Talk:Borderline personality disorder/Archive2

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Archive This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page.
The following discussion is preserved as an archive. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.


Contents

Needs Confirmation or source

I removed "The majority of those diagnosed with this disorder appear to have been individuals abused or traumatized during childhood." until a verifiable source is added.

OK, there's one. Can get more. (Should've seen that before..)Cas Liber 19:55, 5 September 2006 (UTC)
Good idea, Cas. Not all Borderlines were abused! Geelin 14:42, 6 September 2006 (UTC)

Posthumous labelling of Nixon

In the Wikipedia article on Richard Nixon, it was claimed that some people thought him to have a Narcissistic or Paranoid personality. I've questioned it in the discussion page of the former Republican president, as I think it is a poor and misleading comment. Geelin 14:07, 20 September 2006 (UTC)

what does narcessistic or paranoid personality disoders have to do with borderline personality disorder? are you suggesting that he also had that? if not, why are you mentioning it on this page? do you have any proof that he had it? if not, then it isnt relevant. posthumous analysis is not valid. olayak

My point about Nixon is relevant to an earlier discussion on this page about posthumous classification of personality. I didn't say anything about Nixon having BPD. Posthumous classification is valid, as long as it's done thoroughly and objectively. Personality disorders other than Borderline have been discussed or at least mentioned on this page before and there's no reason why it can't be discussed now.Geelin 01:43, 21 September 2006 (UTC)

References

can be tricky navigating references - this particular one [1] I find lacks sophistication (and an author for that matter) - I think there are better ones around.

  1. ^ BORDERLINE PERSONALITY DISORDER. Medical-library.org. Retrieved on September 25, 2006.

This one I really like ; it is succinct and has more understanding of the condition. [[1]] Cas Liber 20:49, 25 September 2006 (UTC)


I question this statistic

"If a patient with BPD has co-morbid factors of substance abuse (alcohol or other drugs), the risk factor reaches an astounding 58% dying from suicide within five years." That certainly is astounding. I added the "citation needed" tag to this line. It reminds me of one of my favorite jokes: 43% of all statistics are made up on the spot. RobertAustin 11:55, 19 October 2006 (UTC)

ACK!!! Inline Citatation Nightmare

I have added a lot of information this afternoon, but much of it was gathered from medical article abstracts archived at PubMed. This is the best kind of resource, especially the reviews and controlled studies I tracked down. HOWEVER, the links look really nasty down in the reference box. How can I improve the look without having two webpages, going back and forth, picking out disjoined bits - journal name, date, number and volume .. list of authors (often very long), title (often long), and the university hospital that sponsored the study. Can I do something like a "Pub-Med Abstract", work it somehow so that citation mark-up?? One way or another, I want poeple to be able to click through and read it themselves. --A green Kiwi in learning mode 00:37, 22 October 2006 (UTC)

OK, have alook now -looks nicer. Is this what you had (have done #17 & 18). NB: 17 is not something to get too excited about researchwise and is not a landmark paper. A much better place for Evidence is the Cochrane collaboration http://www.cochrane.org
I work in mental health ;)
cheers, Cas Liber 01:25, 22 October 2006 (UTC)
Oh Cas, they look terrific!! Thanks so much. Now I can examine the markup and then fix the other ones (tomorrow!). Okay about #17. I will read at Cochrane.org and then go looking for much better research papers. Thanks for helpie a newbie.
Hey, I just noticed the thingie on the top of the page (template?) that says this article is being considered for an FA? Yep, it's got a long way to go, doesn't it? Well, I'm happy if I helped some. I will ask you to please me feedback any time you see something I can learn more about. :o) --A green Kiwi in learning mode 02:05, 22 October 2006 (UTC)

Neuroleptics

Yep, I can see a lot of tidying up which this article certainly needs. The medication bit is very tricky and some of the stuff you have removed is relevant. Antipsychotics have a much firmer use in schizophrenia as dopamine and serotonin blocking agents - they have been used mainly for behavioural control and brief psychotic episodes in BPD. The removal of text suggests the drugs are a mainstay of treatment, which they aren't (though can be very helpful). I think adding the bit back with a bit of wording and a citation needed is helpful. One also has to be sceptical of some studies.
Similarly with bit on mood stabilisers - which I will look at soon.
cheers Cas Liber 01:06, 22 October 2006 (UTC)
Thanks, Cas ... my modus operandi is to generally post a query to the talk page before removing something I have never come across before and that is uncited. Don't know what got into me - maybe something I ate?? ;o)
There is a possibility that I accidently deleted something I didn't mean to -- moving things around in that text box while adding citations and editing text -- well, it gets so darned confusing. Once this afternoon, I actually closed a preview window, not realizing it was just a preview window. Lost everything I had compiled of course. Had to start all over - calling up all the Pub Med searches again.
As for anti-psychotics. I HATE to see them prescribed for anyone who can be managed on anything else at all, alone or in combos. In my opinion, it is so wrong for doctors to take the leap from a trial on lithium and Dapakote straight to antipsychotics. In Great Britain, LAMICTAL is considered the very first med to be tried instead of those cheapies like I mentioned.

A green Kiwi in learning mode 01:32, 22 October 2006 (UTC)

Lamictal is a pretty smooth drug for bipolar but not prescribable under the PBS in australia for that indication unfortunately. Cas Liber 05:19, 22 October 2006 (UTC)

Family Support

Someone (64.12.116.197)just removed the family support section without reason and I don't see any discussion of it here. Kat, Queen of Typos 22:48, 10 October 2006 (UTC)

I would think it a relevant section. There were no answers to Kat and I would like to know why it was removed -- and what was already within that section. I realize that Wiki is not a how-to, but I think some basic substantiated reasearch could cover guidelines and maybe more. It is, afterall, loved ones who most go looking for answers, and it seems we could at least help point them in the right direction.  ? --A green Kiwi in learning mode 02:22, 22 October 2006 (UTC)
Family involvement is importnat in all health manageemnt - must check out the deleted bit.....Cas Liber 05:20, 22 October 2006 (UTC)


OK - this is the text:

Family Support - Risk factors can be reduced by proper diagnosis and supportive care most often with involvement of family members. BPD victims need a strong supportive and loving security net of family and caregivers to get through this. Something as simple as validating love for the BPD victim in spite of behaviours can have a huge impact in reducing risk factors. This is not as easy as it sounds, but it is crucial.

- Family members who wish to help people with BPD are advised to get clear information on the disorder from mental health professionals as this disorder is not easy to understand with the behaviors of sufferers being sometimes very difficult to tolerate and understand. The question "Why are you doing this?" may remain unanswered or validated by distorted illogical thinking. There is a tendency for some doctors to prescribe tranquilizers such as the benzodiazepine group (includes diazepam [Valium] and lorazepam) for symptoms of anxiety or distress that BPD patients may have, but these drugs can increase impulsivity due to disinhibition and may add to the risk factor.[1] - - Victims of this disorder may be very intelligent, loving people with strong personalities in terms of holding opinions and defending their ideas, but their self-image is damaged and they seek fulfilment, sometimes in invalidating environments.

  1. ^ Gardner, D. L.; R. W. Cowdry (January 1985). "Alprazolam-induced dyscontrol in borderline personality disorder" (PDF). American Journal of Psychiatry 142 (1): 98-100. PubMed. 


Overall, the text is emotive but makes some valid points. I think it i worthwhile attempting to rephrase it in a more moderate way.Cas Liber 07:17, 22 October 2006 (UTC)

amylewThanks for adding this in the talk page. I found it very helpful as I found the entire article. Youve got very important information here that has been very helpful to me. Amy

Deleted section on suicide

OK, somebody deleted this bit, propably due to the final statement. Hwever, there are some valid points in this paragraph and I have put it here so that some of the information, once referenced may be returned. cheers. Cas Liber 02:23, 26 October 2006 (UTC)

Old section: Patients with borderline personality disorder are at very high risk of suicide, about 5-10% or about 500 to 1000 times more than the general population. This risk greatly escalates when other co-morbid factors are present. The disorder is often poorly understood by psychiatrists and some psychiatrists simply refuse to accept BPD patients due to their instability (missed appointments, difficulty dealing with them). If a patient with BPD has co-morbid factors of substance abuse (alcohol or other drugs), the risk factor reaches an astounding 58% dying from suicide within five years.[citation needed]

I suggest that the mention of "some psychiatrists simply refuse to accept" will be removed from this suicide part. Although this is partially true (BPD interpersonal relations are often unstable), I doubt the refusal of mental health professionals would be the reason or cause for high mortility in BPD. Jalind 22:39, 2 November 2006 (UTC)
It seems that above mentioned information comes from Stone M (or MH?), published in book chapter "The course of borderline personality disorder" (1989; Stone found a suicide rate of 45 percent when alcohol abuse, borderline personality disorder and major affective disorder coexisted. .. The suicide rate of those presenting for treatment is 10 percent.) and article "Paradoxes in the management of suicidality in borderline patients" (1993; American Journal of Psychotherapy 1993; 47:255-272). But my source is second hand. Also IMHO these sources are getting a bit outdated.
Also there is more recent review-article: "Pompili M, Girardi P, Ruberto A, Tatarelli R. Suicide in borderline personality disorder: A meta-analysis. Nord J Psychiatry 2005;59:319-234." which migh be useful. They tell that (see table 1 text): Expected suicides in a year in 100000 individuals would be averagely 898 if they all suffered from BPD, compared to average 16.6 general population of same size (thus 898 / 16.6 = 54 time more often?). I feel a bit stupid, but somehow their results are hard to interpret. Jalind 22:30, 2 November 2006 (UTC)

Umm..getting the meds straight.....

OK - neuroleptics = antipsychotics

strictly speaking, when we say mood stabilisers we refer to lithium, valproate, carbamazepine and lamotrigine - all of which require blood monitoring, all can cause a rash and various other side effects.

Some antipsychotics can be, broadly speaking, mood stabilisers but given there is a neuroleptic heading they are better discussed there. Actually, antipsychotic is a better name than neuroleptic. Also, one has more chance of getting tardive dyskinesia with lithium and an antipsychotic together. cheers Cas Liber 10:52, 26 October 2006 (UTC)

Actually, could really go to town on the side effects of mood stabilizers but that is probably better on their own page...Cas Liber 11:04, 26 October 2006 (UTC)


Yes, neuroleptics ARE antipsychotics, and the use of both is not a negative for an encyclopedia article, as long as the reader understands they refer to the same kind of drug.

