Talk:Borderline personality disorder

Article is too big

At almost 10,000 words this article should definitely be trimmed, per WP:TOOBIG. I suggest we create articles for some sections, such as Causes of borderline personality disorder (redirect to the "Causes" section), diagnosis, signs and symptoms; like we already do for management and misdiagnosis. The Blue Rider File:Postal horn icon.svg 16:00, 14 March 2024 (UTC)

I agree, I’ve done copyediting to most of the current content. Snipping out excess or twice-repeated content. However, for the most part it was just fact checking, updating some facts that play an important role, and letting it all flow nicely. I’m sitting with the following facts after my huge copyedit:

1. Causes should be grouped into three: genetic, neurobiologic, psychosocial. And then we expand if so on the new research into that.
2. In diagnosis, we put the criteria into prose, possibly removing the subtypes or prosing the subtypes by Millon as I haven’t seen their substantiveness in all the medical literature I’ve read there isn’t much mention of them?
3. Adolescence should move more forward or to a separate section termed prodrome where like schizophrenia there may be a prodrome or adolescence behaviour pre-disease pattern prior to developing the disease, as this is so “pervasive” unlike a mood disorder there is a prodrome of sorts I’ve picked up on although that is original research.
4. The differential diagnosis section is giving me the “ick”. It’s very overwhelming as summarised BPD can occur comorbid with a lot of other conditions, and not so typically talked about vice versa, if you get what I mean. And it speaks of the statistics in the old terms of Axis I and II instead of Sections I and II and I think we should speak of them in comorbid other personality d/o and comorbid other mental d/o (like mood d/o, trauma d/o etc.)
5. Management I need to tackle the main article, then we can filter what needs to be there knit pick onto the BPD article, maybe by {transclusion}? -- I’ve never done that before so you’re suggestions would be appreciated.
6. Epi I touched a little with the latest stats
7. Prognosis and History and Controversies I haven’t touched at all!!

What do you think? waddie96 ★ (talk) 15:33, 16 March 2024 (UTC)

I agree with all the points, I will start by putting the criteria into prose. The Blue Rider File:Postal horn icon.svg 17:55, 16 March 2024 (UTC)

Well, after you put it into prose, it really misrepresents the diagnostic criteria as outlined in the DSM V TR. I don't think diagnostic criteria is the time for prose, or any sort of personal editing or paraphrasing. It should be presented the same way it is in the scientific, medical, text. I see criteria such as self harm and fear of abandonment under the ICD section, but why is none of it listed in the DSM V section? Why is that part all loosely summarized and missing major diagnostic components of the disorder? 2600:8801:9A01:7070:0:0:0:E5D6 (talk) 07:40, 23 August 2024 (UTC)

@The Blue Rider I don't think there's anything wrong with it being long it provides the most information 45.19.219.33 (talk) 19:25, 21 March 2024 (UTC)

Good day, and welcome to Wikipedia. See Wikipedia:Welcome and Wikipedia:Article size. waddie96 ★ (talk) 20:29, 21 March 2024 (UTC)

I can't speak to the state of copyediting since I haven't thoroughly examined the article, but I think branching any of this off into a separate article would be a huge mistake. You suggest, for example, branching 'Causes of borderline personality disorder', yet I just trivially removed about 400 words from that section solely by trimming out two subsections which read like two people came in and decided to write a short essay about their favorite paper. With that done, the current section 'Causes' is of a totally reasonable and manageable length within this article. What I can almost guarantee would happen if it were branched is that 1) none of the people who branched it would stick around to maintain it long-term, and it would never see that kind of care and attention again, 2) the article would either not be much longer (if at all) than it would be as a section here or it would metastasize and come to be dominated by people indiscriminately turning single papers into entire essay-like subsections (whereas here it can be localized and easily eliminated, fewer eyes are on a subarticle like that), 3) it would be linked to basically just by this article, making it hard to find for typical readers, 4) coordinating what goes in the main article or both would be tedious, contentious, and likely detrimental to the completeness of the main article, and 5) the quality of both would suffer as they split editor attention. Biology of depression works so well because it's been so widely explored by hundreds upon hundreds upon thousands of studies. It really needs that space. With the suggestion to branch any article because it would make for a robust article on its own, I think there needs to be a standard of "prove it", i.e. present in a sandbox the exact version of what you think this article's first revision should look like and let editors examine that, not just whatever future ideal they can come up with in their head. TheTechnician27 (Talk page) 09:45, 14 April 2025 (UTC)

