This article first appeared in Psychiatric Times on July 20, 2016
Douglas Berger Psychiatrist Tokyo, comments on “Update on Diagnostic Issues for Borderline Personality Disorder” by Peter Fonagy, OBE, FMedSci, FBA, PhD, Chloe Campbell, PhD, and Anthony W. Bateman, MA, FRCPsych, July 19, 2016 issue of the Psychiatric Times:
It is unclear how the proposals in this article are any more valid than the current categorical criteria. For example, the article doesn’t mention the exclusion criteria for a personality disorder when the criteria can be explained by another psychiatric disorder. For example, the trait stage of diagnosis for BPD notes 7 traits that could easily be due to a mood disorder: emotional lability, anxiousness, separation anxiety, depressivity, and/or ADHD or a manic spectrum disorder: impulsivity, risk-taking, and hostility.
Until there is a reliable biological or genetic parameter that can validly discriminate BPD from these other disorder spectrums, it seems prudent to have the modesty to admit that the diagnosis of a personality disorder, especially BPD, will still be far from a valid construct no matter how categorical or dimensional we want to make a mix of them.
Doug Berger, M.D., Ph.D.
US Board Certified Psychiatrist
Dr. Doug Berger, a psychiatrist in Tokyo, Japan, has written in the past on the topic of what’s healthy when it comes to children using electronics and how can parents know when their children are spending too much time in front of the computer, TV, video game console, etc.
Here we ask him to elaborate on a few questions:
1. How do rates of electronic use among children compare over the last two decades? Do you see a trend of electronic use among children only increasing in the future?
Clearly the development, marketing, and use of these devices has exploded in the last decades, and the there seems to be no end in sight of this trend continuing. Quantum computing, mem computing, holography and other technology will take over the next generation, and the fun and excitement that children have with gadgets, creation, and competition, will continue as these technologies unfold.
2. What are the some of the consequences for children spending too much time with electronics, both as far as mental health and physical health?
There are some positives and clearly also some negatives. The positives are for these children to grow up as part of their environment that will increasingly use smart devices that are integrated into every aspect of life and career opportunity. Logical thinking and problem solving can be cultivated using and programming these devices.
The negatives are spending too much time with devices at the expense of other in-person activities, sports, socializing, etc. Spending inordinate amounts of time doing thousands of operations on a device every month or zoning into videos or internet sites that in the end start to have limited life value and are at the expense of other studies is another large problem. Parents and children may get into conflict about overuse of devices, children (and adults) may bully each other on-line, and negative outcomes may emerge.
3. What are some parental techniques that parents can employ to limit their children’s electronic use?
Setting times where using devices is permitted, giving rewards for having a balanced lifestyle, penalties for device over-use, and education about what the child is losing by spending too much time on a device, are some good ways to mold a child’s device use. Scaring children that overuse of a device will lead them to have poor grades and few job prospects later in life may be effective.
4. When can parents tell when a psychiatrist is needed when it comes to their children and electronic use?
Overuse that is running out of control, zoning-into devices for long periods, tantrums when told they are over time limits, bullying or fighting on-line, and poor grades in school. Parents also need to have some balance and should be careful of “military law” at home in controlling their children. A fair but effective reward and penalty system mixed with a warning about how life may not go well is always better than “military rule” at home which can ruin the cohesion of parents with their children.
Read more on Dr. Doug Berger’s comments as it relates to children and electronics