NO NO NO. Lamictal doesn't have blood levels drawn. No matter how much, no matter how long. I would ask for your citation. (I'll get back to you on that one)Cas Liber 13:18, 26 October 2006 (UTC)

And the Lamictal "rash" is not AT ALL like the types of rashed common to allergies or to Lithium (where it is a acne type break out, not an itch). It is simplistic overkill to lump all so-called rashes into one great heap. I would ask for your citation. (I'm not lumping all rashes, just that carbamazepine and valproate can have serious problems as well. I didn't mean to trivialise lamictal)

And all the psychiatrists I happen to know consider ANY DRUG THAT STABILIZES MOOD SWINGS to be a "Mood Stabilizer". Perhaps the entire medication categories deserve a rethink. (OK, will check consensus on that - yep, many categories are arbitary that is true)

Antidepressants are not mood stabilizers. Tranquilizers are not mood stabilizers. But Lithium, Neuroleptics, valproate and anti-seizure medications are mood stabilizers. --A green Kiwi in learning mode 11:47, 26 October 2006 (UTC)

(neuroleptics can be mood stabilisers but that is not their primary function but a (distant) secondary one)


As to a lithium/neuroleptic combo resulting in a higher incidence of tardive dyskinesia, I would as for your citation. This may very well be true, but I want to see it for myself. --A green Kiwi in learning mode 11:47, 26 October 2006 (UTC) (comin' right up)Cas Liber 13:18, 26 October 2006 (UTC)

(OK, I have a reference for lithium worsening the extrapyramidal effects of dopamine antagonists (i.e. antopsychotics). I was wondering whether this was veering off the path of BPD though. The reference is:

  • Sadock BJ & Sadock VA (2003). "Biological Therapies", in Sadock BJ & Sadock VA: Synopsis of Psychiatry. Lippincott, Williams & Wilkins, 974-1150. ISBN 0-7817-3183-6. 

Question is, put it here as well as on lithium and TD pages? cheers. Cas Liber 14:47, 26 October 2006 (UTC)

Over-reliance on Cochrane? Also, very little NPOV here

I feel that there is an over-reliance of Cochrane's limited literture reviews. Only 4 papers on Borderline, And, whether supported by Cochrane or not (I found their conclusions to be very non-commital for the most part), it seems they are being used to support all or nothing points of view that are very anti-psychiatry and anti-meds.

(Cochrane is highly regarded as a research collaboration trying to review RCTs in meta-analyses. It is often non-committal because the evidence is equivocal. Because they only look at RCTs alot of data is excluded. Alot of their other material does recognise the benefits of various medicines :)Cas Liber 14:26, 26 October 2006 (UTC)

I remember back, not that many years ago, where there was a virtual minority of one doctor in Florida breaking revolutionary ground in treating what he called "biological unhappiness" in his borderline patients. Nowadays, not only is it accepted and acted upon that a BPD's emotional distress and dysfunction can be alleviated. Additionally, quality of life and ability to be gainfully employed and a participating member of the community can be markedly enhanced. It is increasingly suspected by researchers that bipolar disorder and the so-called borderline personality disorder are closely related. As more brain scans and MRIs and such are done, the differences and similarities can be mapped and analyzed, and eventually scientists will have a firmer grasp.

(I have no problem with epidemiological links with BPD, Major Depression and bipolar. I also have no problem with a biological basis for BPD. If you google Allan Schore there is a load of stuff about early trauma leading to serotonin abnormalities. He did a particular paper in 2003 but I can't find the #$#$# reference at the moment, which also explains why SSRIs work well.)

By definition, personality disoders are static, unyielding, unchanging grossly dsyfunctional personalities. If a so-called personality-disordered person improves, really changes, then that is proof that they never had what psychiatry recognizes as a disordered personality. It has been common for disorders of personality and character to slip in and out of the DSM. PDs have been a major sticking point in getting the DSM-V published, having already made it 2 years late in its release.

(People are adaptive, there is research by McGlashan which shows 2 out of 3 people with BPD improve significantly over time - it is a 1985 or 86 study and should be referenced here somehwere. If you google it it will come up. Static is not a good word, longitudinal yes but people are adaptive.)

Getting back to this article not having a neutral point of view, it is not for an encyclopedia to preach and reinforce a point of view held by only a segment of society or a profession. It is not for us to influence the reader to believe that medicine for the disorder is good or is bad. It is not for us to influence the reader by misleading them in how the treatment of BPD is or is not changing. No matter how emotionally invested you are in pushing therapy over meds, it is pushing a point of view, and that cannot be allowed. You must stop deleting material that offends you personally. All that matters is whether or not it is supported by the literature and well-accepted and acted upon by a preponderance of psychiatrists. --A green Kiwi in learning mode 12:56, 26 October 2006 (UTC)

(Um..... nothing in this article offends me as such and I agree with alot of the edits you've done. It is just a matter of striking the right balance. I am not sure to which material deleted you are referring (?). There are a couple of other IPs as well editing. cheers :)Cas Liber 14:26, 26 October 2006 (UTC)



How to Integrate Opposing POV

I spent considerable time earlier writing some extended thoughts about the graceful and thorough integration of other POVs into the article. And then I come back to see if I had any responses.. and find that it's not here. Again, I must have forgotten to switch from the preview screen to the publish screen. I lost it all. So, nothing to do but try it again.

I had written about how it is VERY important for ALL opposing and divergent points of view on such a volatile diagnosis in such a state of diagnostic flux. But here is what I propose as I have seen it done to excellent effect elsewhere, textbooks et al.

The one thing we all must get away from immediately is sprinkling opposing POVs hither and yon, especially within the treatment areas, but also in etiology and even diagnosis. Some opposing points of view, the NO MEDS - ONLY THERAPY is one thing which should had its very own sub-category (under treatments) - AND there should be subcategory to links that support this point of view, including support groups.

Again, in those sections that are detailing the prevailing psychiatric psychotropic approach, whether with or without directional therapy, should be allowed to fully put forward what is known to be true about these medications, both positive and negative. But statements such as "meds aren't used" is ridiculous in this present day and have no part of an up to date encyclopedia entry. BUT, in its own opposing POV section, it can advocate for this point IF one can find professional citations decrying the use of meds and advocating only unsupported psychotherapies.

If this article is to go anywhere as a featured article candidate (and I presume some of you out there have been around a long time and are very invested in this outcome), then we must all bite the bullet and pull together to produce an exquisitely well written, tightly stitched together, and impressive presentation of the topic.

The treatment category, the meds section, will have to have some re-organizationsl work to bring it into a sensible presentation of psychopharmacotherapy. I will change the OUTLINE (only the outline) on the page so you can visualize what I am talking about. This is not a dictate, but a vision. --A green Kiwi in learning mode 12:22, 28 October 2006 (UTC)


Creating Directional Outline

I imported the article to date, and then spent of few hours sorting and shuffling things about. LOTS of great stuff, but I think if it is sorted more and laid out differently, it will make a lot of difference in readability.

Take a look, and if you feel moved to so, pick a bare section that interests you and help develop it.. Or work on condensing one of the busy sections (like the links and such). I THINK that anyone can select "edit this page" and take out as much or as little as they would like to have on their own draft pages. If you want one for yourself, post to my talk page and I will explain how easy it is. --A green Kiwi in learning mode 12:22, 28 October 2006 (UTC)

Draft looks really good, much better than the text on the page currently. Most psychiatrists advocate the uses of various agents as you've outlined.

Incidentally Anorexia is classically related to more obsessive personalities and bulimia to the cluster B group. If the use of meds is described as outlined then I don't really think that a no meds section is needed, or something under general treatment heading like:

Some people with BPD elect to not use medications. Reasons may be varied, from sensitivity to the medications' side effects to intrapsychic issues about what being reliant on a medication means to them. (A medication may have complex meaning for these people)
this is not worded well but you get the idea.
As long as a bit of discussion is on the talk page you should be able to overhaul it. Someone did it to the Psychiatry page a few weeks ago for a big improvement. I am a bit stuck with my income tax which I should be doing right now.........................................................

cheers Cas Liber 12:45, 28 October 2006 (UTC)


Hey Cas!!! I am so relieved that you have, so kindly and generously, responded to what I've cobbled together. Thank you for filling me in on the eating disorder thing and other things you have taken the time to explain to me. As I learn, I can refine that outline. I am very knowledgeable about bipolar, most of the Cluster B PDs, and very much on meds. Therapies, rather vague. So I am not pretending to know it all -- I am just interested in helping out here. It would be so much fun to be part of an FA attempt!!
Seems a very sound, solid re-write so far to me. Just a suggestion, maybe put notation numbers for the references that check out to make it easier to put them inline eventually in the right places.
Also consider removing all external links except the last first category, and then sift through them very carefully and pick "six of the best". Support groups are generally considered non-notable and best excluded. Online support groups are unregulated, unacountable and there is literally no objective way to ensure the quality of them either exists, or will be sustained. It's a minefield of subjectivity unsuitable to Wikipedia in general and, to my mind, an insult to an article of the quality you propose here.
Personal pages are another kind of minefield, keep one (even the very best of them) and you make a case for keeping them all, and that just isn't possible. --Zeraeph 19:51, 28 October 2006 (UTC)
PS Forgot to mention the possibility of creating seperate reading list article and characters from fiction article...particularly if you want FA. --Zeraeph 23:50, 28 October 2006 (UTC)

Feedback on keeping track of references & advice on outside links

Seems a very sound, solid re-write so far to me.

thank you. /but I sure don't consider it a rewrite by any means. I've built a a different expanded outline (and better, I hope) and sorted and relocated dibs and daps, doing little besides dumping them in their new home categoires.

