeft voor de dingen die gedaan moeten worden.

Het wordt makkelijk afgeleid. Het is vergeetachtig als het bezig is met dagelijkse

dingen.

DSM criteria ADHD

Het kind beweegt onrustig met handen en voeten en zit te draaien op zijn stoel.

Het staat op, als het moet blijven zitten. Het gaat rondrennen of overal op klimmen op

plaatsen waar dat niet hoort. Het kan moeilijk rustig spelen of ontspannende

dingen doen. Het is de hele tijd in de weer en draaft maar door. Het praat aan een stuk door. Het kind antwoordt al, voordat de vraag helemaal

gesteld is. Hij gooit het antwoord er als het ware uit.

Het heeft moeite om op zijn beurt te wachten. Het verstoort bezigheden van anderen.

http://www.trimbos.nl/default19442.html http://www.hulpgids.nl/ziektebeelden/adhd_DSM.htm

Differentiatie ADD/ADHD en hoogbegaafd

Hb-ers vertonen niet in elke situatie ADD/ADHD karakteristieken. De context waarin het gebeurt is belangrijk.

Hb-ers maken bewust keuzes.

Narcisme/Hoogbegaafd

DSM criteria Narcisme

Een diepgaand patroon van grootheidsgevoelens (in fantasie of gedrag), behoefte aan bewondering en gebrek aan empathie, beginnend in vroege volwassenheid en tot uiting komend in diverse situaties zoals blijkt uit vijf (of meer) van de volgende:

1. heeft een opgeblazen gevoel van eigen belangrijkheid (bijvoorbeeld overdrijft eigen prestaties en talenten, verwacht als superieur erkend te worden zonder de erbij horende prestaties)

2. is gepreoccupeerd met fantasieën over onbeperkte successen, macht, genialiteit, schoonheid, of ideale liefde

3. gelooft dat hij of zij "heel speciaal" en uniek is alleen begrepen kan worden door, of hoort om te gaan, met andere heel speciale mensen of mensen (of instellingen) een hoge status

4. verlangt buitensporige bewondering 5. heeft een gevoel bijzondere rechten te hebben, dat wil zeggen onredelijke

verwachting van een uitzonderlijk welwillende behandeling of een automatisch meegaan met zijn of haar verwachtingen

6. exploiteert anderen, dat wil zeggen maakt misbruik van anderen om zijn of haar eigen doeleinden te bereiken

7. heeft gebrek aan empathie (invoelend vermogen): is niet bereid de gevoelens en behoeften van anderen te of zich ermee te vereenzelvigen

8. is vaak afgunstig of meent dat anderen op hem of haar afgunstig zijn 9. is arrogant of toont hooghartig gedrag of houdingen http://www.hulpgids.nl/ziektebeelden/narcistische.htm#dsm

Differentiatie Narcisme en hoogbegaafd

Kenmerken die tegenstrijdig zijn met narcisme: Is zeer competent op/in een gebied. Slechte focus en/of neglect van anderen gebeurt alleen

als geabsorbeerd voor/bij een taak. Laat empathie en sympathie voor anderen zien,

kanbescheiden zijn ondanks goede prestaties. Geeft blijk een idiosyncratische voorkeur te hebben,

anders dan prestatiebehoefte. Laat in de ene setting narcistisch gedrag zien, niet in een

andere setting. Het narcistische gedrag is een relatief nieuw fenomeen. Heeft een positief en realistisch zelfbeeld en een sterk

vertrouwen in zijn kunnen.

Obsessief compulsief/Hoogbegaafd

DSM criteria Obsessief compulsief

Een diepgaand patroon van preoccupatie met ordelijkheid, perfectionisme, beheersing van psychische en intermenselijke processen, ten koste van soepelheid, openheid en efficiëntie, beginnend in vroege volwassenheid en tot uiting komend in diverse situaties zoals blijkt uit vier (of meer) van de volgende:

1. Is gepreoccupeerd met details, regels, lijsten, ordening, organisatie of schema's, hetgeen zover gaat dat het eigenlijke doel uit het oog verloren wordt

2. Toont een perfectionisme dat het afmaken van een taak bemoeilijkt (bijvoorbeeld onvermogen iets af te maken omdat het niet aan eigen overtrokken eisen voldoet)

3. Is overmatig toegewijd aan werk en productiviteit, met uitsluiting van ontspannende bezigheden en vriendschappen (niet te verklaren door een duidelijke economische noodzaak)

