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RfC regarding the picture used in the self-harm section

There is consensus to include the image under discussion per WP:MEDRS compliant sources which supports that self-mutilation is a common symptom of BPD and WP:NOTCENSORED.Further Doc James & SparklingPessimist are here-in advised to refrain from making changes to specific article content under discussion in a RFC, prior to it's closure.Winged Blades Godric 17:04, 17 April 2017 (UTC)resigned at 17:29, 17 April 2017 (UTC)

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Image under discussion.

I am posting this RfC in regards to the image that is used in the self harm section of this article, I don't think it's inclusion is necessary because it adds nothing to the article and everyone knows what cutting is and we don't need the visual. Also the image can be triggering to people who have self-harmed before. However, due to the non-censorship policy, I thought I should get some consensus first before removing it. Thank you for your attention and input on this matter.ThatGirlTayler (talk) 01:09, 5 April 2017 (UTC)

Note: Opening user has changed their username to User:SparklingPessimist

Discussion

Did you read the discussion above? Jytdog (talk) 01:34, 5 April 2017 (UTC)

@Jytdog: Yes, but I thought I should get an official consensus, seeing as one wasn't reached in the previous discussion. ThatGirlTayler (talk) 01:39, 5 April 2017 (UTC)
  • Remove. I came here because I saw the RfC notice, and I carefully read the talk section above before responding. I honestly do not see a consensus in that earlier discussion for including the image, so I think that this RfC is entirely appropriate. And I really cannot see how anyone would need to see the image here in order to comprehend what cutting is. The image does nothing to improve the informational value of the page. --Tryptofish (talk) 02:13, 5 April 2017 (UTC)
User:Tryptofish, the image was replaced with a less graphic image. QuackGuru (talk) 14:07, 16 April 2017 (UTC)
  • Keep—this or any image with similar informative value (a compromise worth considering). I don't count a voting consensus in the discussion just above. However, performing a Google image search using the title of this article returns images of less value and with no context, Which is better for a person seeking information on this subject, for whatever reason? Wikipedia, with requirements for neutral, unbiased presentation, with requirements for reliable sources? Or a Google image search with probably no context and no requirements for anything else? Pulling a tarp over information that some object to has never turned out well. When that is done there is no protection against wrong information. I think this touches on several of the five pillars of Wikipedia. Seventy years ago there was little reliable, public information on human sexuality or mental illness... or a long list of other vital subjects. — Neonorange (talk) 02:52, 5 April 2017 (UTC)
    • @Neonorange: I think everyone knows what cutting is, the image is really not necessary it adds nothing to the article, everyone knows what cutting looks like we don't need an image. What does it add? What purpose does it serve? If people already know what cutting looks like then it doesn't really add any new information.ThatGirlTayler (talk) 03:46, 5 April 2017 (UTC)
@ThatGirlTayler:—well no, if it were not for this image in this article in Wikipedia, I would not...I would not have made much distinction among tattoos, nose rings, cuttings, or most any type of body modification... don't assume everyone has had the same life experiences as you may or may not have had. And don't, from this statement, assume that I have led a sheltered life. Cutting is on the low end of the self hurt spectrum... as is the association of suicide with cutting compared with some other mental illnesses. — Neonorange (Phil 05:50, 5 April 2017 (UTC)
@Neonorange: I didn't say anything about you being sheltered. When people say self-harm, I think everyone knows what they're talking about.ThatGirlTayler (talk) 14:22, 5 April 2017 (UTC)
No, you did not mention 'sheltered'—I was just preemptIng that argument. But I still must disagree with your statement—no, everyone does not know what 'self harm' specifically means. That is exactly why we have encyclopedias. We work here to build an accurate, precise, and comprehensive reference. In much of the last century, information about birth control was banned—there are those who would still ban it today. Is this a similar health and freedom of information issue? I think it is. This RfC touches on the very foundations of Wikipedia—keeping such an image in this article is part of our mission. — Neonorange (talk) 22:19, 5 April 2017 (UTC)
User:KoshVorlon, the image was replaced with a less graphic image. QuackGuru (talk) 14:07, 16 April 2017 (UTC)
  • Keep - The image provides a visual illustration of what self harm associated with Borderline Personality Disorder is, just like images in Wound and Chicken Pox visually depict those conditions. Removing it with the expectation that everyone is familiar with it is inappropriate - this is an encyclopedia for people to gain knowledge and our readers are worldwide. -- Dane talk 15:30, 5 April 2017 (UTC)
  • Remove – I agree with earlier statements that the image on Self-harm should suffice. The presence of the image in this article (with so few other images) places undue weight on cutting. – gwendy (talk) 18:15, 5 April 2017 (UTC)