Just a suggestion, maybe put notation numbers for the references that check out to make it easier to put them inline eventually in the right places.

ah... Notation numbers? Could you please explain this to me.. Since
It's ok, you were putting refs in as far as I can see, they just needed a bit of polishing and square bracketing --Zeraeph 01:34, 29 October 2006 (UTC)

Also consider removing all external links except the last category, and then sift through them very carefully and pick "six of the best".

well, at least that is a guideline, whoever tackles the task. Today has been so long and grueling. All I can think of is SLEEP.
I did my best "hatchet job" which leaves a nice, clean slate to build on. --Zeraeph 01:34, 29 October 2006 (UTC)

Support groups are generally considered non-notable and best excluded. Online support groups are unregulated, unacountable and there is literally no objective way to ensure the quality of them either exists, or will be sustained.

hmmm.. can see your point, but wiki is filled with statements current only for "now" (and wonders when that now expires.
Already expired in the case of at least 3 links.--Zeraeph 01:34, 29 October 2006 (UTC)

It's a minefield of subjectivity unsuitable to Wikipedia in general

well, it is quite the usual at wiki to include this one nod of the head to this being a web world we live in. Which Wiki pages deal with this?
I'll post them when I get them...but it's common sense really, remember, Wikipedia isn't supposed to include anything but solid, verified information. --Zeraeph 01:34, 29 October 2006 (UTC)
While I am not a user of any kind of bpd forums, I am also aware that the groups of "family/loved ones" is a mixed bag of good sites and those focused on strongly communicating that the BPD is a heartless crazy monster. So that is scarcely a support group for epilepsy or heart disease.
And NEITHER approach is a neutral point of view and thus both are unacceptable. That is, as you will learn, the relaxing part of Wikipedia, your opinions (and everyone else's) stay at home while you edit. It's just about verifiable information, a bit like paralegal research --Zeraeph 01:34, 29 October 2006 (UTC)

and, to my mind, an insult to an article of the quality you propose here.

hmmm.. I understand.

Personal pages are another kind of minefield, keep one (even the very best of them) and you make a case for keeping them all, and that just isn't possible. --Zeraeph 19:51, 28 October 2006 (UTC)

ah.. wasn't aware there were links to pages like that. What do you think of AJ Mahari's site? I didn't happen to see her site on the lists. I like her strong message of recovery. good chatting with you ... --A green Kiwi in learning mode 00:07, 29 October 2006 (UTC)
An awkward one...like toddlertime...it's a huge site into which a lot of effort has gone over many years but way POV and toddlertime is inclined to lobbying. However, in the case of AJ it is the personal experiences of a Borderline who turns out to have been misdiagnosed and is now rediagnosed as Asperger Syndrome...which is more of an unstable nuclear missile dump than a minefield in terms of site written from pertsonal experience...also...you post AJ Mahari, you have to repost toddlertime, and then "My Borderline experiences" and THEN...EVERYBODY'S Borderline experiences...if you see what I mean??? It's so much easier to stick with medical and official resources. --Zeraeph 01:27, 29 October 2006 (UTC)

NOTICE

I am immediately bringing back in the article in it's presently edited form. There have been FOUR edits today that I will insert as quickly as possible. I wish to assure everyone that I have deleted nothing while keeping the article hostage in my draft page. :o)) What has been accomplished is Re-Creating the index/outline and by sorting through and relocating this and that.

My intent in doing this was to advance this topic to FA (featured article) status. My intent is not to take this topic away from anyone, but to make it more exciting and fulfilling to edit. I again urge everyone to stop a moment and add something - or change something!

Please do always add to your edit summaries as it is always nice (and helpful) to know what you were thinking or intended when you made the edit.

I decided I really had to do this right now as I realized that I might end up losing someone's edits as the number climbed. I had gotten two positive feedbacks and have acted on that affirmation. So here goes nothing!

PS: I have added a couple of chatty sounding bits - I will deal with them as soon as I can find them. If you find them first, feel free to edit them! --A green Kiwi in learning mode 22:55, 28 October 2006 (UTC)

Very well done...the links were tangled up but I fixed them for now. Looking at the article the lists of references, further reading etc desperately need sorting of to a list page...there are so many, and in more than one category...so I think I'll shift them all, at least for now...sort them later? --Zeraeph 00:06, 29 October 2006 (UTC)
Thank you! Go right ahead. I was intimidated at link sorting and I trust your judgement. (note my response to you above a few minutes ago) --A green Kiwi in learning mode 00:10, 29 October 2006 (UTC)
Seriously, it really IS coming along as a very high quality, informative and objective article. The kind I like best. It is a pleasure to be able to polish the technical bits (not fully, they will need all kinds of final tweaks)...but note the magic format for making commentary disappear...notes are useful, but best kept private.--Zeraeph 01:39, 29 October 2006 (UTC)

Origin of the term

Shouldn't Gunderson be mentioned somewhere in that paragraph? Can't understands why no-one ever has --Zeraeph 06:14, 29 October 2006 (UTC)

Fear of abandonment

this article talks about a person making great effort to avoid abandonment. does anyone have any information on a woman who will become pregnat to avoid her husband from leaving her? Keltik31 20:26, 28 November 2006 (UTC)

Question about abbreviation, genetic origins, and room for opposing POV

I just want to put these up for discussion.

First, I have primarily encountered this disorder in the literature (and in documentation) abbreviated an BoPD or BOPD rather than BPD, with the intent of removing confusion with Bipolar Disorder, which is abbreviated as BPD. I would like to hear others' opinions on adopting this abbreviation. It seems to me that since "BPD" is ambiguous it should probably be avoided.

Second: The line "The Scientists also believe that BPD is genetic. Approximately 35% of children whose parents have BPD will show signs of the disorder" should be modified to soften the assertion "BPD is genetic" to something like "may have a genetic component". The bare assertion "is genetic" is hopelessly oversimplified:

  • It suggests that some heritable trait causes the disorder in isolation from environmental influence, when in fact this is not known or even believed to be the case, and there is probably considerable interaction between inherited traits (diathesis) and environmental influences (stress).
  • A 0.35 correlation between a parent's diagnosis and the child's diagnosis would be food for thought -- especially in a study of children reared by others than the borderline parent(s) -- but not conclusive. But to "show signs of" the disorder is not the same as to "have" the disorder.
  • It glosses over the fact that BOPD cases can arise without any familial history of mental illness.
  • It ignores the fact that a child raised in a household with borderline parents is far more likely than others to be exposed to borderline behaviours, emotional dysregulation, parental withdrawal, abuse, and/or invalidation, all of which are held to have aetiological significance.

As a general note, any attempt to ascribe any complex behavioural pattern to genetic determination in any simple way is an very heavy claim that requires very heavy evidence.

Third, there is considerable controversy within psychiatry about this disorder. Some psychiatrists dismiss its very reality; others believe that while it is a real disorder, it is overdiagnosed; still others believe that the "borderline" label is vaguely defined and used as a wastebaket into which difficult patients are tossed ("difficult patient syndrome"). Others are highly concerned about labelling effects. I see nothing about this controversy in this article. Would anyone object to its inclusion?--7Kim 20:13, 14 December 2006 (UTC)

I agree with you about the wording of the (possible) genetic component; any combination of genetics and psychiatry is in danger of being over-simplified, and needs careful wording.
About the controversy surrounding BPD, it should probably have its own passage in the article, if you can find reliable medical sources for each of the various POVs you mentioned. Citation is especially important when it comes to dissent in the medical community.
As to the abbreviation, I really don't know. *Shrugs* LeaHazel : talk : contribs 10:08, 15 December 2006 (UTC)
As far as the abbreviation goes, the theoretical literature is inconsistent and I have not been able to discover an authoritative source that "lays down the law", if you will. I do know that in psychiatric practise the abbreviations "BD" and "BoPD" are used for bipolar disorder and borderline personality disorder respectively and the abbreviation "BPD" is deprecated as ambiguous. Actually, that is, I think, a good enough statement right there. I'll edit that in, and I think it will stand challenge. —The preceding unsigned comment was added by 7Kim (talk • contribs) 17:49, 15 December 2006 (UTC).


The use of book "Listening to Prozac" as source material

I am a bit surprised to see this popular press book being used as an authoritative text here. I would prefer to see some good journal literature reviews of the use of ADs in borderlines.

In addition, children, teens and young adults are now the specific identified populations more likely to have suicide attempts in the early weeks of treatment, while older adults do not show this propensity. Of course, the rate of suicide attempts is, still, MUCH LOWER than would be present in untreated depression. If there is considerable independent statistical data showing specific differences in BPDs, let's present it.

If this article is to promote the notion of ADs being dangerous, it MUST have the ENTIRE picture represented. And, of course, the entire subtopic needs citations. --Kiwi 05:07, 21 December 2006 (UTC)

Agree with all of the above :) Cas Liber 06:44, 21 December 2006 (UTC)

Which Acronym to Use

I have been "hanging out" at BPD and BD forums for some years now, and within patient populations, those are the exclusively used abbreviations for BPD and BD. It is vital that BPD NOT be used for Bipolar, because then there is too much confusion since it would too easily be sorted into the PD pile since you can't expect people to recognize that you are splitting one word into "two words."

Additionally, whether you google or check for acronyms, you get Barrels of Oil per Day. Seems best to stay away from such a little known acronym

  • Acronym Definition
  • BOPD Barrels of Oil Per Day
  • BOPD Bataan Ocean Petroleum Depot

--Kiwi 05:07, 21 December 2006 (UTC)

At work people generally still use BAD for Bipolar Affective Disorder, though the Affective seems to have been dropped in recent times. cheers Cas Liber 06:44, 21 December 2006 (UTC)
I noted above that BOPD is sometimes used, especially by clinicians, to distinguish borderline personality disorder from bipolar disorder. A little further digging shows that the current standard is BPD for borderline personality disorder and BD for bipolar disorder, and BOPD passed out of favour eight or ten years ago (an abnormal-psych textbook, published eight years ago, is the latest "official" use of "BoPD" I could find, and it listed both), even though for purposes of strict unambiguity in such areas as medical documentation it might be preferable. Apparently the reasoning was to reserve "PD" for "personality disorder", which makes good sense. So the article should use BPD. Still, a caution to the reader that the acronyms may vary or be misused seems in order. --7Kim 23:11, 21 December 2006 (UTC)
Two cents — Make sure the relevant disambig pages have the distinctions, and include the material that such abbreviation nomenclature is in an evolving state. // FrankB 18:18, 27 December 2006 (UTC)
Could something about this be added to the section on terminology near the top of the article? EverSince 18:30, 27 December 2006 (UTC)

Concerning Etiology

I think that the overall outline has signifant built-in room for presenting the various theories -- but I do hope that it is CLEAR throughout that most researchers consider certain populations for being more at risk for BPD and PTSD. There is, it is presently believed, to be correlated to a genetic propensity.

If anyone around here recalls, there is a research psychiatrist at one of a pediatric medical school department in Dallas Texas (think it is Southwestern) who published longitudial research back in 2000 or 2001 about PTSD in childhood being very strongly correlated with the diagnosis of BPD as the children grew older. Hopefully that is still published online.

I have heard here that SOME BPDs are considered "pure BPDs" as they do not respond (or respond only partially) to medications, only therapies... But I can tell you relatively authoritatively that there are bipolars that never manage to get good to excellent results with meds.