4. Is overdreven gewetensvol, scrupuleus en star betreffende zaken van moraliteit, ethiek of normen (niet te verklaren vanuit culturele of godsdienstige achtergrond)

5. Is niet in staat om versleten of waardeloze voorwerpen weg te gooien, zelfs als ze geen gevoelswaarde hebben

6. Is er afkerig van taken te delegeren of met anderen samen te werken, tenzij deze zich geheel onderwerpen aan zijn of haar manier van werken

7. Heeft zich een stijl van gierigheid eigen gemaakt ten aanzien van zichzelf en anderen; geld wordt gezien als iets dat opgepot moet worden voor toekomstige catastrofes

8. Toont starheid en koppigheid.

OCP and Relationship to Giftedness: For decades, clinician lore has suggested that persons with obses sive-compulsive characteristics are

disproportionately persons of at least above-average intelligence, though a search of the literature reveals no research studies documenting this link, and there has been little attempt to relate it to the concept of giftedness. Such a relationship should not be surprising, however, particularly since several studies (e.g., Rogers & Silverman, 1997) have noted a relationship between giftedness and per fectionism.

Persons with OCD or OCPD are also perfectionists in the sense that they worry about their inadequacies and imperfections, which results in feelings of guilt or anxiety. Both gifted persons and persons with OCD or OCPD attempt to manage their perfectionism, anxiety, and guilt through intellectualizing and thinking of ways to relieve ten sion and exert control over their environment.Gifted children and adults spend a great amount of time in thought, and they are characteristically idealists who are concerned with issues of right versus wrong, fairness, high standards, and improving the world (Rogers & Silverman, 1997; Silverman, 2002).

They think about how they could be or how the world should be, and they can envision it. But they can also see clearly how both they and the world fall short of this ideal.Gifted children develop such idealism at a very young age, when they begin experiencing greater and greater control over their environ ment but have not yet come up against and accepted their personal limitations. For many of them, this leads to a feeling of personal respon sibility. They are upset when they see homeless persons, and they are disturbed by images of hungry children.

Some gifted children have diffi culty falling asleep at night because they worry about terrorism and the people who are being hurt and killed throughout the world.

In a manner that is similar to many persons who suffer from OCD, gifted children may worry continually and excessively and have feelings of personal guilt and responsibility. Reassurance does not alleviate their persistent, disturbing thoughts, and distress usually accompanies these thoughts.It is also important to realize that anxiety is contagious, and chil dren often "catch it" from their parents. When children trip and fall, for example, they often look around to gauge how worried they should be. If they see a worried parent, the lower lip goes out and they may begin to wail. Conversely, if they are reassured, they can shrug off a minor tumble. The nature of growing up means a gradual growing away from parents.

A person with OCD who worries or who performs certain rituals in an attempt to decrease worry often recognizes that his thoughts or behaviors are excessive or unreasonable. He may even view them as silly. Trichotillomania (compulsive hair pulling) is such a behavior, in which the person rubs or pulls hair from the scalp, eyebrows, or eyelashes, sometimes to the extent that a bald spot appears. This child may know that the nervous habit is non-productive, but he cannot seem to stop.***The gifted person, on the other hand, often does not see certain rit uals as excessive or unreasonable, and indeed she will be able to describe elaborate scenarios of why and how her thoughts and behaviors are not only reasonable, but also rational and appropriate given the circum stances. When viewed from this perspective, others may even see her point. For example, a pilot may rigidly follow a step-by-step preflight procedure of checking the airplane before allowing people on board always doing things in the same sequence and refusing to be distracted. Most people would find a ritual like this reassuring.

The gifted person's fretting behavior is more often directed toward a positive end, rather than being negatively unproductive, self-critical, or atoning.

Thus, the level of impairment is different for persons with OCD versus those who are gifted. Though the thoughts or behaviors may be similar, the person with OCD is impaired and unable to function; the gifted person is flourishing in his quest to solve the underlying personal characteristics or problems of society that are the origin of his worry.The DSM-IV-TR specifies a frequent relation of OCD and OCPD to perfectionism and to eating disorders, and there is some documenta tion that eating disorders are related to giftedness (Neihart, 1999). Daily and Gomez (1979) reported that 90% of their patients with eating disor ders had IQ scores of 130 or higher, and Rowland (1970) found that more than 30% had measured IQ scores of 120 or above. Blanz, Detzner, Lay, Rose, and Schmidt (1997) likewise found significantly higher IQ scores among adolescents with anorexia nervosa and bulimia. Touyz, Beumont, and Johnstone (1986), however, did not find a relationship between high IQ and eating disorders.The DSM-IV-TR also suggests that a hereditary component likely exists in Obsessive-Compulsive Disorders. Of course, there is a heredi tary component in intellect too. It is unclear how much the two are intertwined.

