Talk:Haltlose personality disorder

Defamatory

As a stub, this entry is obviously incomplete, but it does give the impression that modern psychiatry has not progressed very far since the days of Kraepelin more than a century ago. It describes an “individual” in the terms that a criminologist might use. It would appear that the disorder is considered merely as the product of a wilfully misdirected mind.

As it stands, the stub is defamatory. Perhaps it is hoped that the patient can be shamed into denial and subsequently be declared cured – the diagnosis is the cure - while the underlying problems remain.

The entry needs to include typical complaints with which patients present. It should also consider that the patient might actually be suffering from, and be disadvantaged by the disorder.

The German adjective haltlos (“a” pronounced as in “half”, “o” as in “horse”) describes an absence of Halt, which is obviously related to the English noun “hold”, as in “foothold”. Halt is the metaphysical property that prevents something slipping or falling, or being blown or washed away, thereby enabling it to fulfil its function or purpose. In the figurative sense it might be understood as “faith” in the wider sense, as used in the expression, “to keep the faith” (see also the song of this name by Bon Jovi), meaning that which gives one the inner strength or so-called moral fibre not just

• to not go down the road beyond pragmatism to opportunism, or, in the worst case, criminal activity,
• to resist inappropriate impulses and addiction,

but also the strength

• to keep smiling and be nice to others,
• to persevere and not be discouraged in the face of adversity,
• and, of course, to not despair and succumb to mental illness in any form.

Halt is something children need from their parents and carers to make them resilient and it is what people seek in religion and, unfortunately, in some cases, nationalism, extremism and various other –isms.

There may be a higher incidence of Haltlosigkeit among the so-called undesirable elements in society. However, it is hard to imagine that this subgroup would be capable of much more than opportunistic petty crime, in many cases attributable to youthful folly - in contrast to those with e.g. antisocial personality disorder. And it does not follow that all persons that are not blessed with Halt are potential criminals and drug addicts etc. as might be imagined from the stub. They need help, not condemnation.

The article should take these additional aspects into account in this, the 21st Century. Duncan Dolittle (talk) 00:05, 3 August 2016 (UTC)

ICD

If this is an ICD-10 disorder the corresponding ICD-10 code should be mentioned. I guess it is included in F60.8 ("others"), but I am not sure. --84.115.204.211 (talk) 19:07, 13 February 2019 (UTC)

 Done You are correct, it is included in F60.8, which is listed at Haltlose personality disorder#External links. Daask (talk) 14:11, 14 February 2019 (UTC)

• The incipit now states Haltlose personality disorder (HLPD) is an ICD-10 personality disorder... That looks to me like a possible overstatement, as it could seem to imply that it has its own specific code. Rather, it is cited within the 2021 ICD-10-CM Diagnosis Code F60.89 ("Other specific personality disorders") as one of a series of diagnoses to which this (miscellaneous) code is applicable. In practice, that would mean that if I needed to assign an ICD-10 code to a case, or cases, bearing a diagnosis of Haltlose personality disorder (for example in an epidemiological study) then I would classify it under F60.89 Other specific personality disorders. That doesn't make me think of it as an ICD-10 personality disorder. So, imo, that claim needs to be reassessed/reweighted. 86.180.70.117 (talk) 21:18, 6 October 2020 (UTC)

Adler

A close reading of the Adler source makes it clear there is some overlap between his headings "2" and "3", whereas headings "4" and "5" are clearly discussing other personality disorders. I have tried to honestly represent his intentions in the 1917 journal publication, but welcome discussion if I have interpreted anything incorrectly. HaltlosePersonalityDisorder (talk) 06:04, 7 October 2020 (UTC)

Some awkward reliable medical sourcing issues here

(ping @User:HaltlosePersonalityDisorder). This notable and - apparently (per ICD-10, at least?) - clinically pertinent page currently seems to ignore WP:MEDRS, Wikipedia's reliable medical sourcing guidelines, and this is a major issue here. One particular source of concern is the structural conflation of clinical claims and psychiatric history (for example, description of the disorder directly in the historical words of Adler and others, without secondary sourcing). Clearly, there is a real problem with an apparent dearth, in any language, of even *relatively* recent reliable medical sources in the clinical literature (cf Langmaack 2000 [1], Cullivan 1998 [already cited inline]). In a rapid glance at PubMed, GoogleScholar and GoogleBooks, I largely drew a blank at spotting potential MEDRS in the English language ([2]?), and few obvious candidates in other languages either; I don't know if User:Markworthen (ping :-) might be able to make any rapid suggestions, perhaps based on Psych databases I'm not able to access.

Normally, a page regarding a clinical condition would be structured broadly along the lines of WP:MEDMOS#Diseases or disorders or syndromes in such a way as to distinguish between clinical claims of current relevance (requiring MEDRS sourcing) and historical content (requiring WP:RS, but not necessarily WP:MEDRS; eg[?] PMID 31114930), as has has been done with other personality disorders currently recognized by DSM (eg Borderline personality disorder, Antisocial personality disorder, etc) or otherwise (eg Passive–aggressive personality disorder). To me, that seems problematic here, due to the apparent lack of available MEDRS.