Building on this is that it is common in a minority of bipolars for medications do not "last" forever. There is a school of thought that the brain "adapts" to the "new normal" induced by medications. The theory proposes that the brain (ANYONE's brain) struggles to regain "its OWN normal" and thus the brain chemistry is eventually changed back to its former balances.

If this is here again (still), we need to see citations for it and for the two other possiblities being presented... --Kiwi 05:23, 21 December 2006 (UTC)

One thing that jumped out at me in my first read of the article was that certain linkages are suspected, but not differentiated as being so. The section on the prevalance of suicidal tendencies comes to mind. There is no mention that there may be a disconnect, and that such people may also be suffering from clinical depression. In other words, such co-diagnoses are not uncommon and even likely, and this needs some careful handling. Best regards // FrankB 18:25, 27 December 2006 (UTC)

Kernberg and Transference-focused Psychotherapy?

A generally good article, but I'm surprised about the relative lack of information about Kernberg and TFP. TFP has been manualized and, according to presentation by his group at a Yale conference of BPD I had attended at Yale a few months ago, has been shown to be as effective as DBT with lower drop-out rates. I will try to add stuff on this in the future...Faustian 21:14, 21 December 2006 (UTC)

Mass removal

I wanted to get some discussion on this edit, which I've reverted. I felt that if a big change (such as removing larges amounts of information) needed to be discussed a bit first, since consensus and compromise is important in the article. I don't want to seem like I'm just reverting, and I would like to assume good faith, but I also feel that making such a huge edit without an explanation (and that edit summary doesn't cut it, for me) is very risky and may not be in good faith. So, please, let's discuss how to make the article better. If anyone has any objection with any of the material in the article, point it out, so we can work on improving it. Thanks! —Keakealani 06:46, 24 December 2006 (UTC)

I absolutely agree with and endorse the above comment, in addition I would query just how such drastic deletions can possibly improve an article nominated as having "good article" status, recently, and on the strength of the very text deleted. --Zeraeph 09:34, 24 December 2006 (UTC)
I pretty much agree. Too much information was removed, not to mention important sources. If text is removed, it needs to be discussed in the talk page beforehand, and there has to be a valid reason, such as verifiability. I also think the article is quite good as it stands, although of course there's always room for improvement. LeaHazel : talk : contribs 17:23, 24 December 2006 (UTC)
I certainly agree also, get the feeling it wasn't intended as vandalism.
Unrelated to that, I may as well take the opportunity to mention that I think the 1st & 2nd paragraphs of the intro could be combined, and the 3rd revised to cover both the proposed PTSD and Bipolar connections and mention other proposed aspects of etiology such as genetics. I'm also planning to remove the 'psychological roots' bullet-pointed bits as seeming informal/psychoanalytic without source (e.g. project on to) and because it says people with BPD often think they are fundamentally bad or unworthy but then itself describes them as having "inner self deficiencies"... I think the psychotherapy subsections below that need sorting. EverSince 17:40, 24 December 2006 (UTC)
Really good suggestions...The introduction, actually, could be combined without changing most of the wording, if the transition is good. I think I'll go ahead and change that...revert or edit if you disagree with my changes. —Keakealani 18:16, 24 December 2006 (UTC)

My LORD! And everyone here so restrained and polite in dealing with the seemingly senseless mass deletions. There is a difference between editing boldly and acting out. ;o) Thanks to those who have reverted the changes, insisting on discussion of any proposed wide-ranging changes. --Kiwi 23:39, 24 December 2006 (UTC)

As far as a BPD - bipolar link, this is not something which should occur in the intro as it is not a core issue. By all means a discussion later on somewhere is fine. Disturbance of self (and hence low self esteem) is a pretty core feature though. cheers Cas Liber 01:09, 25 December 2006 (UTC)
What do you mean it's not a core issue? It's a huge issue concerning BPD. Discernment between the two, misdiagnosis, reluctant diagnosis because BPD is an axis-II condition, which insurance companies don't like much. It should at least be mentioned, because the behaviors of both can be mixed up even by a person that knows what to look for. Speedemon86 20:27, 4 January 2007 (UTC)
We don't have the Managed Care/Insurance problems here in Australia, so in terms of coverage this isn't as big an issue. Also, since many public health centres are running DBT groups, there is less marginalisation of BPD than there was 10 years ago. I do think a discussion is owrthwhile in the text - see how others feel about it. cheers Cas Liber 21:08, 4 January 2007 (UTC)

Organizing the discussion......toward FAC

Maybe the best way to go is to archive much of the talk page and do a really focussed overhaul (if needed) section by section, starting with the intro, and then nominating for FA. The article will continually be tampered with but if FA will give a much better platform to conserve a particular format. There seem to be a bunch of determined editors making real progress and I don't think it is that far off FAC (it is comprehensive, I think the intro is about right in terms of length and content).

The other reason I think the time is good now is things can so easily go off the boil and folk can focus elsewhere. cheers Cas Liber 01:14, 25 December 2006 (UTC)

PS:Meant to add that BPD is an emotionally laden issue much like many others on wikipedia where there are always going to be strong opinions. I think getting an FA on this would be a major and noteworthy achievement due ti the controversial nature of the topic (unlike, say, a football team or pokemon etc. Not that I have anything against pokemon.......;) ) Cas Liber 01:20, 25 December 2006 (UTC)

Cas, I fully agree with you about archiving this page and doing the section by section discussion. I also agree with you about the bipolar stuff not belonging in the intro (and if it was me who put it there, I apologize), but I do believe that my "contributions" were mainly confined to separating what was already here into various "piles of paper", then sorting them into a logical progression of topics. While our unknown guest thinks otherwise, if you pick up any professional text on BPD, all these topics will be covered. HAVE to be covered if anyone is to be fully informed about what the disorder is (or is not) about.
People need to realize that much of what is "known" is still considered theory, tho there is now much good research to substantiate those theories. As to responses to medications and responses to the right kinds of therapies, there is a great deal known - tho research continues. Thank goodness!
A Blessed Season of Renewal to Everyone .... --Kiwi 05:48, 25 December 2006 (UTC)
I figured my last few posts were/are a structured way to keep the communication lines as open as possible. Hey you don't need to apologize ;) you've done a heap to make sense of what was there previously and really taken this article a long way. cheers (now back to the Xmas pressies...) Cas Liber 07:16, 25 December 2006 (UTC)
Kiwi I don't think anything was done (by you or anyone else) re the bipolar issue, I think it was just something I mentioned here. EverSince 11:56, 25 December 2006 (UTC)

Introduction review

OK folks are we happy with the intro? This is the place for discussion on length; same length/longer/shorter and anything else to be added or subtracted from it. Once there is a sort of consensus then the next step would be playing around with it to make a really good intro. Cas Liber 01:17, 25 December 2006 (UTC)

eg. I would not want BPD - bipolar link in intro but if am outvoted would happily work with consensusCas Liber 01:21, 25 December 2006 (UTC)

I only mentioned the bipolar issue because at the moment the 2nd para says only that BPD is seen as a "particular manifestation of post-traumatic stress disorder". Whilst I don't disagree, it is also commonly seen as being on a bipolar spectrum due to things like mood changeability and interpersonal issues etc, and of course BPD onset isn't always associated to experience of trauma. I like the plans. EverSince 06:57, 25 December 2006 (UTC)
I think that the introduction should be limited purely to defining the disorder and perhaps discussing its relation to common society (i.e. what is means in common parlance). Any theorized connections (be it to PTSD or bipolar) might be best off in another section, perhaps at the same place that discusses the chance of another disorder occuring with BPD. /2¢ —Keakealani 07:49, 25 December 2006 (UTC)
Eversince, I certainly understand about your desire to present a balance, but Keakealani, I agree with you, that both need to be dealt within the subtopic on etiology. --Kiwi 08:11, 25 December 2006 (UTC)
I agree this should be addressed in the main body of the article. I have a dim recollection of a help guide saying that intro's should ideally summarise the range of key issues addressed in the article to follow, though, and if that is done perhaps a basic indication of the abuse/trauma/bipolar context should be included. EverSince 12:06, 25 December 2006 (UTC)
Umm - agree para 3 was better elsewhere but I liked para 2 there (though it did need a bit of a tweak). The idea that BPD is pervasive and one of the main things is its effect on relationshps is central Cas Liber 12:20, 25 December 2006 (UTC)
I don't disagree Cas Liber & please feel free to re-edit anything I do of course. My feeling was that the main points of that new 2nd para were pretty much covered in the 1st para, including relationships - and it seemed to be undoing Keakealani's tidying of two separate overlapping paragraphs in to one paragraph, that was discussed here. EverSince 12:40, 25 December 2006 (UTC)
How's this? Totally agree about the overlap now that I look at it properly. According to the MOS an articel this length should have 2 or more likely 3 paras which mention the key points which are expanded upon later. I wanted to try and emphasise that it is a pervasive condition which affects all parts of life (without being repetitive). Feel free to revert or play with it. cheers Cas Liber 21:36, 25 December 2006 (UTC)

Edits to Psychopharmacotherapy and Highlighting the no-drug approach

Some inaccurate changes were made, so I did some revisions (not reverts) and added some other material to (hopefully) make clear the need for the particular outline used.

I have also given the "no drug route" advocates an expanded and more prominent presentation so it is more easily found in the outline index box at the top of the page. Cas Liber - what do you think?

Have added some expand flags for subsections that have been overlooked for a long time now. I would like to stay longer, but I have a holiday dinner to prepare a dish for and bake a pie and it is 2am here. Thank goodness, dinner will not be until mid-afternoon. --Kiwi 08:07, 25 December 2006 (UTC)

I like the two subheadings Value of combining pharmacotherapy and psychotherapy, and Case for BPDs who forego psychopharmacotherapy - I'm pondering whether they'd be better somehow under where the psychotherapies are talked about rather than at the end of Pharmacotherapy - trick just trying to get an idea of making the whole thing flow nicely really (too late for this now - needs a real lookover..). cheers Cas Liber 12:18, 25 December 2006 (UTC)
Yes, I like those two titles better, too - very exactly describing the contents of those sections. Can't figure out what possessed me to change them, so I have changed them back.
Well, as to those two sections, I have considered maybe taking them out of the Therapies section.. but I'm not completely certain as to what to do with them.
Did you see that I have proposed a totally new section called "The Chances for Recovery"... taking out of the "treatment & recovery" title... as a discussion of therapies is really an area to deal with the concept of recovery. Many psych-workers still consider BPD to be uncurable and only manageable with medications and therapy. Plus, what impact is associated with teaching loved ones about their roles and how to change former harmful or even destructive patterns of response.
Thoughts? --Kiwi 13:25, 25 December 2006 (UTC)
I think I slightly reworded those subheadings not Kiwi, & reordered them. I felt it made sense for them to occur after the topics which they were talking about combining or foregoing, and I thought the wording could be a bit more....neutral or standard, but don't feel at all strongly either way. I like the idea of a section on recovery rather than just treatment, I'll try to add to it sometime. I guess there could be a section on 'services' too including things like therapeutic communities. EverSince 14:07, 25 December 2006 (UTC)

Pervasive relocations & small additions

I haven't been here in so long (except to drop a comment or two on the talk page) - and wouldn't have ventured to the article page (which I hadn't read in ages) if it hadn't been for those mass deletions. In finally reading it after all this time, I saw so many things that I felt could be better featured. I haven't deleted anything, didn't rewrite - just moved things around and added a bit, here and there.