    That is strange justification. Just because an entire article is not great does not mean we must remove the good parts to balance it. Doc James (talk · contribs · email) 00:11, 10 April 2017 (UTC)
User:Gwendy, the image was replaced with a less graphic image. QuackGuru (talk) 14:07, 16 April 2017 (UTC)
User:CapitalSasha, the image was replaced with a less graphic image. QuackGuru (talk) 14:07, 16 April 2017 (UTC)
User:Martinlc, the image was replaced with a less graphic image. QuackGuru (talk) 14:07, 16 April 2017 (UTC)
  • Keep, the picture gives a very good illustration of what self-harm is all about. Remember many of the readers of this article will not have had any experience of seeing self-harm, and will wonder what it looks like. The mental state of someone who engages in self-harm is typically very traumatic and disturbed, and such a person has to deal with emotional distress on a level that is extreme. Triggers for self-harm I suspect very rarely results from seeing an image of self-harm, but is usually caused by the emotional disturbance that the self-harmer is experiencing - whether it be coming from a traumatic childhood, a personality disorder or substance induced, etc. An image on Wikipedia is irrelevant to the mental distress of such an individual, it is the underlying disorder that is the problem. Also Wikipedia is not WP:censored, and I do not find a compelling reason given here to justify censoring this image and to ignore Wikipedia policies and guidelines. Finally, self-harm (and suicidal ideation) is so very common to Borderline Personality Disorder affected individuals that its inclusion is more than justified.--Literaturegeek | T@1k? 13:54, 6 April 2017 (UTC)
  • Remove. According to the article, BPD increases the risk of self-harm, putting this image in gives undue weight, implying s-h is fundamental to BPD. Plus, as others have said there is little educational value in putting in a photo of self-harm, we know what it looks like. Pincrete (talk) 16:35, 9 April 2017 (UTC)
User:Pincrete, the image was replaced with a less graphic image. QuackGuru (talk) 14:14, 16 April 2017 (UTC)
  • Strong keep First of all Wikipedia is NOT censored. Self harm is a very common symptom in BPD. Why would we hide a clear and common sign in a disease? Yes some health problems suck. Our goal is to provide information / knowledge not to hide details because they may make some people feel uncomfortable. The article says "Nearly 70% of people with BPD self-harm without trying to end their life." It is a classic part of this condition. Doc James (talk · contribs · email) 00:05, 10 April 2017 (UTC)
  • Strong remove and replace as per User:WhatamIdoing's comment below that the most common forms of self-harm are not the dramatic deep-cutting that is typically shown for effect. The goal is indeed to educate, which is why the image should be representative of that fact. Also, as a general comment to the notion of "making some people feel uncomfortable," I don't think it's unreasonable to consider that certain imagery, which can cause severe anxiety and PTSD-related reactions in some people with mental illnesses who express self-harm (and this is backed up in the literature), should be judged for context. In that same vein, the epilepsy article for example avoids displaying rapidly-flashing animated images, even when that article specifically cites such images. SamuelRiv (talk) 00:52, 11 April 2017 (UTC)
    Can you provide some evidence for your statement please. Doc James (talk · contribs · email) 05:38, 12 April 2017 (UTC)
User:SamuelRiv, the image was replaced with a less graphic image. QuackGuru (talk) 14:07, 16 April 2017 (UTC)
  • Remove I agree with others that it gives undue weight to self-harm and cutting in particular. Most people know what cutting is and what it looks like, If readers need examples and more information of self-harm then they can go to the Self-harm page. While we shouldn't censor a picture for being unpleasant or unexpected, we also shouldn't display such images unless it's necessary, and I don't see how it's necessary here.Saith89 (talk) 11:58, 11 April 2017 (UTC)
User:Saith89, the image was replaced with a less graphic image. QuackGuru (talk) 14:07, 16 April 2017 (UTC)
  • Strong keep — this specific type of self-harm is very common and important to know about. Far from what Saith89 says, most people do not know what it looks like — and even if they did it does then not harm them to be reminded. We must look to find the least offensive image that still conveys the topic, and none of the three that are suggested here are in any way problematic — but rather chosen with great care. Carl Fredrik talk 06:26, 12 April 2017 (UTC)
  • Remove - Wikipedia is not censored, quite rightly. "Some articles may include images, text, or links which are relevant to the topic but that some people find objectionable. Discussion of potentially objectionable content should usually focus not on its potential offensiveness but on whether it is an appropriate image, text, or link.". Is it an appropriate image? Self harm is one of many symptoms of BPD. Cutting is one of many self-harming behaviours. Cutting is only mentioned as a 'such-as' with no indication that this form of self harm is related to BPD. An image of cutting scars does very little to illustrate the condition of BPD, it illustrates the outcome of self-harming. It is currently the only symptom with an image, giving this one particular form of symptom undue weight. And it's inclusion could cause distress. Scribolt (talk) 11:17, 12 April 2017 (UTC)