Overeenkomsten Hb/OCP

Ze zijn perfectionistisch in dat zij zich zorgen maken over hun inadequaatheid en imperfectionisme wat leidt tot gevoelens van angst en schuld. Beide proberen deze gevoelens te rationaliseren door intelectualisatie en manieren bedenken om de gevoelens te dempen en controle over hun omgeving uit te oefenen.

Hb-ers zijn idealisten die zich bezig houden met issues van goed/slecht, eerlijkheid, hoge standaarden en verbetering van de wereld.

Differentiatie OCP/Hoogbegaafd

Een Hb-er kan beargumenteren waarom hij iets perfectionistisch doet. Een OCP-er herkent/geeft toe dat zijn gedrag excessief en onredelijk is, hij zou het zelfs als suf kunnen benoemen.

Een Hb-er doet dingen gericht op een positief einde i.p.v. de productiviteit negatief te beinvloeden.

Combinatie Hb/Antisociaal

DSM criteria Antisociaal Er is vaak sprake van impulsiviteit; beslissingen worden genomen zonder rekening te

houden met de gevolgen, Ze zijn vaak snel geïrriteerd en agressief waarbij ze geen rekening houden met het gevaar voor zichzelf en voor anderen. Er kan sprake zijn van roekeloos autorijden, gevaarlijk seksueel gedrag of drugsmisbruik en ze komen vaak in financiële problemen. Hun gedrag is vaak onverantwoordelijk ten aanzien van de werkgever, familie, vrienden excetera en ze hebben meestal weinig berouw over hun daden. Zelf vinden ze wel terecht was wat ze hebben gedaan. Ze voelen zich vaak verheven boven andere mensen en hebben geen realistisch beeld van zichzelf. Sommigen hebben een talent om anderen voor zich in te nemen. De klachten die ze zelf ervaren zijn vaak: gespannenheid, ontevredenheid, een depressieve stemming en zich snel vervelen. Soms zijn er angstklachten en verslavingsproblemen.1. niet in staat zich te conformeren aan de maatschappelijke norm dat men zich aan de wet moet houden, zoals blijkt uit het bij herhaling tot handelingen komen die een reden voor arrestatie kunnen zijn 

2. oneerlijkheid, zoals blijkt uit herhaaldelijk liegen, het gebruik van valse namen of anderen bezwendelen ten behoeve van eigen voordeel of plezier 

3. impulsiviteit of onvermogen "vooruit te plannen"  4. prikkelbaarheid en agressiviteit zoals blijkt uit bij herhaling komen tot vechtpartijen

of vechtpartijen of geweldpleging  5. roekeloze onverschilligheid voor de veiligheid van zichzelf of anderen  6. constante onverantwoordelijkheid zoals blijkt uit het herhaaldelijk niet in staat zijn

geregeld werk te behouden of financiële verplichtingen na te komen  7. ontbreken van spijtgevoelens, zoals blijkt uit de ongevoeligheid voor of het

rationaliseren van het feit anderen gekwetst, mishandeld of bestolen te hebben.

Combinatie Hb/Antisociaal/Narcisme

In veel onderzoeken komen de OCP trekken bij hoogbegaafden naar voren. Combineren we dit, en de sluwheid van hoogbegaafden, met antisociale trekken, dan hebben we een antisociale in evenwicht. Of een hoogbegaafde in evenwicht, wat je wilt.

Idem voor Narcisme.

Hier een aparte presentatie over de antisociale persoonlijkheid op basis van een boekje van de GGZ.

In het boek waar deze presentatie over gaat wordt geen vergelijking gegeven met de antisociale persoonlijkheid.Blijkbaar komt dit volgens de schrijvers niet voor?

http://www.slideboom.com/presentations/157764/Antisociale-trekken-komen-overal-voor.

Opmerking

Er zijn vele misdiagnoses mogelijk. Voorop staat dat bij een goede anamnese, goede waarneming, en een nuchtere kijk de vergissing niet zal worden gemaakt.

Discussie vragen

Heeft een hoogbegaafde OCP-er meer besef en controle over zijn OCP?

Heeft een hoogbegaafde Narcist zijn narcisme beter in de hand en kent deze de invloed van zijn gedrag op zijn omgeving?

Versterkt hoogbegaafdheid de al aanwezige persoonlijkheid?