Agree, I don't think it needs a separate article. I think a lot of the article is just repetitive and too detailed. Zenomonoz (talk) 09:48, 14 April 2025 (UTC)

The diagnosis section is also too big, and probably doesn't need tables of comorbid diagnoses, given these rely on primary source studies. Zenomonoz (talk) 09:51, 14 April 2025 (UTC)

I heavily disagree about the table. The Grant et al. 2008 study was primary, sure, but it involved 35,000 participants. This is entirely serviceable for how we use it. As noted, I think your argument that "they are described in the body already" isn't just weak, but it in fact disregards how tables are used and why they're useful in this context. A table is useful as a summary of what someone has read in the prose; once they're done reading, they can consult the table and better understand the data they've just read. It's also useful for someone who doesn't care about the prose and just wants the hard numbers. This is outright common on Wikipedia; for example, most every article on a video game will have a section called 'Reception'. This will discuss how the game was received by different outlets (including numerical ratings), and it will include a table summarizing these ratings. If anything, I would suggest that there are few instances where a table should exist in an article absent any prose, whereas I can think of quite a few where mixed usage is ideal. I think most of your edits so far have been well-reasoned, but I can say that the removal of the table impedes my personal comprehension of the article, makes the article worse in my opinion, isn't well-justified. TheTechnician27 (Talk page) 15:45, 15 April 2025 (UTC)

Image

The image used in this article is weird. It says that it's "Idealization" by Edvard Munch, but when I click on the image it says that it's "The Brooch. Eva Mudocci". Is the image right for the article, considering that it's a portrait of someone else who does not have BPD and not something else? Should the image be changed to something else? Spinixster (trout me!) 08:04, 12 September 2024 (UTC)

The image represents Edvard Munch's idealisation towards Evangeline Muddock. Edvard Munch allegedly had BPD and therefore its symptoms were allegedly depicted through his art. Morslyte (talk) 09:54, 20 September 2024 (UTC)

Do you have a source saying that it's an idealization? It could just simply be a stylized portrait. Plus, I don't think it's a good image to represent BPD as a whole, since, again, just a portrait of someone. Spinixster (trout me!) 10:24, 20 September 2024 (UTC)

Again, I want to hereby draw attention back to what we call this image. Ostensibly, to me as well, the caption seems to claim that the picture is actually called "Idealization"; I have in fact had the exact same concern as @Spinixster originally posted about. I believe that we really need to clear this up. Also, we must make sure that the claim of idealization is not further original research, and that is it is suggested somewhere for this specific piece of art, that it is clearly stated that this too is a suggestion. BlockArranger (talk) 21:23, 8 June 2025 (UTC)

I agree. I think it's too much of a stretch to take a single work of art from a person rumored to have BPD (as asserted above, I am unfamiliar with these rumors) and use it to represent a partial feature of the disorder. It's just too many dots that need to be connected for it to make sense, and misstating the title is inappropriate. I think it would be better to have no image than a confusing one that only points to rumor and allusion. ArtesianAction (talk) 12:31, 17 June 2025 (UTC)

In support of removing the image by Munch and also removing references to Munch in this article, the claim that Munch had BPD is supported only by citing one pharmaceutical marketing publication, and one academic article that does not claim Munch had BPD, and if anything, argues that such a diagnosis would be mistaken. The first source (Aarkrog) cited for the claim that Munch had BPD is of unacceptable quality for two reasons: it is a publication by a pharmaceutical company, Lundbeck, that makes and markets two medications prescribed for BPD, and Munch was not diagnosed with BPD. It appears to be a marketing publication making speculative a diagnosis of a famous artist in order to promote its pharmaceutical products. The second source, the article by Wylie, that is cited for the proposition that Munch had BPD does not support that claim, rather it argues that under severe stress Munch displayed certain qualities of BPD due to him having Narcissistic Personality Disorder (speculatively, undiagnosed). Spz2025 (talk) 15:52, 13 April 2025 (UTC)

Agree with removing text about Munch. Very good arguments, Spz2025. Lova Falk (talk) 16:26, 13 April 2025 (UTC)