Thank you for your comment Doc James. You partially addressed my concern, however, I will still support removal. Firstly, the graphic image, even if it is a representative image of self harm within BPD, attributes more weight to this particular set of behaviours than the other symptoms, because it's the only one and it's graphic and more importantly, self harm is not the most characteristic symptom of BPD (which presumably per the article is marked sensitivity to rejection or criticism, and intense fear of possible abandonment). More generally though, I remain unconvinced that the benefit of being provide an image of a particular symptom benefits this article enough to outweigh the potential distress it might cause. If someone visits the page for self harm, they might reasonably expect to see an image of such. If someone visits the erection page, they might reasonably be expected to see an image of a penis. If someone visited the page viagra, they might not expect to see an image of an erect penis, even though it is without doubt clinically relevant to the article. As it could cause distress, and although self harm is relevant to BPD, I have not seen an argument that an image of it in this article is. Scribolt (talk) 06:12, 13 April 2017 (UTC)
No actually "self mutilation" is one of the 9 symptoms of BPD per the DSM5[3]
Just because we do not have other appropriate images does not mean we should remove the appropriate images we have.
You claim "potential distress it might cause". Do you have a reference for this? If signs of self harm caused self harm, people looking at their own scars would be a trigger. Doc James (talk · contribs · email) 23:48, 13 April 2017 (UTC)
I did not say self multilation is not a symptom of BPD. I said that this article (and please correct it if this in incorrect) states that the most characteristic symptom is the sensitivity to criticism and rejection. I did not say that the distress the image of self harm may cause is in any way linked to self harm sufferers or trigger self harm. It's a graphic image of self mutilation which could cause anyone distress. And I do not believe that an image of an erect penis would be appropriate in the article of viagra (I personally would not be caused any distress by stumbling across it that context, but many might). There isn't a requirement to have everything mentioned in an article illustrated by an image. Scribolt (talk) 10:39, 14 April 2017 (UTC)
User:Scribolt, the image was replaced with a less graphic image. It appears this RfC is no longer needed. It accomplished its goal. QuackGuru (talk) 14:00, 16 April 2017 (UTC)
  • Keep. There is no controversy over the image. The image is very relevant. I think the article needs more images. Articles are boring without images. "Cutting" is the most common form of self-mutilation for borderline personality disorder according to a 2008 review (PMID 19068333). QuackGuru (talk) 00:18, 14 April 2017 (UTC)
Thank you User:QuackGuru. User:WhatamIdoing we now have a MEDRS compliant source supporting that self mutilation occurs in 50 to 80% and that cutting is the most common form. Doc James (talk · contribs · email) 01:19, 14 April 2017 (UTC)
Extended content
  • Note- A 2014 review states "Self-injurious behaviors (SIB), such as superficial cutting, occur in 70-80 % of BPD patients, which are associated with emotional relief."[1]
  1. ^ Ducasse, Déborah; Courtet, Philippe; Olié, Emilie (2014). "Physical and Social Pains in Borderline Disorder and Neuroanatomical Correlates: A Systematic Review". Current Psychiatry Reports. 16 (5). doi:10.1007/s11920-014-0443-2. PMID 24633938.
QuackGuru (talk) 14:38, 16 April 2017 (UTC)
  • Keep per WP:NOTCENSORED. "Wikipedia may contain content that some readers consider objectionable or offensive‍—‌even exceedingly so. Attempting to ensure that articles and images will be acceptable to all readers, or will adhere to general social or religious norms, is incompatible with the purposes of an encyclopedia. ... Some articles may include images, text, or links which are relevant to the topic but that some people find objectionable. Discussion of potentially objectionable content should usually focus not on its potential offensiveness but on whether it is an appropriate image, text, or link. Beyond that, "being objectionable" is generally not sufficient grounds for the removal of content." Apologies if the quote is a bit long. — Gestrid (talk) 07:31, 14 April 2017 (UTC)
  • Keep per QuackGuru. The images are fundamental and very informative. Best regards. --BallenaBlanca (Talk) 21:17, 15 April 2017 (UTC)
  • keep while i kind of understand the objections, we have sourced content in the article that self-harm is a symptom of BPD. Self harm occurs in 50 to 80% of people with BPD. The most often method of self harm is cutting This is a visible thing, depictable in an image. The image is 100% valid and relevant to this article. The objections about WEIGHT are empty. Jytdog (talk) 06:34, 16 April 2017 (UTC)
  • Keep – Wikipedia is WP:NOTCENSORED and we cannot assume that a random reader knows exactly how such cuts would look before they actually attempt it on themselves. In that sense, the image may act as a deterrent: if this image gives pause to some readers and dissuades them to grab the knife, that's a more valuable social effect than hurting the sensitivity of other readers who have already been there, as the OP argues. Finally, on the suggestion to replace this image with a "less dramatic" one, I'm not convinced: the "healed scars" image happens to be more jarring to me than the "fresh cuts" one which is being debated. Either keep the first image or remove it, but don't try to soften it. — JFG talk 14:54, 17 April 2017 (UTC)