Is Narcisme of Antisociaal wel zo slecht? Hebben we het nodig?

Deel van de inhoudsopgave van het gebruikte boek

Contents- Foreword xv- Preface xix- Introduction xxiii- What Is Meant by the Term "Gifted"? xxviii

Are Gifted Children and Adults at Risk for Problems? . . . . xxix - Many Diagnoses? xxxiii

- Role of Health Care Professionals xxxiv

- Chapter 1. Characteristics of Gifted Children and Adults 1- Behavioral Characteristics 4- Frequent Referral Problems for Gifted Children 5- Frequent Referral Problems for Gifted Adults 7- Intensity/Sensitivity/Overexcitabilities 10- Intellectual Overexcitability 11- Imaginational Overexcitability . 12- Emotional Overexcitability 13- Psychomotor Overexcitability .. 14- Sensual Overexcitability. 15 Overexcitabilities and Misdiagnoses 15- Thinking and Learning Styles . .. 16- Problems Associated with "Visual-Spatial"- Non-Linear Thinking/Learning Styles 19- Problems Associated with "Auditory-Sequential"- Linear Thinking/Learning Styles .. 21

- Idealism 22 Peer Relations 22- Asynchronous Development 24- Judgment that Lags behind Intellect 26

Interest Patterns 28 Advanced Interests that Are Unusual, or -- Quite Numerousand Diverse, or Overly

Focused .. 29

- Creativity Problems from Educational Misplacement or Lack of Family 30 - Understanding 31- Diagnoses and Gifted Children and Adults 31

- Chapter 2. Attention-Deficit/ Hyperactivity Disorder 35- ADD/ADHD, Gifted, or Both? 36- Impairment 41- Activity Level 41- Diagnostic Criteria 42- Traditional Attempts at Diagnosing ADD/ADHD 44- Rating Scales 45- Hyperactivity and Impulsivity 48 Tests: Intelligence, Achievement, and Neuropsychological . 49- Personality Testing 49- Hyperfocus 50- Differentiating ADD/ADHD Behaviors from Gifted Behaviors 51- Situational Specificity of Behaviors 52- Gifted Children with ADD/ADHD 54- Medication 55- Similarities and Differences 57- Incompatible or Contradictory Features 58- Summary 59

Chapter 3. Anger Diagnoses 61- Gifted Children and Anger 61- The Anger Diagnoses 65- Oppositional Defiant Disorder 66- Oppositional Behavior in Gifted Children 68- Incompatible or Contradictory Features 69- Conduct Disorder 70- Incompatible or Contradictory Features 73- Intermittent Explosive Disorder 74- Incompatible or Contradictory Features 75- Disruptive Behavior Disorder NOS 75- Incompatible or Contradictory Features 76- Narcissistic Personality Disorder 76- The Narcissism of Giftedness 78- Incompatible or Contradictory Features 82- Summary 82

Chapter 4. - Ideational and Anxiety Disorders 85- Obsessive-Compulsive Disorder 87- Obsessive-Compulsive Personality Disorder 89- Relationship to Giftedness 91- Asperger's Disorder .. Similarities between Asperger's Disorder and Gifted

93 - Behaviors .. 98

Differentiating Characteristics 100

- Situational Specificity . 102 - Introverted or Asperger's Disorder? 103- Incompatible or Contradictory Features . 104- Schizoid Personality Disorder . 105

Similarities to Gifted Children and Adults 106- Incompatible or Contradictory Features . 108- Schizotypal Personality Disorder 109 Similarities to Gifted Children 111- Incompatible or Contradictory Features . 112- Avoidant Personality Disorder 112

- Similarities to Gifted Children and Adults 113- Incompatible or Contradictory Features 115

- Chapter 5. Mood Disorders 117- Bipolar Disorders (formerly called "Manic-Depressive") . . 119 - Characteristics of Bipolar Disorders . .. 119 - Bipolar Disorders in Adolescents and Adults 122 - Bipolar Disorders in Children 122 - Rapid-Cycling Bipolar Disorder in Children 123- Similarities to Gifted Children and Adults . 123- Cyclothymic Disorder 125- Depressive Disorder 125- Dysthymic Disorder 131- Similarities to Gifted Children and Adults . 132- Existential Depression 133- Chapter 6. Learning Disabilities 137- Diagnosing Learning Disabilities 141- Dyslexia and Other Language-Based Learning Disorders . . . 145 - Reading Disorder, Disorder of Written - Production, and Oral Production Disorder .