I hate to say this, but the original conversation is about the image on top of the article. While I support the removal of the Munch-related text based on arguments by @Spz2025, the question is still "Should this image be removed/changed?" And if changed, what to? CorrectionsJackal (correct me) 00:52, 14 April 2025 (UTC)

@CorrectionsJackal I think the image on top could be changed because in my opinion it doesn't even capture the essence of BPD very well. On the other hand, I really do think that the picture with the two faces, representing idealization and devaluation (according to the narrative), should be retained somehow, as it illustrates the phenomenon rather well, as I see it. I don't know how, of the top of my head, but it could possibly be possible to keep it without making the claim that Munch definitely had BPD. In general I believe that this article should not contain speculative posthumous armchair diagnosis, regardless of it is a scholar sitting in the armchair. It counts as trivia rather than actual information about BPD, and if included anywhere, it could be discussed in an article about Much. BlockArranger (talk) 02:12, 14 April 2025 (UTC)

@BlockArranger I'm strictly talking about the image on top of the article, which appears to be a seemingly normal portrait of Eva Mudocci, who does not have BPD, by Munch, who is only speculated to have BPD. It might be inappropriate to have that as the image to illustrate BPD as a whole. A different image should be chosen for the infobox, such as the one with the two faces, or the portrait be removed entirely. Sorry if I was not clear earlier. CorrectionsJackal (correct me) 02:25, 14 April 2025 (UTC)

@CorrectionsJackal Well, I see. Could I possibly suggest going back to the time when the picture was "Despair" by Munch, as I have not managed to find any clear reason as to why it was switched out? This article doesn't have to and shouldn't speculate whether or not Munch had BPD, but I believe the illustration was good, and I was even rather surprised when it was changed to the current one. The Despair image did in my opinion in many ways convey the experience often had by people with BPD. BlockArranger (talk) 02:29, 14 April 2025 (UTC)

@BlockArranger I agree, and I also had no idea why the image was changed. We should invite some editors to form a consensus, so in case the image gets switched out again, there's a reason to undo it back. CorrectionsJackal (correct me) 02:33, 14 April 2025 (UTC)

As we have not managed to form a consensus, I am going to WP:BEBOLD and thus change the image. I explain my reasoning below:

Background:

I won't go further back than to here to find the Brooch painting. The statement is: "I agree with Tom (LT) that "inability to make contact with one another" is a symptom of further disorders, as well. So it may not be specific enough here, and a painting showing this trait may not be the best choice. Therefore I took a very specific trait of BPD - idealization and devaluation of others in personal relations - and selected paintings by Munch that have been associated with just this BPD trait in the professional literature. I assume that this solution will be widely considered appropriate for the opening section of the article. Thanks to all for the discussion leading to this outcome."

This was later changed to another image, which I have seen no-one request back. Seems like it was introduced in order to get a proper citation regarding Much's relation to it and BPD (I forgot exactly where it was introduced).

The Brooch image seems to have been re-introduced by an IP user with no explanation of the change, found at (24 Novemeber 2019). It was in fact reverted within hours.The erstwhile picture continued to be displayed until Morslyte "[r]everted back to original image, as was discussed in the talk page and no opposition was made" on the 18th of May 2020. Further discussion / edits followed in May. Later on, though, the Brooch images seems to have been retained.

Then, a bit later, (21 September 2021) someone added the Despair picture. It seems like it wasn't opposed at the time. There is a post related to it here. Apart from the image being changed to a "HQ" one in March 2023, I don't notice any controversy.

The reason we got the current image back is because someone decided that we had in fact not reached a good consensus to change to the Despair image. Thus, three years later, the Brooch came back in this edit, with the summary "I checked history of the image change, and some user "proposed" a change, went on to change it immediately afterwards, the discussion never went forward, nobody agreed to it, therefore, I'm reverting." It was briefly changed back to Despair.

Now to the current situation:

This was reverted on the 20th of September 2024 with the explanation that "you cannot change a Wiki page on your own will as if you are an authority, your opinion is your opinion, there are clear rules which should be followed, if you have an issue with the other image you should propose such a change and it should be reached a consensus."