Comments and Complaints taken here! --Kiwi 09:34, 25 December 2006 (UTC)

I think getting the structure well-ordered and tagged and agreed on like this will be a good foundation for it to build up well. I've tried to make the subheader levels consistent. EverSince 12:33, 25 December 2006 (UTC)
Hi EverSince... Thanks for finding the appropriate homes for those two new bits that I dumped in the intro!! I knew that someone would find the perfect places, and you did.
I have read the overview of Mood Stabilizers over and over. It does cover the topic well, I think, but as always I wish the names of specific medications could be reserved for the subtopics below it. But that will come with time. for the moment, it is okay.
Lithium is still the most widely used mood stabilizers in the world, is valuable as a dual-function drug, and has a unique method of action. It does, in other words, need to be featured in its own subtopic MUCH MORE that Depakote does. True, Depakote is usually the second drug to be added to Lithium or substituted for Lithium, but again that because of the low cost of both. Depakote is, in the final analysis, simply one more of the antiseizure meds. I feel very strongly about this issue, regarding the importance of lithium and that Depakote can be shooed into its proper category. --Kiwi 13:35, 25 December 2006 (UTC)
I don't have any problem with lithium having a subheading to itself within medication or within mood stabilizers - if that was lost through my edits it was just a side-effect of trying to reorder and tidy things EverSince 13:57, 25 December 2006 (UTC)
On Meds missing
Lithium seems to be a elephant gun. AFAIK, Prozac, Zoloft, Paxil and Wellbutrin are also used with some efficacity for emotional stabalizing this condition. // FrankB 18:34, 27 December 2006 (UTC)
Hi Frank.. Yep, Lithium is an elephant gun. First thing most docs try you on (better, I think, than going to an atypical antipsychotic!!). I did VERY well on an old tricyclic AD -Desipramine. Still recommended, but has strong anti-cholinergic side-effects. Used it, sole therapy, for 7-8 continuous years. And I've been on Prozac, Zoloft and Wellbutrin. I would only recommend Paxil for my worst enemies - coming off that is, apparently, a true nightmare (maybe not for everyone). I tend to switch among ADs and to tweak my doses. BPDs and BDs have to become full partners with their docs - and their docs have to trust their patients' feedback and judgement. --Kiwi 11:22, 28 December 2006 (UTC)

Just a note to say I'm doing some more 'pervasive' relocating/reordering/cites needed etc, partly just trying to avoid overlaps in content. I hope this isn't over-editing, i'm just going for it being bold, as usual please revert anything. EverSince 10:49, 29 December 2006 (UTC)

Done for now... I've tried to do it by section & use edit comments & keep stuff & be clear EverSince 14:27, 29 December 2006 (UTC) p.s. Kiwi, I think the Lithium section needs more of a summary, in relation to BPD, incl. sources, just left it like that for now

Still hoping I'm not doing anything objectionable, in the absence of comments..... Also wondering if anyone could advise on formatting the refs - when the citations I add appear in the footnotes, they often seem to have a messy-looking gap between the article title and the journal name, and doesn't seem to matter how I move the words around, it still appears? EverSince 21:23, 4 January 2007 (UTC)

Citations seem great to me...After much experimentation I THINK the nasty little format problem may be due to the script only being able to handle so much text in a link effectively. I am trying to work round it by finding ways to only put a part of the title in the link. --Zeraeph 22:23, 4 January 2007 (UTC)
Thanks Zeraeph. Weird one eh, doesn't seem to be unique to this page but might be to something I'm doing (sigh) EverSince 10:21, 6 January 2007 (UTC)
This format issue seems to be sorted generally, thanks again. EverSince 23:45, 25 January 2007 (UTC)

Whatever happened to....

Didn't there used to be a good bit in this article on the various proposals of alternative names for the disorder, and the issues people have with the BPD term? Gone for a while now I think but if no objections I'll try to find it in the history and re-add it. Have a feeling there was other stuff too. EverSince 14:18, 25 December 2006 (UTC)

It was orignally in the lead somewhere I recall - putting in under a subheading under the mnemonic maybe? Cas Liber 21:09, 25 December 2006 (UTC)


This is what I was thinking of:

"The name originated with the idea that individuals exhibiting this type of behavior were on the "borderline" between neurosis and psychosis. This idea has since fallen out of favor, but the name remains in use, as noted in the Diagnostic and Statistical Manual of Mental Disorders; the ICD-10 has an equivalent called Emotionally Unstable Personality Disorder, borderline type. Many who are labeled with 'Borderline Personality Disorder' feel it is unhelpful and stigmatizing as well as simply inaccurate, and there are many proposals for the term to be changed or done away with. [2]. Emotional regulation disorder and Emotional dysregulation disorder have been suggested by TARA, (Treatment and Research Advancement Association for Personality Disorders) as having "the most likely chance of being adopted by the American Psychiatric Association."[3]. Emotional regulation disorder is the term favored by Dr. Marsha Linehan, pioneer of one of the most popular types of BPD therapy, but Impulse disorder or Interpersonal regulatory disorder would be equally valid alternatives, says Dr. John Gunderson of McLean Hospital, near Boston. Dyslimbia has been suggested by Dr. Leland Heller. [4] Australian psychiatrist Carolyn Quadrio has promoted the term Post Traumatic Personality Disorganisation (PTPD), arguing the term summarises the condition's status as both a form of Chronic Post Traumatic Stress Disorder (PTSD) as well as Personality Disorder and highlights the fact that the condition is a common outcome of developmental or attachment trauma[1]. The most colorful suggestion so far is Mercurial disorder, proposed by Harvard's Dr. Mary Zanarini. [5].

I'll add most of it back in, where Cas Liber suggests, if no objections. EverSince 14:52, 26 December 2006 (UTC)

Hey, this is great - and, in my opinion, very much needed. I give it a thumbs up for putting it back in! --Kiwi 16:38, 26 December 2006 (UTC)
Ditto - many articles have a history of naming somewhere toward the beginning of the article. Go for it :) Cas Liber 19:44, 26 December 2006 (UTC)


ThanQ, I've put it back in, reworded. Changed the subheadings a bit while I was at it. I found a paragraph regarding mental health services that also used to be in the article:

"Patients often need extensive mental health services, and they account for 20 percent of psychiatric hospitalizations.(Zanarini MC, Frankenburg FR. Treatment histories of borderline inpatients. Comprehensive Psychiatry, in press.) It is recognised that they often receive poor service, however, in part due to lack of sympathy with or understanding of self-harm, impulsivity or so-called 'non-compliance'"

The ref seems to refer to

Treatment histories

Also noticed

Mental health service utilization

& quick search showed stuff like

nurse attitudes positive attitude change

lived experience of services

experience & knowledge

So I'll add something about this back in soonish too if no objections. EverSince 15:24, 27 December 2006 (UTC)

Shortening the article

I get a message that the article is long. The most straightforward to move is the section on Non-BPD which could go on a separate page with a 1 or 2 line summary here. It seems to be a fairly distinct topic unlike much other material which is interlinked. Cas Liber 05:18, 26 December 2006 (UTC)

As I browse quickly, I'm inclined to say that the treatment sections are the largest, and although it would take quite a bit of reworking I think it would be plausible to create another article called something like Treatments of borderline personality disorder. Unsure of how that would be received - I realise it's an integral part of the article, but it's also the largest, and theoretically, the article should focus more on what the disorder is, not how to get rid of it. —Keakealani 06:50, 26 December 2006 (UTC)
Hi Keakealani. Since the treatments for Bipolar and Borderline PD are identical, this does present problems - The Bipolar article is as long as this one is, yet has virtually ZERO coverage of treatments. And it would cause an outrage against many Borderlines to be referred to a page entitled "Treatments for BPD and BD" -- but then again, we could scarcely have two identical articles with nothing different but the names at the top. I have a (long) series of thoughts about this at the bottom of this topic section. apologies - forgot to sign - Kiwi 26 December 2006
I know - that's what I mean about interconnected. The Non-BPD can be easily transferred and is not a particularly core topic. The first time I had heard of the term was here on wikipedia and I have worked in mental health for over 10 years...Cas Liber 09:02, 26 December 2006 (UTC)
Do you mean too long content-wise, or too long megabyte-wise? Because I think the article goes into an appropriate level of detail, except for a few occassional repetitions that should be merged into coherent paragraphs. If the article is heavy on the server, splitting might be appropriate, but I don't think content-trimming is. LeaHazel : talk : contribs 10:01, 26 December 2006 (UTC)
Ummm-content, but mainly WRT wikipedia guidleines (how hard and fast are they anyway? Cas Liber 10:29, 26 December 2006 (UTC)

It seems to me that maybe some of the pharmacological information is superfluous to an article on BPD (though vital to any articles on the specific drugs where it should be moved) like the lengthy section on side effects, and some of it is unfortunately expressed as personal opinion. Perhaps it could be ruthlessly pruned back to cited, specific and neutral information?