146 - Writing 147 - Language Production .. 148 - Learning and Memory Problems 148

Prullaria en propaganda?

"Even if you have doubts about the extent of your giftedness, you will really bring your talents to life if you will embrace your drive to become, serve, create, achieve, and contribute.

Self-recognition is not to fuel egotism or elitism, but to align with a more powerful, creative part of you that will let your heart, your knowledge, your talent loose on the world."

[Mary Rocamora, founder and director of the school.

1. General Characteristics Do you have a large vocabulary? Are you multi-talented? Do you have so many interests and abilities that it is hard to focus your energies on developing

any of them to your satisfaction? Are you possessed of an unrelenting (and possibly off-the wall) sense of humor? Can you occupy time usefully without external stimulation? Are you persistently goal-directed in your behavior? Is your creativity apparent in all areas of endeavor? Do you have the need and the energy to develop more capacity?

2. Entelechy “Derived from the Greek word for having a goal, entelechy is a particular type of motivation, need

for self-determination, and an inner strength and vital force directing life and growth to become all one is capable of being. Gifted people with entelechy are often attractive to others who feel drawn to their openness and to their dreams and visions. Being near someone with this trait gives others hope and determination to achieve their own self-actualization." (Deirdre Lovecky, "Warts and Rainbows: Issues in the Psychotherapy of the Gifted", Advanced Development, Jan., 1990)

Are you directed by an inner vision of your purpose in life, or have a dream that is all-consuming? Are you highly motivated to be all you are capable of being? Are you deeply involved in creating your own destiny? Do you continue to believe in yourself and your vision, even when no one else does? Are others attracted to your vision, wanting to participate?

3. The Overexcitabilities (part of the Theory of Emotional Development of Kazimierz Dabrowski), which determine developmental potential:

"The forms of `overexcitability' are particularly prominent in the gifted and creative because there we find a higher level of energy and capacity for sustained effort; enhanced differentiation and aliveness of sensual experience; greater avidity for knowledge, discovery, and attitude of questioning and questing; greater vividness of imagery, richness of associations, and capacity for detailed visualization, and greater depth and intensity of emotional life. One may think of these five forms of overexcitability as the substrate of giftedness and creative talent." (Piechowski, Silverman, Cunningham, & Falk, 1982) ---

A. Psychomotor excitability: Are you a high energy person? Do you love intense physical activity and movement? Do you feel constantly pressured to take action? Are you impulsive? Do you have nervous habits? Are you restless, always on the go, incapable of just relaxing? Do you talk compulsively? Are you a workaholic? B. Sensual excitability: Are you often moved to tears by music or the visual arts? Are you prone to eating and drinking excesses because they give you intense pleasure? Are you adventurous where new sensory experiences are concerned (food, music, erotic

experimentation, different environmental settings, for example)? When you recall an experience, can you also recall the sensory aspects? Is the touch, smell, taste, and sight of sex as important to you as having an orgasm?

C. Intellectual excitability: (Not to be confused with high intelligence, since many highly intelligent individuals do not

enjoy intellectual activities and pursuits) Are you always questioning everything? Do you love to explore a wide variety of theories and ideas? Are you able to examine ideas outside of the framework of your own opinion? Do you enjoy research, analysis, and theoretical thinking? Is problem-solving a source of immense satisfaction? D. Imaginational excitability: Do you write, speak, think, or dream in vivid imagery? Do you embellish the plain truth in ways that make your end of a conversation more impactful

or amusing? Do you express yourself in ways that demonstrate a rich association of images and

impressions? Do you entertain yourself endlessly with private jokes and wacky visual, auditory, or

associational images? Do you creatively reframe events to support your perspective on life?

E. Emotional excitability: Are you excruciatingly sensitive, with intense emotions? Can you describe your feelings with great precision? Do you have intense emotional attachments to others? Are your emotions sufficiently profound to take you beyond yourself into areas of philosophical

consideration? Do you suffer from extraordinarily high levels of fear and anxiety or suffer attacks of

psychological depression?