I wonder, if for three years one image seemed fine enough to have it kept displayed, why does the Brooch have more merit by its removal not having been discussed enough? The merits of Brooch are that we haven't convincingly made the argument for its removal. Despair, though, does not rely on Munch's relation to BPD, but rather on what it depicts. It worked fine for three years, and in my opinion, there should have been a discussion on whether or not to bring back the Brooch picture.

I have also not yet seen convincing arguments for why the Brooch would actually be a good image for this article, even at its original introduction; I see people explaining why it isn't that bad, even though Munch's BPD is contntious to say the least, as well as the image not necessarily depicting any idealization. Should we really default to "original", just because it came first? I get that it's important to discuss changes, but now someone just decided that three years of ostensible acceptance is worth throwing out of the window because another image came first.

Based on all this and given that I have obtained some agreement here, I will make the change. BlockArranger (talk) 00:12, 27 April 2025 (UTC)

Agreements from whom? Furthermore, you say the image depicts it better, however, that's your own personal opinion. I find the bizarre use of post-modernist colours to be misleading and confuse anyone uneducated in mental health to conflate it with schizophrenia/delusional thinking. That alone is reason enough to maintain the original image until someone can come up with a concrete reason of why it shouldn't be. Morslyte (talk) 16:55, 28 April 2025 (UTC)

Well, I sort of disagree with your presumption that vibrant colors would to that extent be associated with Schizophrenia, but I get your point.

I do, though, believe that something should regardless be done about the text. You yourself have claimed that "Edvard Munch allegedly had BPD and therefore its symptoms were allegedly depicted through his art." I can also refer to @CorrectionsJackal for the view that "Munch [...] is only speculated to have BPD." I also see @TheTechnician27 make an observation of the source being somewhat suboptimal.

Thus, I find it highly problematic that the text says that Munch "is presumed to have had" BPD. Presumed, de facto, (by whom?), really? I believe that it is a misrepresentation. Either we should state who it is who presumes this, or we could make the very factual claim that he has been suggested to have had BPD. I believe that no-one is disputing the suggestion having been made - but presumtion? I beg to differ somewhat. I think that regardless of the image, we should change it! BlockArranger (talk) 18:04, 28 April 2025 (UTC)

What would you all say about this image then?

File:Edvard_Munch_-_Separation_-_Google_Art_Project.jpg

It depicts "separation" - precisely what people afflicted by BPD fear. The man is seen in despair as a result of the woman departing. Also, in my opinion, emptiness could be read into this as well. BlockArranger (talk) 18:48, 28 April 2025 (UTC)

We can immediately dismiss the Wylie WH (1980) source, as having read through it 1) I can find no evidence they ever even mention BPD, 2) it's debatable if BPD was even well-understood enough at the time to have made such a retroactive diagnosis as it was published Winter 1980 whereas the DSM-III (1980) contained its first formal description as personality disorder, and 3) the article expressly describes Munch as having NPD – cluster C as well but nonetheless distinct under our current diagnostic frameworks. This to my mind completely fails verification and even directly contradicts what we're saying, which is a bad sign given it's one of our three sources. I would go so far as to say that our use of it is an outright lie. I've also removed it from the article on Munch, because its inclusion (and subsequent re-addition after an IP correctly removed it two years ago) is – put bluntly – a goddamn embarrassment to the project.

Tove Aarkrog appears to be a psychiatry researcher with multiple peer-reviewed publications on BPD. This was published in 1990, and thus our understanding of it had surely matured somewhat, although I can't imagine nearly as much as 35 years later. I think the ad hominem argument that this being published by a pharmaceutical company it makes it non-credible isn't sound. Pointing to it not being peer-reviewed is much more sound. Additionally, it's a photo gallery more than it is a sound scientific exploration of how Munch could be diagnosed with BPD. This to me is flimsy as a source – not inherently, but on its merits.