As I find it difficult to know what to suggest in practice, I'm wondering whether (in addition to Markworthen) User:WhatamIdoing (a further ping :-) – a highly experienced WP:MED editor who has an interest in such editorial issues – might have some thoughts on this. 86.144.125.239 (talk) 16:02, 7 October 2020 (UTC)

Thank you for the ping Agent 86. ;^] ¶ I had never heard of Haltlose personality disorder! Very interesting. I suggest trying to improve the article as you (we) are able. I agree that it needs work. But it is not so bad that it should be deleted. The more medical citations needed tag/template is spot on. Mark D Worthen PsyD (talk) [he/his/him] 18:18, 7 October 2020 (UTC)

Thanks for the discussion, as the person being discussed - I appreciate that people are at least reading my work, even if some of the criticism seems ill-placed :) I don't have a "main" Wikipedia account, I created this simply because while reading about other PDs I had clicked through to "Haltlose" same as you no doubt did, and was shocked to see an ICD-10 diagnosis listed as a two-sentence stub. I think it had a longer article in the Romanian or Serbian or something Wikipedia.

There are some English-language sources that seem reputable, the only source that I agree is "weak" is "the youtube one" which I included because the YT account had an official-sounding name, but looking more closely at it I see it's not likely an RS; that said, it is literally only being used to say it's potentially Cluster-A related. If that detail has to become (cite needed), I doubt anyone would mind.

But does it appear to be a European-centric diagnosis, uncommonly used in the English speaking world? Yes - very much so; though as you can see from the article, that fact has itself been criticized by leading professionals as causing a paucity of further research on the subject. *shrugs* Whether it's only of "historical" interest and not "current", as a layperson I may tend to agree - but medically it's still included in the ICD-10 and I assume we have to go with that, not our gut feelings. JSTOR has a few more Germanic-language sources I intend to mine for information, including more recent ones - but ultimately I imagine what would be the most useful for ensuring the best possible article might be to encourage other de.wikipedia.org editors to help write one there (I prefer reading en. and thus working on en.), and then in six months we can compare the two.

I do find it odd that the MEDRS template you put at the top of the page just recommends things like Google Newspapers, rather than medical databases - or am I misunderstanding your complaint and you would wish for less scholarly research used as references and like newspaper reports better? That would seem ill-advised if we wanted accuracy, but I do not know Wikipedia policy on such and do not feel like reading dozens of pages of decades of croft to determine such - beyond noting that WP:MEDRS makes zero mention of psychiatry/psychology concerns - it is related to ensuring it does not offer medication dosage recommendations or other "biomedical" advice incorrectly.. HaltlosePersonalityDisorder (talk) 18:58, 7 October 2020 (UTC)

Thanks for that HaltlosePersonalityDisorder. Just a few very rapid replies :-) ... Please don't think I was making "complaint"/s - rather, I was just trying to identify editorial issues that need to be addressed. Given the paucity of recent clinical medrs, combined with the apparent enduring clinical usage of the diagnosis (at least per ICD) I really don't have any straightforward solutions to propose. But, clearly, that doesn't mean I don't want to encourage you from your constructive editing of a topic which Mark D Worthen PsyD considers "Very intersting". Quite the opposite! Also, please don't worry about the details/quirks of the MEDRS template I applied (basically to alert readers of the page that the clinical information isn't current, per Wikipedia MED guidelines) - I certainly wouldn't suggest searching newspapers for reliable medical citations (lol, I hadn't noticed that one). Also... I didn't intend to criticize you username (the problem here arose from a good-faith concern that a username which coincides with a page that user is intently focused on expanding might conceivably be an indication of a possible WP:COI - because such things have been known to happen...).

I'd like to take more time to consider the question of historical/clinical content in the light of what you're saying, and of course listen to the views of others (unlike Markworthen, I'm a complete layman here :) .... Editorially, my initial thought is that, given the ICD-10 status as a listed diagnosis it could be good to glean at least a little current clinical information, in the broad spirit of the WP:MEDRS (including WP:MEDPRI, etc, and the most elastic reading possible of WP:MEDDATE; maybe post 1990[?]). Then the remaining information could be reframed from an appropriately historical perspective, using secondary sourcing wherever possible (maybe with suppporting primaries to direct interested readers to the original texts). Maybe WhatamIdoing will have some thoughts of her own? :-) Cheers, 86.144.125.239 (talk) 20:24, 7 October 2020 (UTC)

Potential sources not yet found, but supposedly discussing Haltlose Personality Disorder

• P. Becker, 'Vom "Haltlosen" zur "Bestie". Das polizeiliche Bild des "Verbrechers" im 19. Jahrhundert' in A. Liudtke (ed.), 'Sicherheit' und 'Wohlfahrt'. Polizei, Gesellschaft und Herrschaft im 19. und 20. Jahrhundert (Frankfurt 1992), 97-132. ("From Haltlosen to Animals: The Policing Image of Criminals in the 19th Century")