I have just tried an experiment in placing some sections that need serious pruning inline to see what effect it has...reversion of any, or all (except the requests for citation, for FA status they are essential or the related text must go) will not offend. Might be a technique to experiment with other text that may be superfluous? --Zeraeph 10:42, 26 December 2006 (UTC)


--Zeraeph 10:42, 26 December 2006 (UTC)


Cas liber ... You said that someone told you the article was long? Did they say it was "too long" or just "long". If you go look at Bipolar, for instance, it is as long as this article is. Look at others, and there are many even longer. Even longer than many talk page at WP.
One thing to consider, with all the indexing to make this article user-friendly, we have a lot of headers that take up room. Remove a lot of them, and you immensely "shorten" the article -at least the LOOK of the article. But should we remove headers to make it LOOK shorter? I don't think that would be helpful.
But I, too, was looking at what could be overlap, things that could go elsewhere.... so...
  • I went looking for the Mood Stablizer article. And it was dreadfully inadequate. But I began considering that once we produce a good section on Mood Stabilizers, we could merge the two articles and with only a brief coverage of Mood Stabilizers in this BPD article, we could then provide a link to the vastly improved topic page.
  • With Antidepressants, that article has absolutely ZERO coverage of how ADs virtually always provoke a Manic response in Bipolars and Borderlines if not conjointly administered with a sufficiently strong dose of Mood Stabilizer. This Manic response can often push the patient into a frank manic psychosis that necessitates hospitalization. The AD article strongly needs a Subtopic specific for BPD & BP.
  • So I went looking at the Bipolar Disorder Article. This time, I found virtually ZERO regarding the topic of treatment. Here again, that article could strongly benefit with a sub-subtopic on medications, with links to vastly improved Mood Stabilizer and Antidepressant articles.
So what we have are THREE articles (AD, BP & Mood Stabilizers) that need to have what we are building here. But to expect us here to suddenly try dividing our attentions among 4 articles would, I think, cause this one to suffer greatly.
Therefore, I would SUGGEST that we consider doing our work here, then we can EXPORT our labors to the other articles, thereby improving all of them at once.
Anyway, we could not export anything at the moment without having it deleted overnight for lack of citations. So, I suggest, one step at a time.
HOWEVER: If we are going to toss out most of the medication sections out of this article, then it only stands to reason that we must also toss out most of the Psychotherapy sections, too, and after a short discussion, just put in links to the wiki topics that cover each type of therapy.
Why do I say that? When borderlines DO get medical attention for their symptoms, they are very likely to get medication, but only very rarely do they get to ever sit in an office with a psychotherapist. This is due mostly to lack of adequate insurance coverage for psychiatric disorders. Most policies still mandate no more than 12 sessions per year (15 minutes long) with a psychiatrist for "med checks". Even "good" policies that provide for psychotherapy seldom allow for weekly appointments, maxing out at two a month.
The fact of the matter is, treatment is both very complicated and very vital to both BPDs & Bipolars if they are to be able to well integrate into society, be able to get and hold down a GOOD job (ie, one with good insurance benefits), and improve and maintain good interpersonal relationships. So if we aren't able and willing to cover these subjects here, we MUST ensure that the wiki linked pages do.

--Kiwi 16:06, 26 December 2006 (UTC)


Hey Cas - i finally figured out where you got that message. There used to be a ratherly firm size limit because back then a number of older browsers had size limits. Now, here is what WP says -
* Though article size is no longer a binding rule, there remain stylistic reasons why the main body of an article should not be unreasonably long, including readability issues. It is instead treated as a guideline, and considered case by case depending on the nature of the article itself.
* For stylistic purposes, only the main body of prose[1] (excluding links, see also, reference and footnote sections, and lists/tables) should be counted toward an article's total size, since the point is to limit the size of the main body of prose.
So even tho we MIGHT, COULD and maybe even SHOULD merge medications articles with the existing Mood Stabilizers & AD articles , currently, we don't have to worry as there is no portion of the article that is unreasonably long, certainly not to the point that it interfers with the readability and comprehension of the material. --Kiwi 17:34, 26 December 2006 (UTC)


OK - cool (and the project groweth even bigger.......) cheersCas Liber 19:47, 26 December 2006 (UTC)


Cas, you said (back up a ways)-> The first time I had heard of the term (Non-BPD) was here on wikipedia and I have worked in mental health for over 10 years..."

The first time I noted it it was in the past few months. I have since seen that it seemingly comes straight from support forums for Non's. I don't like it and I don't think Wikipedia should encourage the use of the term. This is why I feel this way -->

Because it instills an even greater distance between US and THEM. It implies They are SICK, but WE are not sick. It further stigmatizes those with BPD. And it objectifies them by labeling ourselves as GOOD PEOPLE who are just the innocent victims of BPDs.

Suddenly those persons aren't fellow human beings, a parent, a child, a spouse, a friend, a coworker... they are a label. When someone comes on a support forum and says, I am a Non... then something is wrong with this picture. The Non's are distancing themselves, and by suggestion they are (and I find this on support forums for other PDs), implying that they have no mental illness.

And studies show that this is certainly no blanket assumption.

So I hope it can be avoided. loved one of someone With BPD than the person married to A BPD. The Non-BPD should treat The BPD this way.

When you have BPD, you are not A BPD, not a label. You are far more than your disorder, more than a diagnosis.

Also, it is unfortunate that Borderline is an ancient term that stems from an out-moded notion that Borderlines were a shadow disorder existing between Normal People and Schizophrenics. I would like to see it changed in the next DSM.

Okay, I'll stop jumping up and down, yelling from my soapbox. --Kiwi 21:02, 26 December 2006 (UTC)

The problem I have with the term is that everyone has issues (check transference nad countertransference) and we can all be in for a stormy time when interacting with people with BPD. The idea there is a subset of people NonBPDs doesn't make any sense to me. Cas Liber 21:25, 26 December 2006 (UTC)
The term "Non-BPD", "nonBP", or simply "Non" is used in the notable book Stop Walking On Eggshells and related internet forums to refer to a person without BPD who is in a close relationship with a person with BPD. It does not apply to the general public. I also would like to see the name changed to something more precise.
There should be a section here on "effect on others", describing briefly the problems that arise in people in close relationships. While everybody does have issues, the phenomenon of projective identification does occur with significant regularity among "nonBPs."
From personal experience with two such people, I can verify that they instinctively use the mind control tactics (YouTube) of cultists to trick people into caring for them and remaining in relationships. What they don't realize, can't realize on a fundamental emotional level, is that they don't need to trick people into loving them. There are people willing to befriend them, and even to love them, and who won't abandon them if things get rough. --BlueNight 15:41, 20 February 2007 (UTC)
Book, and authors are not in accord with WP:NOTE and WP:RS (Just another thought, in that if the book had any validity it would also be considered non-peereviewed original research see WP:OR). It's just online, minority psycho-babble with no basis in academic or scientific thought or opinion. If you can find a better sources for the concept of Non-BP feel frre to include them. Here is a link to the original discussion [6]--Zeraeph 17:56, 20 February 2007 (UTC)

Experimental inlining of text slated for deletion

(Note - this quote below is an excerpt from Zeraeph's comment elsewhere)

she said, "I have just tried an experiment in placing some sections that need serious pruning inline to see what effect it has...reversion of any, or all (except the requests for citation, for FA status they are essential or the related text must go) will not offend. Might be a technique to experiment with other text that may be superfluous?" --Zeraeph 10:42, 26 December 2006 (UTC)


Now, KIWI (me) SAYS ----

I disagree that what has currently been inlined is superfluous.
I do not think it is a helpful way to point out recently added material that needs to be rewritten and citations added for the following reasons:
  • the only people who will ever get to view the removed text are those who decide to edit THAT PARTICULAR subtopic.
  • Since this article is very well indexed, when it is edited, very little editable text is revealed, thus making it unlikely to have a chance for anyone to edit out point of view or provide citations
  • No one will go looking for missing text as most of the inlined material was up no more than 12-15 hours
  • Finally, in one instance - covering the cognitive deficits of mood stabilizers, an entire sub-subtopic was completely removed from view. Consequently, only the editior would notice the missing subtopic.

--Kiwi 16:06, 26 December 2006 (UTC)


then KIWI adds:

BUT, on the other hand, I DO acknowledge and admit that some/much of what I added yesterday DOES have too much "POV" and I need to correct that. And if I don't do a good job, please let me know what it is (about what I still have there) that is WRONG. I have a bit of difficulty of grasping that facet of encyclopedic writing.
But even if it is besmirched with a POV-sounding presentation does not mean it is not true - I will start finding the citations ASAP. Unfortunately, almost all of these were taken from announcements from the universities and/or conferences involved, and I pasted them to a forum that went down and will not have the back-ups reinstalled til after New Year's.
But I think I will be able track down most, if not all of them, from some databanks I have access to. It will just take a tiny bit. Maybe a lot of tiny bits!  :o)) --Kiwi 16:50, 26 December 2006 (UTC)
I HAVE AN IDEA!!!! Zeraeph, do you think it would be okay to place these inlined portions (them being entire paragraphs or more) into one of those funny little boxes I sometimes see - the are set off, if I recall exactly, with dashed lines all around them??? They may even be tinted a different color (?). How are those done? If you tell me how to make those things, I can do them this way. As fast as I can. That way I (and everyone else) can easily spot them and I don't have to search through the entire article for the inlined areas. And if anyone else wants to edit or contradict anything I wrote, they can certainly do so. What do you think? --Kiwi 20:26, 26 December 2006 (UTC)


Saw your note over at WP:VPT. I think the "funny little boxes" you mean are made by putting a space before text.
Like so.
It has uses, but it's not usually used around disputed text. For one thing, you don't get line wrapping, so you would have to put in line breaks manually which is really inconvenient. The disputed text can always be copied to the talk page for discussion and improvement. Gimmetrow 01:00, 27 December 2006 (UTC)


Me too

Ditto looking in from WP:VPT. Trying something. (Look at this in a section edit-- this may be of use to you):
   1...
   2...
   3...

    OR

    1...

    2...

    3...

    A few minutes back, I commented out some out of place table stub along with an 'blockquote'.

   
From Wikipedia, the free encyclopedia.
gives one option though... even the links stay healthy... but the text is forced into a new block and line instead of lining up with previous indenting margin. (See this Para and Template:I2 (edit talk links history) and {{Indent}} (AKA 'I') TO SEE HOW they are forcing newlines instead of wrapping with the current left margin

   
From Wikipedia, the free encyclopedia.

   You spell those: {{I2}}{{ Co |TEXTCOLOR |bgColor |From [[Wikipedia]], the free [[encyclopedia]].}} . <g>
   Hope that helps. Best regards. // FrankB 16:03, 27 December 2006 (UTC)
It looks from what Zaraeph said about not being offended that he wouldn't object if those inline'ing tags were removed, if that would make it easier to NPOV & source them quickly. Or someone's suggested inline that content to be worked on could be temporarily moved to a talk page? EverSince 18:24, 27 December 2006 (UTC)



Another suggestion, now that I see the dynamic growth of this talk in a quick perusal. Use Template:Fact (edit talk links history) which makes a discrete line annotation, and flags the areas that need cites attention for all. I'd highly recommend such in this dynamic. In fact, there should be something along the same lines for pov/npov issues. Let me check Category:Wikipedia templates and see what I can locate. (I'm not planning on working on the article directly, but I'm glad to support you all as I can.) <g>

    Also, note the suggestion made Kiwi on a temp page to evolve things, vice main article space for these involved and complicated edits. There is a version of Template:Inuse (edit talk links history) for a section edit as well, iirc.