Thirdly, we have JF Masterson cited in the second caption, and we cite chapter 12 "especially pp. 212–213". (Incidentally, our article on Masterson was until just now a mass of what appears to be original research characteristic of poorly edited early 2010s-era biographies.) This was in 1988, so still pretty old, but ahead enough of the formal description as a PD that I wouldn't raise a fuss with the date. Masterson was a psychiatrist specializing in personality disorders, and thus I don't think his credentials are in question. This is a book published by Simon and Schuster, not a peer-reviewed medical publication, and so it feels a little bit weird that neither of our sources (discounting Wylie altogether) would be peer-reviewed by other medical experts. Half of page 212 and the entirety of page 213 are a brief summary of his psychological symptoms throughout his life (keeping in mind this seems to be the entirety of the discussion on Munch), and Masterson states: "From his graphic portrayals of separation anxiety and abandonment depression and the difficulties he had in personal relationships in his life, I hypothesize that he was a borderline personality [...]" Masterson additionally talks about instances of substance abuse, childhood trauma, loneliness and abandonment, interpersonal issues (including tenuous relationships), and fractured sense of self. This is definitely our strongest source, but keep in mind that we have another source (peer-reviewed) in Wylie 1980 diagnosing him with NPD. If somebody could gather more sources (robust and preferably recent) echoing that Munch was likely BPD, I think this is fine, but Masterson 1988 can't stand on its own for something this obviously contentious.

Lastly, I think it's debatable if the portrait really does a good job at representing BPD. The black-and-white imagery and the expression are... Serviceable, I guess? BPD isn't as easily digestible as something like uni- or bipolar depression or NPD (which our images do a good job of representing), so it's hard to come up with something that screams "borderline". I think outside of something egregious, which to me this image isn't, we should have a modest consensus around a new image before considering removing this current one. TheTechnician27 (Talk page) 22:17, 14 April 2025 (UTC)

Thank you for your analysis of the sources! Well, provided that your analysis is correct, I agree with your conclusions. So far, however, I would state more clearly that I don't see a reason for this article to discuss Munch much at all, as he is regardless not of that much relevance to BPD. I think the Eva Mudocci picture in itself would not carry much merit at all by itself, if it weren't for the fact that this article had already previously had a painting by Munch, and at the same time at some point someone included the information about Munch having BPD.

I believe that a picture used in this article should arguably have clear merits on its own, regardless of the artist; I would most definitely prefer an artwork which to many clearly would illustrate a core aspect of BPD, even if made by someone of excellent mental health. On the other hand, I believe that the Despair painting more clearly illustrated a "BPD experience", and it could work even without claiming that Munch must have had BPD. Maybe, it would be possible to make the claim that Munch "has posthumously been suggested by [whomever] to have suffered from BPD, just for context if nothing else.

Surely, it must be possible to find sources for the phenomenon being depicted in the Despair painting being phenomena associated with BPD. Sure, I get that this might lead to a WP:SYNTH situation, but I am hereby merely suggesting that this close-to-worst-case scenario might somehow be possible to avoid. BlockArranger (talk) 00:51, 15 April 2025 (UTC)

I agree this image is puzzling. At the very least, the formatting suggests that it is a work titled "Idealization" which is, as you noted, untrue and I think should be altered. But I also struggle to connect the portrait to the disorder as described and I would be in favour of removal altogether. ArtesianAction (talk) 10:03, 30 May 2025 (UTC)

Uncomfortable / Triggering section head image?

The current section lead image for Signs and Simptoms can (and do) look quite uncomfortable (for me at least). Maybe we should illustrate the point w/ something else?

After a while of searching i still haven't find a good-enough image that is released under CC-BY. Perhaps we can just... draw a new image and upload it?

Does someone know how to paint...? I'm an utter rookie when it comes to handling my apple pencil. irisChronomia (talk) 17:22, 20 January 2025 (UTC)

Do you mean an image that illustrates abandonment? It's one of if not the biggest hallmark of BPD, and thus I think an image illustrating abandonment should be included. The current image does it in a clear, effective way via easily recognizable silhouette, showing a person helplessly reaching out for someone leaving them and breaking up inside as they do it (it being played out by two black silhouettes against a white-ish backdrop could even be nodding to black-and-white thinking which serves as BPD's other most recognizable hallmark; the shattering at their core can even be nodding to an unstable sense of self). Even the watermark which I'd suggest we should strive not to have in any form is done as elegantly, subtly, and tastefully as it can reasonably be.