Other images

An example of the long term scars that may form following self harm

Would people be more comfortable with this one instead? Doc James (talk · contribs · email) 17:08, 10 April 2017 (UTC)

I would like that much more, it just looks like scratches. SparklingPessimist Scream at me! 17:50, 10 April 2017 (UTC)
Scars rather than scratches. These are the long term effects typically. Doc James (talk · contribs · email) 21:40, 10 April 2017 (UTC)
They look like scratches, but either way I like it a lot more than the one we have now.SparklingPessimist Scream at me! 22:19, 10 April 2017 (UTC)

https://www.ncbi.nlm.nih.gov/pubmed/16740834 found that pinching or scratching was the most common form in that sample. Why don't we use a picture of someone pinching or scratching? I understand that cutting is "iconic" and "dramatic", but I think that we'd be better off educating our readers about what's common instead of what gets people to click on headlines. WhatamIdoing (talk) 23:52, 10 April 2017 (UTC)

I like that idea, too. Cutting is not the only form of self harm and isn't necessarily the most common.SparklingPessimist Scream at me! 00:46, 11 April 2017 (UTC)
User:WhatamIdoing the source you mention is not even about BPD?
Let's look at one that is.[4]
"It has been approximated that 65-80% of individuals with borderline personality disorder (BPD) engage in some form of NSSI."
"The most common type of self–injury was cutting (71.20%), followed by banging head (37.30%), pinching self (32.20%), and scratching or scraping skin (30.50%)."
If we are going to show the classic symptoms of BPD it is in fact cutting with this being the most common form of self harm in this population. Doc James (talk · contribs · email) 17:53, 11 April 2017 (UTC)
I agree with Doc James, we should try to stick true to the actual depiction of the symptoms. I would also be okay with using this picture of scars instead of the current image if that works as a compromise? -- Dane talk 04:39, 12 April 2017 (UTC)
(edit conflict) The only source I could locate quickly was self-harm without being specific to BPD, which is better than nothing or personal POVs, but not as good as the solid meta-analysis that I was looking for (and which doesn't seem to exist). Both of these primary sources suffer from the 'convenience sample' problem of using university students. (Of course, there are difficulties in any such survey, especially if visible scars prompt investigation and a BPD diagnosis, but providers don't even ask about pinching. I wouldn't be surprised if different sources came up with significant different results.) WhatamIdoing (talk) 04:44, 12 April 2017 (UTC)
It is also not as good as a study that is looking at the actual condition in question. If you have other sources about this condition and self harm that come to different conclusions happy to look at them. Doc James (talk · contribs · email) 03:55, 13 April 2017 (UTC)

Closure of RfC

I'm thinking I should leave this discussion open for another week before moving for closure, what do you guys think? Would that be long enough? SparklingPessimist Scream at me! 00:54, 13 April 2017 (UTC)

@SparklingPessimist: Agreed, another week seems like sufficient time to see if anything else comes up and/or allow further !votes and rebuttals. -- Dane talk 04:19, 13 April 2017 (UTC)
@SparklingPessimist: There is no policy based reason to remove the image. Close and move on. QuackGuru (talk) 00:26, 14 April 2017 (UTC)
@QuackGuru: Just because you don't think it should be removed doesn't mean everyone agrees with you.SparklingPessimist Scream at me! 00:29, 14 April 2017 (UTC)
A lot of people disagreed with me on a lot of things but it was never based on policy. I have been right about 99% of the time. QuackGuru (talk) 00:37, 14 April 2017 (UTC)
This is about following consensus, not about what you personally as an individual think should be done. SparklingPessimist Scream at me! 00:39, 14 April 2017 (UTC)
Consensus must be based on policy reasons. According to consensus there is a WP:SNOW keep. QuackGuru (talk) 00:41, 14 April 2017 (UTC)
I count 9 removes and 7 keeps, that is not WP:SNOW, if I closed it now, I would remove the image based on consensus, but I am giving it another week. You do not get to hijack an RfC and dictate what should and shouldn't happen. SparklingPessimist Scream at me! 00:45, 14 April 2017 (UTC)
We do not count votes, but we look at evidence based arguments. I have provided high quality sources that self mutilation is part of the most commonly used diagnostic criteria, that self harm occurs in most people with BPD, and that the most common form of self harm in this group is cutting.
With respect to policy we are WP:NOTCENSORED and we do not remove content because it is disturbing. Yes healthcare is sometimes disturbing. Or goal is to provide high quality health care content (not try to hide such content from people).
The arguments to remove this image because we do not have other high quality images is not reasonable. We do not remove good text because an article does not have sufficient other good text. Wikipedia is a work in progress. Doc James (talk · contribs · email) 01:16, 14 April 2017 (UTC)
I'm not closing until I can see that consenus is reached and all parties or a majority of them agree to a certain outcome. SparklingPessimist Scream at me! 01:36, 14 April 2017 (UTC)
And @Doc James: It would be greatly appreciated until you waited after this RfC is closed to replace the image as this can be seen as disruptive editing, thank you. SparklingPessimist Scream at me! 01:51, 14 April 2017 (UTC)
Just because an RfC is ongoing does not mean that further improvements to the article cannot be made. Also as you opened the RfC you are not to be the one to close it. Doc James (talk · contribs · email) 01:54, 14 April 2017 (UTC)
(Edit conflict) @Doc James: not according to Wikipedia:Requests for comment#Suggestions for responding specifically:
  • Edits to content under RfC discussion may be particularly controversial. Avoid making edits that others may view as unhelpful. Editing after others have raised objections may be viewed as disruptive editing or edit warring. Be patient; make your improvements in accord with consensus after the RFC is resolved.

Thank you. SparklingPessimist Scream at me! 02:00, 14 April 2017 (UTC)

Removal of image per Undue. SparklingPessimist Scream at me! 04:23, 14 April 2017 (UTC)
Are you seriously trying to say that I cannot add a literature review about the frequency of self harm during the discussion? I have been editing this article a long time[5]. Additionally I had agreed to get an image of healed cuts in a previous discussion. Doc James (talk · contribs · email) 05:26, 14 April 2017 (UTC)
@Doc James: You replaced the image before the RfC was closed, you can do anything besides replace the image until we have reached consensus. SparklingPessimist Scream at me! 05:48, 14 April 2017 (UTC)
Sure will restore the prior image. We will likely need a new RfC for the new image than. Doc James (talk · contribs · email) 05:52, 14 April 2017 (UTC)

On the "policy-based reasons":

Quack, your argument about "No policy-based reasons have been given" is nonsense. You are wrong. First, a policy-based reason for excluding it was actually given (namely, that it may have given undue emphasis on a minor point). The fact that you personally disagreed with other editors' policy-based reasoning does not mean that policy-based reasoning was not given. Secondly, no policy-based reason for including the image has been given.