   I gotta run, no joy on a pov version, but built this comparison of things you all may find useful. Good editing! // FrankB 19:14, 27 December 2006 (UTC)
To be honest I felt most of the text I placed inline could be as easily deleted, except that some of it could be moved to articles it is specifically relevant to, not least because the size of the article is way out of control and some things have to go. Placing text inline was just an experiment in seeing how far that would reduce the article size and correct the balance in terms of the pharmacology appearing to "take over".
Which is what I meant by encouraging others to do likewise (maybe I should have made it clearer?) by placing pieces of good, but perhaps dispensible text inline for a while to see what kind, and size of article that left behind.
However some of the things I placed inline were expressed as opinion, and should not have appeared in a namespace in those terms at all. --Zeraeph 05:37, 28 December 2006 (UTC)
I personally agree the meds section is a bit too long. I think we have to just directly work on it - someone's made everything visible in the article and so anything changed or deleted, even if quite a lot, will be clearly in the history for anyone to rework & reinstate if they want EverSince 14:29, 28 December 2006 (UTC)


Moving Non-BPDs. How about a BPD take on relationships?

The following italicized EXCERPTED text has been copied & pasted here for ease in discussing the issue of intimate BPD relationships:

The most straightforward to move is the section on Non-BPD which could go on a separate page with a 1 or 2 line summary here. It seems to be a fairly distinct topic unlike much other material which is interlinked. Cas Liber 05:18, 26 December 2006 (UTC)

The Non-BPD can be easily transferred and is not a particularly core topic. The first time I had heard of the term was here on wikipedia and I have worked in mental health for over 10 years...Cas Liber 09:02, 26 December 2006 (UTC)

I have been looking at the Non section again, fully agreeing that it needs moving. All it would take is a mention on several Non-support groups, and they would be hip deep in editors.
But even though relationship issues have been briefly touched upon, I think it could maybe be a significant addition to deal with these issues from the perspective of the partner with BPD. Just a thought.—Preceding unsigned comment added by A Kiwi (talk • contribs)
Probably not a very good idea to solicit editors on any online support mailing lists as these lists never, in themselves, seem to meet the criteria for notability are subjective and POV at best, fanatical and agenda driven at worst, not a suitable attitude to introduce into a Wikipedia article I would have thought? --Zeraeph 14:32, 29 December 2006 (UTC)

Why do antipsychotics "stabilize mood"?

A Kiwi deleted this and the Why do anticonvulsants "stabilize mood"? headers. This is legitimate, because both of them were empty with nothing but an expand-section tag under them. Yet the reasoning of "it is simply too complicated to deal with on Wiki - it's a graduate-level topic" doesn't ring well with me. Wikipedia is an encyclopedia; nowhere in the guidelines or mission-statement does it state that there's a threshold for the complexity level of an article; or if does, I've never seen as much. Graduate students and doctorants and even fully-fledged academics read and edit Wikipedia.

I feel that this is important information, and someone with the knowledge and understanding of it needs to create an explanation on Wikipedia. Anticonvulsant and antipsychotic might be a more appropriate place than here, but currently the former has no mention of mood disorders and the latter has one line about the drugs being used as mood stabilizers even if no psychosis is present. As I said, I'm not arguing against the deletion in practice, but against the conceptual deletion - the call that this information does not belong on Wikipedia. LeaHazel : talk : contribs 08:00, 29 December 2006 (UTC)

Easily fixed - hopefully someone will expand the relevant articles - it would mainly be the articel olanzapine which is the antipsychotic with the most mood-stabilizing effect. cheers Cas Liber 08:51, 29 December 2006 (UTC)
It is mentioned in the lead of olanzapine as it mentions it is used to treat bipolar disorder. Cas Liber 09:00, 29 December 2006 (UTC)

On overlap in BPD/Bipolar - New research

Pardon my long absence. We had a family tragedy over the holidays and I was not up to much of anything. Now I find the forum owner of where I had posted so many journal research articles has still not restored archives, so must do it the longer, more difficult way. So many changes, hope I can find my way around. The first thing I have to post is some cutting edge research on the BPD/Bipolar overlap. Many doctors are pushing for significant changes in the next DSM. Kiwi 01:41, 5 January 2007 (UTC)

Glad you're ok, the research sounds good. EverSince 10:24, 6 January 2007 (UTC)

Masterson on BPD?

That whole approach seems to be missing, and it is very significant, to the point where, without it, article is not presenting all POV. Must do a little work when I have time. --Zeraeph 14:59, 20 January 2007 (UTC)

Lack of impulse control / Difficulties in sense of self

Currently, the following is found under the heading of "Lack of impulse control", despite already being mentioned earlier in the Signs and Symptoms section: "Rather than deciding whether they are heterosexual, homosexual or bisexual, they often change their minds between the three, resulting in ignored feelings, confused emotions and an overactive imagination which usually makes the situation worse for them."

Firstly, "deciding whether they are heterosexual, homosexual or bisexual" seems highly innaccurate, both in the use of the word "deciding" and in stating that one must be either straight, gay or bi.

Secondly, why is this under the "Lack of impulse control" section at all?! Is one to "decide" on a sexuality and then feeling anything is to be classified as "lack of control" and a possible symptom of a mental disorder?

Should this section be removed completely or re-writing and moved (possibly to a new section on difficulties in the sense of self)? —Preceding unsigned comment added by 82.2.139.75 (talk • contribs) 07:28, 25 January 2007

Personally I totally agree. Also don't like the way it talks of "they" all doing this or that. A section on sense of self sounds interesting. EverSince 23:40, 25 January 2007 (UTC)
I think the wording of the section is POV, blanket-terming and somewhat inflammatory, and it could use some rewriting. Unless... well, it's not well-cited, and maybe it should be removed altogether. (Also, please sign your posts.) LeaHazel : talk : contribs 13:28, 26 January 2007 (UTC)

Removal of unsourced material

There are a lot of statements in this article that have had [citation needed] and {{Fact}} tags for a long time. I think these should be deleted unless someone can provide reliable and verifiable citations to support the statements. MarkWood 23:31, 27 January 2007 (UTC)

I agree. DPetersontalk 23:28, 30 January 2007 (UTC)
I agree too, if the information is valuable and valid somebody will put it back with citations. --Zeraeph 00:03, 31 January 2007 (UTC)
All done...but it's left me feeling like Hannibal Lecter (I thought I'd say that before anyone else could). I hope there are going to be some new, cited edits to fill the gaps, though, when I looked closely I found quite a lot that wasn't even relevant to BPD. --Zeraeph 01:07, 31 January 2007 (UTC)
Nice work...the article is much improved...thanks! DPetersontalk 01:57, 31 January 2007 (UTC)
Agree -much pruning and the article looks much the better for it. Are you thinking of heading to FAC sometime soon.....Cas Liber 03:55, 31 January 2007 (UTC)
I also agree the pruning was necessary to tidy things and keep the focus. I do feel, though, that in some cases it's removed any reference to issues at the core of the disorder, some of the wording for which had been balanced through consensus discussions over time, which could make addressing and sourcing these issues more difficult. I added a lot of those "citations needed" tags a few weeks ago, I suppose it has been a while now. I would like to replace some of what was there and, over time, source it. EverSince 09:56, 31 January 2007 (UTC)
That's absolutely how I feel myself, but I also feel that, once properly sourced, a lot of the removed text would have to change for accuracy. There was a lot of wild speculation mixed up with core issues and no sources for either. (Truth is the intro itself needs sourcing or removing too, but I couldn't just remove THAT.) Best thing to do is bookmark the last revision before I got into my "Hannibal" zone [7] and refer to it as notes for sourcing and revision? --Zeraeph 10:07, 31 January 2007 (UTC)
Excellent idea. LeaHazel : talk : contribs 12:20, 31 January 2007 (UTC)
A lot of it did need improving and sourcing. It's not my preference but I'm OK to work on it that way and hope others are, and I certainly don't want to be chopped up to go with a nice chianti! EverSince 12:56, 31 January 2007 (UTC)
The "needs citation" tags were up for a while...no one added source material, suggesting either that there isn't interest or that the statements have no basis. In any event, removal seems appropriate and if there are valid references, the interested parties can add the material and references. DPetersontalk 22:55, 31 January 2007 (UTC)
I agree with removing material that is unsourced.MarkWood 23:47, 8 February 2007 (UTC)
In looking to add content and sources on the main features of BPD, there is an apparent problem of overlap with the list of DSM criteria which are themselves, of course, one attempt to outline the main features (at least, those seen as most clinically significant and diagnostically relevant). I was wondering if there were any views on whether or how additional info and sources on these features should be integrated within that section, or kept separate. EverSince 20:23, 20 February 2007 (UTC)
If you are refering to the five-point-description by Linehan, I am all for their inclusion, preferably in the section 'signs and symtoms'. --Grace E. Dougle 21:50, 20 February 2007 (UTC)
I was referring to adding or re-adding coverage of some of the issues removed as discussed above, and wanting to clarify this overlap between the subsection on DSM/ICD criteria and the section on signs/symptoms (aka features or issues) EverSince 22:09, 20 February 2007 (UTC)

Differential Diagnosis

I removed the following

"==Differential diagnosis==" Borderline personality disorder often co-occurs with mood disorders, and when criteria for both are met, both should be diagnosed. However, some features of borderline personality disorder may overlap with those of mood disorders, complicating the differential diagnostic assessment.

  • Mood disorders
- Bipolar disorder, especially bipolar II disorder
  • Psychotic disorders
- With borderline, only occurs under intense stress and is not characteristic of disorder
  • Other personality disorders
- Consider patients thoughts, feelings, and behavior to differentiate borderline from other personality disorders - High co-occurrence of borderline and other personality disorders
because it does not make sense and does not have any supporting references. DPetersontalk 01:22, 16 February 2007 (UTC)


Hello Give me 1 day, i'll add references Dr.Gangino 01:33, 16 February 2007 (UTC)

just quick response:

Distinguishing borderline personality disorder from bipolar disorder: differential diagnosis and implications.