4. High Intelligence "Gifted adults differ intellectually from others. They are more sophisticated, more global thinkers. In

addition, they have the capacity to generalize... They can grasp difficult concepts and phenomena. Their imagination and creativity are often incomprehensible to the average person... they have the ability to predict consequences... and foresee problems which are likely to occur. Gifted adults are able to see the pattern of development and growth, and therefore will recognize a trend. This allows them to predict and, by certain actions, to influence the trend." (Annemarie Roeper, "Gifted Adults: Their Characteristics and Emotions", Advanced Development, Jan. 1991)

Are you an independent thinker, individualistic, and mentally self-sufficient? Are you a divergent thinker with unique and interesting perspectives? Are you highly intuitive, with insight and foresight? Do you enjoy experimenting with psychic and metaphysical ideas? Are you relentlessly curious and investigative? Are you verbally agile? Do you love intense discussions? Do you have an exceptional memory? Do you think things out at an accelerated pace? Can you work with extraordinary amounts of mental data?

5. The Search for Truth "Those of us who are contemplative from the heart cannot tolerate the idea that life is accidental,

purposeless, directionless. Therefore, we are faced with two alternatives: to erect and inhabit belief systems so as to posit meaning and purpose, or to cultivate the capacity to feel and experience life directly, and allow it to teach us its secrets, in accordance with our level of development." (Mary Rocamora, director of The Rocamora School)

Do you strive to understand the nature and meaning of life? Have you read extensively on the nature of mind or done any meditation practice designed to help you

experience the nature of mind directly? Are you attracted to, and long for, spiritual or mystical experiences that will provide the basis for a deeper

understanding? Are you preoccupied with death and the possibility of after-death experience? Are you determined to make a meaningful contribution during your life? Do you have strong feelings regarding issues of morality and justice?

6. The "Autonomous Factor" (from psychologist Kazimierz Dabrowski) "... the autonomous factor enables the individual to transcend the limitations of both heredity and

environment through self-determination. The autonomous factor is a sense of inner-directedness, an inner drive to make conscious choices in accordance with those principles which are highest in oneself." (Linda Kreger Silverman, Institute for Advanced Development)

Are you driven toward self-actualization and self-perfection? Are you highly self-aware? Have you demonstrated the capacity for intrapsychic transformation? Do you feel a great deal of empathy and compassion for others? Do you exhibit a high level of moral responsibility and integrity?

7. Perfectionism "In a world in which emotional health is defined in terms of contentment, ability to relax, satisfaction

with self and with life, and lack of inner conflicts, it is no wonder that the perfectionist is perceived as neurotic. Worse, the consistent messages that perfectionists receive throughout life convince them that there is some basic flaw in their personality which must be eradicated. This greatly exacerbates the amount of inner conflict with which they must cope. Not only do they feel shame, guilt and inferiority for not meeting their own standards; in addition, they feel shame, guilt and inferiority for having all this inner conflict. And this is where the tension can mount to the point of paralysis." (Linda Kreger Silverman, 1987)

Are you determined to do your best at all costs? Do you feel inadequate to measure up to your personal standards? Are consumed with self-doubt and self-criticism? Is self-perfection or the perfection of your life's work the central driving force of your existence? Do you have a sense of your potential destiny and feel responsible to live up it? Do you have inappropriately high expectations of others?

8. Introversion "All introverts are perfectionists. All gifted individuals are perfectionists in something (usually not

their rooms). The gifted introvert is the perfectionist squared." (Linda Kreger Silverman) Do you prefer depth to breadth, concentrating on one activity at a time? Are you hard to get to know, more involved with your internal world than you are with others, and

have only a few close friends that know you well? Are you easily humiliated, therefore keeping people at a distance? In a social situation, do you wait to be approached rather than introducing yourself, and take time to

observe others before engaging? Do you develop skills in private before showing finished products to the world? Do you need privacy, respect the privacy of others, and resent having your personal space invaded? 9. Idealism "Advanced development has to do with recognizing and admiring a universal principle such as

justice -- and then growing to the point where you do justice. You do justice, not only because it is right but more so because you cannot do otherwise. You don't believe in one thing but find yourself doing another; you become a just person." (Karen C. Nelson, 1989)

"Excellence may be a universal ideal, but it is a personal goal for only a few. The attainment of excellence begins with a vision -- a vision of what is possible. The vision does not visit everyone; it selects the most fertile ground for its development. What criteria does it use? Inherent capability, surely. However, there must also be emotional receptivity, a willingness to embrace the vision and devote oneself to it. If the ability is there, but the receptivity is lacking, the vision will be fleeting. It only remains with those who are willing to work toward its fruition." (Linda Kreger Silverman)

Are you driven to achieve "what could be" when you think of "what is?" Are you solidly connected to an inner vision and aware that that vision will continually evolve? Do you feel compelled to connect directly with painful social ills, so as to educate others through

your compassion and sacrifice? Do you work tirelessly to make a contribution to better the world, in accordance with your ideals?