Wikipedia is not and has never been censored for any reason if we can legally help it. Just like any other image, the sole merits this CC-BY-SA image is judged by are under MOS:IMAGES. 1) Is the image pertinent? (As established, I think yes.) 2) Is the image an aid to understanding? Given BPD is a psychological disorder and that this isn't the section about neurology, we're assessing the emotions and behaviors of a person diagnosed with BPD. I think the image captures this well and aids the emotional understanding of someone who hasn't struggled with BPD in a way that our necessarily academic treatment of it may not; it arguably (as described above) hits at least three of the most major hallmarks of BPD. 3) Is there reason to believe this is lower-quality than another usable image, either on technical grounds or that the other one is more informative? I honestly don't think so. I think the current image is absolutely fantastic at what it does.

Now we can move onto "Even if Wikipedia were censored...", because I feel the suggestion to implement a new image would be weak even on a bizarro-Wikipedia where "it's offensive; remove it" is even worth considering. Firstly, BPD is a (frankly quite serious) personality disorder characterized highly triggering symptoms and causes. BPD is often rooted in childhood abuse and especially childhood sexual abuse. BPD is linked to disproportionate rates of self-harm and suicide. BPD is linked to eating disorders, substance abuse, uni- and bipolar depression, dissociation, etc. And it often presents with highly chaotic interpersonal relationships and even domestic abuse. A competent encyclopedic treatment of BPD cannot avoid those triggers, nor should it be expected to try. Even if we could accept that we should self-censor our treatment of BPD to avoid making readers uncomfortable, this image is frankly quite benign compared to what's in the prose. It really is a silhouette person perceiving abandonment by another silhouette person and figuratively breaking up inside because of it. You may be the only one to have ever brought up this discomfort, and I think the overwhelming majority of people to within a rounding error would look at this image and feel no discomfort or a level of discomfort that's healthy and transient. If we were to remove it, it seems like the justification would solely be: "We're going to break our rule about censoring this one time for this image that does its job well and is about as benign as it could possibly be because one editor says it made them uncomfortable."

I have panic attacks frequently, and I know it's not as simple as "this shouldn't be uncomfortable to you; try harder". What I am suggesting is that if even an illustration about BPD is making you uncomfortable enough to start a discussion around replacing it, it may be worth 1) attempting exposure therapy in a clinical setting or on your own, or 2) avoiding depictions of mental health disorders until you're in a healthier place emotionally. Replacing this image with something else to avoid discomfort would be needlessly and counterproductively sanitizing an article about an inherently discomforting topic. TheTechnician27 (Talk page) 08:58, 14 April 2025 (UTC)

I agree with you. Additionally it's worth pointing out that enabling people's mental vulnerabilities to go unaddressed doesn't seem like a very optimal strategy. I am also fully sympathetic to people who have such difficulties, but some people finding topics, images, or information hard to deal with is not sufficient reason to exclude said things. BlockArranger (talk) 12:04, 14 April 2025 (UTC)

Agree on keeping the image. Lova Falk (talk) 09:41, 15 April 2025 (UTC)

ICD-10 criteria

I've removed the subsection on the ICD-10 diagnostic criteria but have left a sentence-long description of its similar diagnosis in the ICD-11 subsection (knowing that EUPD previously existed is useful, especially for someone researching the topic further after our article who can now search for this name as well). I think this section was vestigial from before the ICD-11 existed and that it offered little of value to casual readers, student researchers, people trying to understand their condition, or professionals brushing up. TheTechnician27 (Talk page) 14:44, 15 April 2025 (UTC)

Comment

Template:U, I disagree with nearly all of your reinsertions. The article is too long and does need trimming, and excessive detail is not the function of an encylopedia. Second, you have reinserted several primary source studies arguing they were "perfectly serviceable". WP:MEDRS is pretty clear that primary source studies should not be used in this type of article. Zenomonoz (talk) 00:40, 16 April 2025 (UTC)

Short description - consensus wanted

Very recently, a user decided to add the following short description to this article:

"Personality disorder characterized by emotional dysregulation"

While I do not disagree with emotional dysregulation being significant in BPD, I think it is inaccurate by omission of information. I would like to see that we would find a consensus of how we should concisely describe BPD, such that inclusion and omission is not a matter of one user's personal views. I think BPD is far from being in need of more mischaracterization, and I claim that this could be compared to describing dogs as "domestic species with marked barking behavior". BlockArranger (talk) 23:14, 27 May 2025 (UTC)

Is there a short description that you feel would be a better alternative? IntentionallyDense ^(Contribs) 02:36, 28 May 2025 (UTC)