Treatment of Patients With Borderline Personality Disorder DIFFERENTIAL DIAGNOSIS section

Borderline Personality Disorder Differential Diagnosis Dr.Gangino 01:53, 16 February 2007 (UTC)

(the first one is just some letters but the last two are good) Cas Liber 22:46, 16 February 2007 (UTC)

2 Casliber, pls be careful. Delete additional 'ref tag Dr.Gangino 13:58, 19 February 2007 (UTC)


Real can o' worms - could open up a whole section on how the discrete personality disorders in DSM IV lack validity and the most valid seems to be the generic criteria for Personlaity Disorder. Similarly, drug-induced psychotic episodes really murk up the picture when trying to differentiate brief psychotic episodes secondary to BPD vs. schizophreniform pictrure. Cas Liber 01:36, 16 February 2007 (UTC)
You are perfectly right, and we should draw the line there, at least in this section. What you are saying also concerns the general doubts about the diagnosis of this disorder and the way it is described in DSM-IV right now, as well as the fact that personality disorders are an under-researched topic. In another section, however, maybe a qulified addition about what is expected to change in DSM-V would be interesting. This section (Differential diagnosis)as it is is harmless and common knowledge, and sourced now. I'll put it back.--Grace E. Dougle 10:20, 16 February 2007 (UTC)
I guess the issue with both the BPD and bipolar articles is that both have swollen to huge sizes with numerous sections over the past year or so and rather then bloating again people are trying to be judicious about what goes in. I feel this bit is OK with refs and a bit of a rewrite Cas Liber 10:38, 16 February 2007 (UTC)
If references that meet the wikipedia standard of being verifiable can be provided, then a section on differential dx certain belongs in this article, and any other article about a mental health disorder. DPetersontalk 21:36, 16 February 2007 (UTC)
The references (American Psychiatric Association) are definitely ok and they cannot be any more verifiable than being linked to. As you say, a section on differential dx certain belongs in this article. Yes, right, it does belong in this article. If you don't like the wording, rewrite it.--Grace E. Dougle 22:21, 16 February 2007 (UTC)

Non-BPD again

Can I draw your attention to this Wikipedia:Articles for deletion/Non-BPD?

The consensus seems to be that Non-bpd is only notable if it can be cited to more than a single, POV, agenda-driven book (such as "Stop Walking on Eggshells"). I think I agree with that. I have known some of the people directly involved with the creation of this book and it's subsequent agenda and, though whatever I know is original research, and does not belong here, I can assure you I know nothing that suggests that they satisfy WP:RS as sources for a medical article.

The worlds of online psychology is saturated with self appointed expertise that, even when it is not of dubious intent in it's own right, just adds to a growing volume of subjectivity, partial information and misinformation on the internet posted by self appointed experts.

The trouble is it is just TOO EASY fall into the trap of assuming that some of this misinformation is established and verified fact or academic theory, when, too often, it is just one person's, subjective, thinking.

I think it is very important on Wikipedia to dismiss all that misinformation and get back to established and verified fact or academic theory, from reputable sources and objective experts. Most particularly on this, a medical topic. --Zeraeph 13:02, 20 March 2007 (UTC)

That discussion was about whether "non-BPD" merits an entire page, this is about a single mention. Perhaps you're right that the term doesn't need highlighting, but the edit was clarifying how the scientific usage differs from this popularized usage, which seems sensible to me. Regarding the book itself - self-published online psychology is one thing but this appears to be an independently published and widely sold book (with also published "workbook" or something), one of the authors of which is a psychologist and which seems to be much discussed (note the use the book has apparently been put to, that he apparently regrets). In any case, it was explictly not being cited as a source of facts about BPD but as a significant example of some of the often controversial discourse around this, whether justified or not. This is interesting and relevant to the topic in my opinion (which has nothing to do with the extent to which this is seen as medical, about which there are different scientific and professional views of course). I very strongly agree about quality scientific sourcing, as I hope is apparent, but I also think mention of things like this shouldn't be excluded (and the actual policy page for this is WP:A, which links to a FAQ which says "Even if it is actually crankery, we have articles on Phlogiston, and on many less plausible political and social ideas, in order to explain what they are.") If you feel so strongly against this book, why not seek sources for alternative coverage of the issues or critiques of its agenda, rather than just deleting things, which is also too easy to do sometimes EverSince 20:05, 20 March 2007 (UTC)
What I feel is that it would be improper to link all mention of the Non-bpd concept to one very questionable, agenda driven, book (which was the consensus of the AFD) without a verifiable counterbalance.
All else aside, to do so would not be WP:NPOV, and would be an implied endorsement by default.
Paul Mason's regrets are a beginning. I would have no objection to the book being mentioned if alternative views were also expressed, and it was made clear that the book is only included as relevant minority view that many other people find abhorrent...including some people who would self-identify as "Non-bpd's", who's alternative views really do need to be represented? --Zeraeph 22:18, 20 March 2007 (UTC)
I find myself agreeing with EverSince. Mentioning the controversary in NPOV language and a source does have a place here...if only to alert the reader that there is a controversary. DPetersontalk 22:45, 20 March 2007 (UTC)
Problem is, if there is a critique of a book not notable enough to be critiqued elsewhere, does this then constitute Original Research? cheers, Casliber | talk | contribs 22:47, 20 March 2007 (UTC)
PS: I don't see how mentioning the concept adds anything to the article, as I think we've discussed before. cheers, Casliber | talk | contribs 22:48, 20 March 2007 (UTC)

I do think the main thing is to develop the article's coverage of relationship and family issues, including those that may be common but controversial. There is now some sourced balanced coverage of some of these issues - like being sensitive or insecure in attachment, or being (mis)perceived as manipulative or difficult. Overall I think the article's looking pretty good and well-sourced now... EverSince 12:32, 21 March 2007 (UTC)

Agreed. DPetersontalk 14:43, 21 March 2007 (UTC)
Also agreed, basically, the focus of this aspect should be on relationship and family issues, NOT a single, non-notable, agenda driven book, so can I suggest that the priority be placed on presenting those relationship and family issues, and the "Non-BPD" issue not be mentioned until a good, academic, verifiable, start has been made on that? --Zeraeph 17:38, 21 March 2007 (UTC)
I think that's not quite accurate - the book and term were mentioned as one characterization of things, published in the pop lit, with other perspectives and related scientific findings explained and multiply sourced (as mentioned above). You feel the most strongly about this book and term so it's a shame you haven't provided sources on it and these issues. So I do agree it would be most helpful to focus on that, given that you don't want any of this mentioned at all for now EverSince 11:40, 22 March 2007 (UTC)
I am sure there ARE plenty of objecting sources, maybe I can find some (though not today stuff to do away from PC) but surely the issues themselves are infinitely more important than publicising a single, highly pejorative, book? --Zeraeph 12:27, 22 March 2007 (UTC)
Sorry, I agree with Zeraeph. I work in the field and the material that was presented was just not up to par. By trying to define Non-bpds it undermines a whole lot of important material on the transference/countertransference (in psychotherapy) and on the understanding of a BPD's turbulent relationships and why they have them. For a concise, comprehensive summary there would be a waiting list of material which would have a priority higher than this. cheers, Casliber | talk | contribs 12:44, 22 March 2007 (UTC)
The 'material' was one sentence mentioning the usage and one mentioning a characterization exampled by the book, Casliber, I don't think we should keep getting hung up on it. Since I've added quite a lot of scientifically-sourced material on psychotherapy and relationship issues, I don't disagree about the importance of covering that (why don't you add something sourced on the transference issue? that perspective being largely linked to a psychanalytic perspective of course and currently obliquely covered re. TFP). Zeraeph, that sounds fine to me. EverSince 14:16, 22 March 2007 (UTC)
I've re-added some coverage of family- and partner-related problems, with pubmed sources, and just mentioned that these issues are also addressed in published pop psychology and in support groups. Doubt the Mason interview could count as a reliable source because it's just an informal chat transcript EverSince 11:20, 23 March 2007 (UTC)
Personally I think the paragraph you added is great, and WAY better, and more honestly informative, than anything agenda driven. --Zeraeph 11:43, 23 March 2007 (UTC)
Agree. It is an important area. Could go on forever on this tangent (lead into attachment theory/transgenerational nature of abuse etc.) but this is nice and succinct, and needs to be given the size of the article. cheers, Casliber | talk | contribs 16:26, 23 March 2007 (UTC)


bpd diagnosis and sexism

One of my family members has almost every symptom of this condition, which makes life impossible for everyone including himself. I have read however that this illness is rarely identified in men. However, in my own family there are 3 examples of men who almost certainly suffer from it in various forms. I have never knowingly met a woman with this. I think this article should include a discussion on possible reasons for the fact that women are more frequently diagnosed, as i've heard various explanations and i don't believe the explanation is that more women have it. XYaAsehShalomX 17:44, 20 April 2007 (UTC)

The preponderous of women diagnosed with BPD has nothing to do with sexism. It has to with the fact that BPD is primarily psycho-social in nature and, due to documented gender differences in cognitive processing, women tend to be more prone to emotional dysregulation. That is not to say that women are more emotional than men, it is to say that the filters that women use to interpret and integrate their experience and respond to it depend more on right-brained processes than men.
As for your own experience, that says mroe about the family system than it does about gender concerns. Empacher 17:59, 20 April 2007 (UTC)
Ok cool. But surely stuff like identity disturbance and frantic efforts to avoid being rejected might be equally common in men? As well as difficulty controlling anger, alot of men have that? i knew a girl who had a boyfriend at high school who may have suffered from this disease. He self harmed and trashed the library and said he was going to kill himself every time she tried to break up with him, he was extremely possessive and could get very angry, stalkerish, tearful etc and do very odd things, yet at other times he appeared normal. is this bpd? or something else? None of the men in my family self harm as far as i know, although otherwise their behaviour is quite similar. i hope i dont seem rude btw, don't want to upset anyone :) XYaAsehShalomX 21:36, 20 April 2007 (UTC)
This is not the appropriate forum for this conversation, but I will respond briefly by saying that you are describing male depression fueled by control and esteem issues...pretty typical male behavior, but not so much BPD as other stuff...read "I Don't Want to Talk About It" for some perspective. Empacher 22:04, 20 April 2007 (UTC)
Oh, ok cool. I didn't think it was bpd he had, but it seemed a bit like it from what i now know, and he was certainly a strange person. He didn't seem to have identity disturbances, or some of the other stuff that the men i mentioned suffer from but i never knew him that well. And yes you are right, this is not the right place. 134.225.181.239 15:06, 21 April 2007 (UTC)


The above discussion is preserved as an archive. Please do not modify it. Subsequent comments should be made on the appropriate discussion page, such as the current discussion page. No further edits should be made to this discussion.