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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.
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
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.
This one I really like ; it is succinct and has more understanding of the condition. [ [1]] Cas Liber 20:49, 25 September 2006 (UTC)
"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)
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)
A green Kiwi in learning mode 01:32, 22 October 2006 (UTC)
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)
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.
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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
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
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)
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:
Question is, put it here as well as on lithium and TD pages? cheers. Cas Liber 14:47, 26 October 2006 (UTC)
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)
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)
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)
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:
cheers Cas Liber 12:45, 28 October 2006 (UTC)
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 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)
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)
Shouldn't Gunderson be mentioned somewhere in that paragraph? Can't understands why no-one ever has -- Zeraeph 06:14, 29 October 2006 (UTC)
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)
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:
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 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)
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
-- Kiwi 05:07, 21 December 2006 (UTC)
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)
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)
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! — K e akealani 06:46, 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)
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)
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 consensus Cas Liber 01:21, 25 December 2006 (UTC)
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 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)
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)
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)
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)
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
Also noticed
Mental health service utilization
& quick search showed stuff like
nurse attitudes positive attitude change
So I'll add something about this back in soonish too if no objections. EverSince 15:24, 27 December 2006 (UTC)
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)
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)
-- Kiwi 16:06, 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)
(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 ----
-- Kiwi 16:06, 26 December 2006 (UTC)
then KIWI adds:
Like so.
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(
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: <br /><br />{{nbsp|3}}{{ Co |TEXTCOLOR |bgColor |From [[Wikipedia]], the free [[encyclopedia]].}} . <g>
Hope that helps. Best regards. //
Fra
nkB 16:03, 27 December 2006 (UTC)
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)
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)
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)
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)
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
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 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. DPeterson talk 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:
Treatment of Patients With Borderline Personality Disorder DIFFERENTIAL DIAGNOSIS section
Borderline Personality Disorder Differential Diagnosis Dr.Gangino 01:53, 16 February 2007 (UTC)
2 Casliber, pls be careful. Delete additional 'ref tag Dr.Gangino 13:58, 19 February 2007 (UTC)
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)
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)
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)
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. |
Archive 1 | Archive 2 | Archive 3 | Archive 4 | Archive 5 |
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.
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
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.
This one I really like ; it is succinct and has more understanding of the condition. [ [1]] Cas Liber 20:49, 25 September 2006 (UTC)
"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)
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)
A green Kiwi in learning mode 01:32, 22 October 2006 (UTC)
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)
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.
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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
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
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)
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:
Question is, put it here as well as on lithium and TD pages? cheers. Cas Liber 14:47, 26 October 2006 (UTC)
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)
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)
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)
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:
cheers Cas Liber 12:45, 28 October 2006 (UTC)
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 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)
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)
Shouldn't Gunderson be mentioned somewhere in that paragraph? Can't understands why no-one ever has -- Zeraeph 06:14, 29 October 2006 (UTC)
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)
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:
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 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)
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
-- Kiwi 05:07, 21 December 2006 (UTC)
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)
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)
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! — K e akealani 06:46, 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)
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)
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 consensus Cas Liber 01:21, 25 December 2006 (UTC)
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 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)
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)
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)
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)
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
Also noticed
Mental health service utilization
& quick search showed stuff like
nurse attitudes positive attitude change
So I'll add something about this back in soonish too if no objections. EverSince 15:24, 27 December 2006 (UTC)
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)
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)
-- Kiwi 16:06, 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)
(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 ----
-- Kiwi 16:06, 26 December 2006 (UTC)
then KIWI adds:
Like so.
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(
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: <br /><br />{{nbsp|3}}{{ Co |TEXTCOLOR |bgColor |From [[Wikipedia]], the free [[encyclopedia]].}} . <g>
Hope that helps. Best regards. //
Fra
nkB 16:03, 27 December 2006 (UTC)
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)
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)
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)
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)
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
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 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. DPeterson talk 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:
Treatment of Patients With Borderline Personality Disorder DIFFERENTIAL DIAGNOSIS section
Borderline Personality Disorder Differential Diagnosis Dr.Gangino 01:53, 16 February 2007 (UTC)
2 Casliber, pls be careful. Delete additional 'ref tag Dr.Gangino 13:58, 19 February 2007 (UTC)
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)
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)
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)