@IntentionallyDense I am unsure as of yet regarding what I think would be optimal. Therefore, I didn't edit and instead I opted for bringing this matter to the attention of all concerned editors. BlockArranger (talk) 07:39, 28 May 2025 (UTC)

It’s kind of hard to give much input when I don’t know what people are looking for. The current SD is better than no SD but beyond that, there’s not much I have to say about it. Is there anything you could pinpoint that should be changed? IntentionallyDense ^(Contribs) 20:16, 28 May 2025 (UTC)

Q&A

• "The current SD is better than no SD" - agreed.
• "there’s not much I have to say about it" - I hope that more people will come and possibly have input. I mainly also wanted to notify everyone concerned about this development.
• "I don’t know what people are looking for" - I let people define what may constitute improvement. I raised this matter not because I am willing to prove that it is in fact a matter worthy of inquiry; rather, I pointed out a new area of possibly desirable improvement.
• "Is there anything you could pinpoint that should be changed?" - in any way make the definition a bit more nuanced than merely about emotional dysregulation, but even here I primarily wonder what others think about it in general. The short description is not visible in all viewing modes, and thus I want to bring attention to it.

BlockArranger (talk) 22:06, 28 May 2025 (UTC)

What about "Personality disorder characterized by unstable emotions, relationships, and self-image" ? Apathyash (talk) 23:41, 28 May 2025 (UTC)

That sounds good to me. Zenomonoz (talk) 00:03, 29 May 2025 (UTC)

It is significantly better; thanks for the suggestion. I'll go as far as to WP:BEBOLD and update it. It can always be improved more if we have more people uttering their opinions! BlockArranger (talk) 01:33, 29 May 2025 (UTC)

Sorry if I came off a bit WP:BITEY (even though you are not a new editor, I haven't seen you around the psych/med topics) I hadn't eaten yet when I wrote that and really should have put more time into that response. My apologies.

I do like the new proposed SD (as long as it complies with the word length). I would also recommend posting on WT:MED and WT:PSYCH to gain more opinions. IntentionallyDense ^(Contribs) 02:45, 29 May 2025 (UTC)

No problem! I can admit to sometimes possibly also "biting" others. I am active mainly in articles related specifically to psychiatry (hence MED and PSYCH), with an emphasis on personality disorders. I have in fact edited all articles on the ten DSM-5 PDs at least, among related articles on for example diagnostic systems and conceptual frameworks for PDs. BlockArranger (talk) 18:01, 31 May 2025 (UTC)

Evidence for genetic predisposition

There has recently been an edit war between @Remsense and an anonymous user regarding the sentence: "A genetic predisposition is evident, with the disorder significantly more common in people with a family history of BPD, particularly immediate relatives." The keyword here is evident.

While indeed we should not claim something is merely possible when the source says that it is evident, I do believe that this sentence is not great either. This is because BPD being "significantly more common in people with a family history of BPD" is not in itself logically evidence for a genetic predisposition, as this would also be the case if BPD were to be a disorder only transmitted by borderline parents parenting in a way that causes BPD in their offspring, biological or not. And yes, before anyone goes on a rant about this, I am aware that the sentence in the lead does not expressly claim this to be the only evidence; it merely says that this is de facto the case and it implies that this fact is significant. BlockArranger (talk) 23:49, 7 June 2025 (UTC)

All that mattered there was relating what causative claims are actually made by the source. Remsense 🌈 论 23:52, 7 June 2025 (UTC)

Template:Tq

Generally speaking, the evidence supports genetics and non-social environment, more-so than familial environment. This evidence is derived from genetically informed designs and larger twin studies, which do disentangle genes and environment. See this paper which did not find evidence for the abuse hypothesis. In addition, this this earlier overview is probably a useful source for this article. Zenomonoz (talk) 00:05, 8 June 2025 (UTC)

I feel like "suggested" or "hypothesized" may be a decent compromise here. The last time I checked the BPD research, there is evidence that both genetics and environment play a role. I don't think "possible" is the right term but "evident" may not be either. IntentionallyDense ^(Contribs) 03:27, 8 June 2025 (UTC)