We've now established that including cutting in the article is due, but nobody has mentioned a single policy-based reason for why that inclusion must take the form of an image (i.e., instead of just being text).

And, frankly, you're going to have a hard time coming up with any such policy, because there simply are no policies on Wikipedia that say "if you talk about skin lacerations, then you always must include images of it, even though any little kid who's ever skinned his knee knows what that looks like". NOTCENSORED says that we don't remove images for the sole purpose of preventing offense, but that policy does not actually mandate the inclusion of any images at all in this, or any other, article.

There is exactly one policy-based reason for including any image in any article on the English Wikipedia. That reason is "to increase readers' understanding of the article's subject matter". No policy authorizes any other reason for including images in any article.

This means that the only policy-based reason for including this image in this article amounts to "I think most readers are too stupid to know what a cut looks like, so we need to 'increase readers' understanding of [this aspect of] the article's subject' by showing them a picture of skin lacerations". I don't happen to subscribe to that stance myself, and I didn't see anyone above saying this. So even if you buy Quack's argument that there are no policy-based reasons for removing the image (and I don't), it is at least equally true that no policy-based reasons for including the image have been given. (Again, waving at NOTCENSORED is not "a reason for including an image".)

The fact that nobody's put forward a policy-based reason for inclusion doesn't mean that the image must be removed. That just means that this decision has to be made on some basis other than the "policy-based reasons" basis that Quack has been over-emphasizing here. Not every decision can be (or should be) supported by a policy-based reason, and that's okay. We have other valid bases for making decisions, which in this instance include both guidelines (it's probably WP:PERTINENT) and our best editorial judgment (it's probably unnecessary; it may be distressing to a few readers). WhatamIdoing (talk) 16:14, 15 April 2017 (UTC)

@WhatamIdoing: I was bullied into closing it, you sound like you know what you're doing so could you please close it? SparklingPessimist Scream at me! 16:32, 15 April 2017 (UTC)
There's no pressing need to stop people from talking about this today, is there? So I recommend that you just leave it alone for a few days. Wikipedia will still be here next week (although you won't be able to edit for about 30 minutes on Wednesday, 19 April or Wednesday 3 May 2017). WhatamIdoing (talk) 17:28, 15 April 2017 (UTC)

RfC is non neutral

Per Wikipedia:Requests_for_comment#Statement_should_be_neutral_and_brief an RfC needs to be neutrally worded. A bunch of sentences in the wording of this RfC definedly are not. Additionally the RfC makes medical claims without proper sources. We may need to restart this RfC but I guess we can do it with the next image. Doc James (talk · contribs · email) 05:57, 14 April 2017 (UTC)

I think it's pretty neutral, and since it's most likely going to be closed as keep, I don't see the problem. SparklingPessimist Scream at me! 06:46, 14 April 2017 (UTC)
  • This RfC is over and should be closed. Editors were suggesting the image was not relevant. Things changed since I mentioned a review (PMID 19068333) that shows cutting is the most common form of self harm with BPD. All the previous votes for removal are irrelevant since they did not read the review I recently cited. Editors were making opinions that were not based on facts or reviews. See WP:CIR. QuackGuru (talk) 15:12, 14 April 2017 (UTC)
@QuackGuru: and @Doc James: I don't know what to do, a majority of people want the image removed or replaced and since I opened the RfC I can't be the one to close it, right? SparklingPessimist Scream at me! 18:32, 14 April 2017 (UTC)
In this situation, where the RfC was worded in a non-neutral tone, the RfC should be closed and the less controversial self-harm image should be used in the article as a compromise, and if this to is contested, then a second RfC should be run on the new self-harm image. I do not believe re-running the RfC on the same image and with more neutral wording with one side hoping to 'beat the other side' by one or perhaps two votes is the best way forward. Lets go with the less graphic self-harm image, include it in the article and take it from there.--Literaturegeek | T@1k? 19:10, 14 April 2017 (UTC)
If we get a useful compromise (e.g., substituting a less-controversial image), then the RFC was not sufficiently non-neutral to matter.
Generally speaking, non-neutrality is not a fatal flaw for an RFC. The standard for neutral questions is "do your best". We trust editors to be able to figure out what's going on, even if the question isn't written the way that they want. (Also, as a rule of thumb, whoever's claiming that an RFC question is non-neutral is usually on the losing side.) WhatamIdoing (talk) 17:54, 15 April 2017 (UTC)
RfC are required to be neutral. This one is far from it.
Regardless the majority appear to support inclusion despite the non neutral wording.
Anyway this RfC was based on a different image. Thus is more or less void anyway.
Doc James (talk · contribs · email) 23:04, 15 April 2017 (UTC)
I'm counting a lot of removes and no one has yet to come up with an actual policy for it's inclusion and like you said we don't count !votes we go with policy arguments, and there are a lot of policy arguments for it's removal, so. SparklingPessimist Scream at me! 23:21, 15 April 2017 (UTC)
We try to include images of the most common signs of a condition. So how about Wikipedia:Wikipedia is an encyclopedia which is pillar number 1. Doc James (talk · contribs · email) 00:30, 16 April 2017 (UTC)
The logical place for an image of self harm is on the page about self harm. Unless there is an image of BPD (and it is hard to think what that might be), there is no need for one here.Martinlc (talk) 15:38, 17 April 2017 (UTC)
User:Martinlc, your edit summary was "image should relate to page topic".
A 2008 review states "Self-mutilation refers to the deliberate, direct destruction or alteration of one's body tissue without conscious suicidal intent. This pattern of behaviour is common in BPD (50 to 80% of cases) and is frequently repetitive (more than 41% of patients make more than 50 self-mutilations). The most common form of self-mutilation behaviour is cutting, but bruising, burning, head banging or biting are not unusual."[1]
The image does relate to the topic because cutting is the most common form of BPD. QuackGuru (talk) 15:56, 17 April 2017 (UTC)
  1. ^ Oumaya, M; Friedman, S; Pham, A; Abou Abdallah, T; Guelfi, JD; Rouillon, F (October 2008). "[Borderline personality disorder, self-mutilation and suicide: literature review]". L'Encephale. 34 (5): 452–8. doi:10.1016/j.encep.2007.10.007. PMID 19068333.
The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Psychotherapy review

@Doc James: Not sure which of WP:MEDRS stipulations the review and metaanalysis fails. Can you be specific? You didn't give any detail in edit comment, I presume for reasons of space. Cheers. --BowlAndSpoon (talk) 15:42, 11 June 2017 (UTC)

If you look at the edit in question [6] you will notice that the review was not removed (PMID 28249086). In fact it was moved higher up in that section. Doc James (talk · contribs · email) 15:46, 11 June 2017 (UTC)

Prevalence

"About 1.6% of people have BPD in a given year". Where? In the USA? In the world? 81.155.219.227 (talk) 19:49, 30 June 2017 (UTC)

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Signs and symptoms section - source?

There is no footnote covering the list of Signs and Symptoms under that subhead. Where is the list from? DSM? — Preceding unsigned comment added by 70.127.26.247 (talk) 00:00, 31 July 2017 (UTC)

Idealization in Edvard Munch’s The Brooch. Eva Mudocci (1903) - source?

The article features this painting in a prominent place, but gives no source where the idea comes from that the painting features idealization. Searching the keywords on the internet leads only back to this page, or others that seem to derive from it and only feature the sentence "Idealization in Edvard Munch’s The Brooch", without explaining it further either.

The sources are given under the companion image by Munch in the History section. I added a link to that section. (Originally the two images were presented in tandem, but then someone appears to have been fascinated so much by the Brooch that they put it in this prominent place.) Thanks for pointing to this issue. --Saidmann (talk) 20:52, 1 December 2017 (UTC)
Added a ref to the image in question instead. Doc James (talk · contribs · email) 22:29, 1 December 2017 (UTC)

Synonyms

I think most of them are UNDUE, especially the "neurotic psychopathy". I haven't seen sources using the term other than Mario Maj. 185.43.229.130 (talk) 10:56, 12 December 2017 (UTC)

Confusing presentation of statistics?

This article has a problem with the presentation of the data, evidenced by the following two statements:

1. 10% of people with BPD commit suicide

2. 1.6% of people suffer BPD in any given year.

This suggests to the casual reader (although it doesn't actually say) that somewhere around 0.16% of the population are expected to commit suicide at some point, i.e., that the (presumably) life-time risk of suicide due to BPD is 0.16% = 160 per 100,000. Given that the total age-corrected suicide rate for Australia is around 11 per 100,000. I am not qualified to try to convert the 160/100,000 presume life-time risk to annualised to match those statistics, however, it intuitively strikes me as being very high. My gut feeling is that the 1.6% figure has been taken out of context, and is rather 1.6% of some sub-population, or more specifically, that the 1.6% figure is of people who suffer BPD at any point during the year, however short.

Without some indication of the incidence at any point in time, this apparent paradox appears ready to trip readers up (and I have a PhD, so if I got caught by it, others will, too), and to me at least, undermines the authority of the article, unless fully and correctly understood. I tried to hunt through reference 4 to find the missing data, but I can't find a PDF of it anywhere, to match the page numbers from the article. — Preceding unsigned comment added by 118.210.126.35 (talk) 07:34, 5 March 2018 (UTC)


I agree- this tripped me to and clearly is wrong - especially when you take into account that for females (whom suffer much more from BPD) the suicide rate is much lower.