That there are other factors isn't at all under dispute. This makes little sense, though! Why does the existence of other factors make it ideal to water down what is said about this factor? The sentence as written is completely clear in describing the evidence in the cited research for a genetic predisposition. Remsense 🌈 论 03:36, 8 June 2025 (UTC)

That's fair I hadn't thought of that. IntentionallyDense ^(Contribs) 05:04, 8 June 2025 (UTC)

It would perhaps be good if we could concisely make the sentence logically support the fact, because it does not in its current form, as I have stated, which has also prompted dispute from other editors. I understand that the reasoning provided in the research might not be possible to compress very well, but we could always try. Perhaps it would be good to write "A genetic predisposition is evident, and the disorder is significantly more common...", as this would possibly mitigate the problem -- especially if the source does not claim that the prevalence among immediate relatives is the major evidence for the genetic predisposition. BlockArranger (talk) 21:05, 8 June 2025 (UTC)

That BPD has genetic influence is not in dispute, its heritability is quite high. I don't think there needs to be compromise if WP:RS are clear about this. Zenomonoz (talk) 03:47, 8 June 2025 (UTC)

Munch's alleged BPD

While there seems to be a great divide between the opinions of contributors here regarding the choice of image to represent BPD, it seems to me that there is not much disagreement with the sources for Munch having BPD being a bit lacking in several ways. Thus, I find it rather problematic that we claim that "Edvard Munch (1903) [...] is presumed to have had borderline personality disorder". Presumed is the keyword here; I would be much more fine with it if we used language which does not make this article so strongly proliferate a presumption which ostensibly comes from a source which is perhaps neither given much recognition nor is of good quality. I would even argue that even if a specific psychiatrist wrote a paper concluding that Munch had BPD, and it were peer reviewed, we would likely not based on that claim that he "is presumed" (de facto, by whom?) to have BPD. The statement really makes it sound universal or like it is a consensus among those in-the-know, for which I do not find evidence in the article. Also, while @TheTechnician27 states that "[Masterson] is definitely our strongest source", but that it "can't stand on its own for something this obviously contentious", it is not even cited as a source for the main image in the infobox. There, Aarkrog is cited, and @TheTechnician27 specifically says that it's "flimsy as a source"; I agree based on what I know so far. Could we perhaps make it a bit more clear that Munch's BPD is more of a suggestion or hypothesis than agreed-upon fact, even if not necessarily wrong? BlockArranger (talk) 00:16, 8 June 2025 (UTC)

Agree. This is medical article, this whole Munch speculation strikes me as tangential. It could be made clear it's speculation, or it could be removed altogether. Zenomonoz (talk) 00:17, 8 June 2025 (UTC)

@Zenomonoz If I am not mistaken, I have already tried changing the text for the main picture, which was then reverted. I really need to read the conversions about the pictures again but I would not be surprised if the people who are stubborn about keeping the brooch picture would also be stubborn about "presumed". As a sidenote, I think the consensus thing is being abused, as the arguments for keeping it this way including both picture and text would seem to be that there is no consensus for a better option. Well then, do we really have any consensus at all for the current state being fine? This article is not a sacred constitution, but it seems like it is taken to be that way, akin to how in politics it's difficult to change outdated laws due to heritage. BlockArranger (talk) 01:04, 8 June 2025 (UTC)

You are correct to be WP:BOLD. There was actually this discussion 9 years ago in which the consensus was to not include any Munch image, because Template:Tq. Zenomonoz (talk) 01:27, 8 June 2025 (UTC)

Well, I would tend to agree with your point. However, I do believe that several Munch artworks illustrate core BPD phenomena. One of my favorites in this regard is File:Edvard Munch - Separation - Google Art Project.jpg. It illustrates both abandonment issues and perhaps also the despair also seen in the Despair painting. I think that illustration do not necessarily have to have been created by "sufferers", and I also not that sometimes something made by someone with a disorder is sufficient, as in the schizophrenia article. Now that we at least some merits for claiming that Munch is suggested to have had BPD, I think it is fine if we combine it with something that possibly illustrates BPD phenomena. BlockArranger (talk) 22:19, 13 June 2025 (UTC)

I really feel like some sort of a graphic depicting the symptoms of BPD would be best for the lead but I also think people would find issue in that. The current lead photo is imo not great. IntentionallyDense ^(Contribs) 03:28, 8 June 2025 (UTC)