Since the original authors of the 1.6% figure have removed it from their article, I will remove the claim from wikipedia - hopefully someone will be able to update in the future with the correct figure. — Preceding unsigned comment added by 92.11.237.146 (talk) 02:02, 13 March 2018 (UTC)

About 1% of people die by suicide.
0.2% of people have BPD and dye by suicide
Numbers looks fine to me. Doc James (talk · contribs · email) 03:06, 14 March 2018 (UTC)

Literature

The discussion of literature needs secondary sources not linking to the actual books themselves (which is simple original research). Doc James (talk · contribs · email) 13:17, 22 April 2018 (UTC)

yep. Jytdog (talk) 17:09, 22 April 2018 (UTC)
The citations are in proper academic format. The links are to Amazon pages which describe the books. Surely that's more reliable than secondary sources about them. The message from Lois Bujold is directly from the author describing her intentions regarding her novel _Komarr_. Again: surely more reliable than a secondary source quoting her. Why is this inappropriate? BunsenH (talk) 18:10, 22 April 2018 (UTC)
Having read the Wikipedia guidelines regarding original research, it appears to me that you are grossly misusing the term. The comments about the books contain no assertions that are not closely supported by the linked information. BunsenH (talk) 19:24, 22 April 2018 (UTC)
Well it is not a gross misuse. WP content should be driven by independent, secondary sources. What you did here was select books that you are aware of, and cited the books themselves. You selecting them and citing the books themselves, with no independent secondary source, is OR. If you were to cite book reviews instead - book reviews which said something about why the books were important in culture with respect to BPD, we would not be having this argument. You are trying to asset they matter, with no independent, secondary sources to back you up. that is just a waste of your time and everybody else's.
The third item is sourced to a forum and is forbidden under WP:USERGENERATED which is unambigiuous policy. Also a waste of time. Just cite independent, secondary sources and you will have way fewer problems. Jytdog (talk) 19:47, 22 April 2018 (UTC)
I don't believe that your use of "original research" is consistent with how Wikipedia uses the term in this context. I also don't believe that information posted on a mailing list is intrinsically unreliable; it's just the medium. The *source* is the author. I have requested dispute resolution in this matter: https://en.wikipedia.org/wiki/Wikipedia:Dispute_resolution_noticeboard#Talk:Borderline_personality_disorder . BunsenH (talk) 19:17, 13 May 2018 (UTC)
@BunsenH: Get Me Out Of Here is published by Heath Communications, also known as HCI. They are associates of the Hazelden Foundation, which is a treatment center for mental health. HCI distributes Hazelden's many self-help titles to retail chains and mass merchandisers. According to The New York Times:

Hazelden, which has "treated 70,000 "residents" (never "patients"), behaves as much like a well-endowed college as a detox center. Its bucolic grounds, 50 miles outside the Twin Cities, are called "the campus," while discounts on Hazelden's $12,300 month-long "tuition" are called "scholarships." The nonprofit Hazelden empire, which includes a publishing company and a mail-order business selling 12-step gewgaws, has an annual budget of $53 million.[1]

I would ask the editor wishing to add this in a "literature" section of the BPD article: what is it about this book, that makes it such a salient contribution to the discussion on BPD? .spintendo⋅⋅) 21:59, 13 May 2018 (UTC)
I was not aware of those background details. From the book's description, it appeared to be relevant. I had restored that item from a previous deletion (which gave no such explanation), after removing details from the item that could not be substantiated from the Amazon page. I entirely agree that it's important for info on Wikipedia to be adequately sourced, especially for complex/technical matters, and particularly for medical subjects where misinformation could have serious consequences. However, when the assertion is simply "this book is about that subject", it does seem to me that the Amazon page is adequate to substantiate the assertion. The dispute was/is over that, and over the assertion that the item's inclusion was "original research", not because the item was/is inappropriate for the article. BunsenH (talk) 01:45, 20 May 2018 (UTC)
I'm not really sure a character in a SF novel has a place in a Wikipedia article about a medical condition. Looks like classic WP:TRIVIA to me. If that is the nexus of the dispute that initiated DR, then my opinion would be the solution is to just delete it. ☆ Bri (talk) 02:36, 14 May 2018 (UTC)
Is the SF novel less relevant to the subject than the items in the "Film and television" section? BunsenH (talk) 01:45, 20 May 2018 (UTC)

References

  1. ^ Karlen, Neal (1995). "Greetings From Minnesober". The New York Times.

Borderline Personality Disorder - capitalised as a proper noun.

Hi. I edited the article on Borderline Personality Disorder (BPD) to capitalise it correctly. This is a name of a psychiatric disorder and should be capitalised in the same way that Asperger's or Alzheimer's should be. I believe I have made this correction twice now and twice it's been revoked without this even being discussed with me first. What can I do to make sure this is corrected permanently. You can see the article below, which uses the capitalisation correctly.

[1]

Stevenhayward (talk) 20:21, 4 July 2018 (UTC)

Wikipedia goes by what is done in reliable sources. The Psychology Today source you cite above capitalize it, but Mayo Clinic and the National Institute of Mental Health do not. I would tend to go with the latter rather than a popular science magazine (no knock against PT, which I read frequently). Shock Brigade Harvester Boris (talk) 20:33, 4 July 2018 (UTC)
Alzheimer's and Asperbergers are named after people. Other disorders aren't generally capitalized - eg. major depressive disorder, bipolar disorder, etc. Jytdog (talk) 22:18, 4 July 2018 (UTC)
Yup per the above two. Doc James (talk · contribs · email) 02:30, 5 July 2018 (UTC)
Agreed, it's not actually a proper noun. Shouldn't be capitalized and the majority of sources do not capitalize it. Canterbury Tail talk 11:50, 5 July 2018 (UTC)

"Cluster A"

Should "Cluster" be capitalized? We do not capitalize most diseases or conditions unless named after a person? Doc James (talk · contribs · email) 00:49, 24 February 2019 (UTC)

Interesting point! And yet it seems to be established and universal practice to capitalise these disorders (in Wikipedia and elsewhere).
- SquisherDa (talk) 00:56, 24 February 2019 (UTC)

Disagree with many of the changes and not seeing the ref supporting them

Personality disorders are a "long-term pattern of abnormal behavior". Not sure why this was removed?

Which ref supports "but in rare cases, signs might not appear until much later after a life-altering stressful event occurs"

Which ref supports " Many affected experience such mild symptoms that they can still have productive lives"

"unstable relationships with other people, unstable sense of self " was changed to "conflicting relationships with other people, poor sense of self"

Ref however says "intense and unstable relationships" and "Distorted and unstable self-image or sense of self" so not sure why the change? The terms do not exactly mean the same.

Which ref supports "BPD is similar to other cluster B personality disorders—particularly, antisocial, narcissistic, and histrionic—in that it is correlated with varying degrees of dramatic and narcissistic behavior."

"Symptoms may be brought on by seemingly normal events." which is supported by the ref does not mean the same as "The disorder may be brought on by seemingly normal events"

Doc James (talk · contribs · email) 15:09, 20 August 2019 (UTC)

Responding to your first point, schizophrenia is also a "long-term pattern of abnormal behavior", yet it's not a personality disorder. The problem is that this part of the definition is too vague and applies to many mental disorders. Abnormal psychology (2017) describes personality disorders as consisting of "chronic interpersonal difficulties, problems with one’s identity or sense of self, and an inability to function adequately in society." I would start the definition by saying that it is a "long-term mental disorder characterised by..."--Megaman en m (talk) 15:24, 20 August 2019 (UTC)
I agree with User:Megaman en m, but we need more sources. Plus, we need better phrasing and remove redundancy, instead of writing "unstable" for each symptom. How about this wording for the first sentence instead: "Borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD), is a mental illness characterized by a life-long pattern of unstable relationships with other people, strong emotional reactions, and distorted sense of self." ATC . Talk 02:52, 25 August 2019 (UTC)
I prefer the newer wording.--Megaman en m (talk) 07:57, 25 August 2019 (UTC)

Long term rather than life long.

Not sure which text of the ref supports "and sensitivity to rejection or criticism"?

Here is the ref https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml Doc James (talk · contribs · email) 12:00, 25 August 2019 (UTC)

The term Borderline Personality Disorder is triggering for BPD sufferers

The term Borderline Personality Disorder resembles the phrase living on the edge for a bpd sufferer in my case and might be unhealthy for people with BPD 666nirvanarules666 (talk) 22:43, 7 April 2019 (UTC)

No. See Euphemism Treadmill for starters. Zezen (talk) 15:27, 13 July 2019 (UTC)

It’s not offensive to me and the thousands of others I’ve talked to. In fact it’s an accurate name. It feels like living on the borderline of psychosis and neurosis. Aliswho (talk) 19:49, 22 September 2019 (UTC)

Prevalence

Estimates are generally around 1.6% per https://web.archive.org/web/20160322130612/http://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml

Though the DSM 5 says 1.6% but may be as high as 5.9%. Do not think we need the primary sources in the lead. Doc James (talk · contribs · email) 23:51, 10 September 2019 (UTC)

The lowest estimate is 0.5%, highest is 1.6% and this includes trying to estimate undiagnosed patients. It is not as high as 6% or other nonsense. Aliswho (talk) 19:50, 22 September 2019 (UTC)

Self-complexity?

Can someone explain what in the world the "self-complexity" section is trying to say? It is unintelligible. — Preceding unsigned comment added by 100.14.6.193 (talk) 03:06, 19 January 2020 (UTC)

Reference

Per this ref from 2001 https://www.ncbi.nlm.nih.gov/pubmed/?term=11288605

The apathy and other emotions are supposedly in the therapeutics / clinician rather than the pt per

"Cluster B patients stir up a host of feelings; hatred, rage, despair, impotence, apathy, helplessness, feelings of sexuality, the illusion of omnipotence, omniscience, and love. As clinicians, we often try to cope with this affect by disparaging our patient, questioning our own competence, or feeling guilty over what we may have said or done."

Have moved to the body of the text to the diagnosis section. Doc James (talk · contribs · email) 23:24, 9 April 2020 (UTC)

The nonsensical change of the Idealization picture

The user Morslyte that changes the picture from Jacobson's and gives the reason of no opposition in the talk, a talk that doesn't exist so is a false reason, should be changed back I'm not going to get into an edit war with this user on this, but I follow this page frequently and there's no reason for it to be changed ,the previous and rightful image is more correct, it gives the page more identity and is more fitting for BPD, thank you https://en.wikipedia.org/wiki/User:EmilePersaud 10:37, 2 June 2020 (UTC) — Preceding unsigned comment added by EmilePersaud (talk • contribs)

  1. ^ https://www.psychologytoday.com/gb/blog/here-there-and-everywhere/201112/borderline-personality-disorder-big-changes-in-the-dsm-5
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