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Encyclopedia > Borderline Personality Disorder
 Borderline personality disorder 
Classification & external resources
ICD-10 F60.30 Impulsive type, F60.31 Borderline type
ICD-9 301.83

Borderline Personality Disorder (DSM-IV Personality Disorders 301.83[1]) (BPD) is defined as a personality disorder primarily characterized by emotional dysregulation, extreme "black and white" thinking, or "splitting", and chaotic relationships. The general profile of the disorder also typically includes a pervasive instability in mood, interpersonal relationships, self-image, identity, and behavior, as well as a disturbance in the individual's sense of self. In extreme cases, this disturbance in the sense of self can lead to periods of dissociation.[2] The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Diagnostic and Statistical Manual published by the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, also known as DSM-IV-TR is a manual published by the American Psychiatric Association and includes all currently recognized mental health disorders. ... Personality disorder, formerly referred to as a Characterological disorder is a class of mental disorders characterized by rigid and on-going patterns of thought and action. ... Emotional dysregulation (or affect dysregulation) is a term used in the mental health community to refer to an emotional response that is not well modulated. ... In math, splitting means partition. ... A mood is a relatively lasting emotional or affective state. ... Italic text This article does not cite any references or sources. ... It has been suggested that this article or section be merged into Self-concept. ... Identity is an umbrella term used throughout the social sciences for an individuals comprehension of him or herself as a discrete, separate entity. ... For the Björk song, see Human Behaviour Human behavior is the collection of behaviors exhibited by human beings and influenced by culture, attitudes, emotions, values, ethics, authority, rapport, hypnosis, persuasion, coercion and/or genetics. ... Identity in psychological terms relates to self-image, self-esteem and individuation. ... Dissociation is a state of acute mental decompensation in which certain thoughts, emotions, sensations, and/or memories are compartmentalized because they are too overwhelming for the conscious mind to integrate. ...


The disturbances suffered by those with borderline personality disorder have a wide-ranging and pervasive negative impact on many or all of the psychosocial facets of life, including ability to hold down a job and relationships in work, home, and social settings. Comorbidity is common; borderline personality disorder frequently occurring with substance use disorders and mood disorders. Attempted suicide and completed suicide are possible outcomes without proper care and effective therapy. In medicine and in psychiatry, comorbidity is either The presence of one or more disorders (or diseases) in addition to a primary disease or disorder; or The effect of such additional disorders or diseases. ... A mood disorder is a condition where the prevailing emotional mood is distorted or inappropriate to the circumstances. ...

Contents

Diagnosis

Diagnosis is based on the self-reported experiences of the patient, as well as markers for the disorder observed by a psychiatrist, psychologist, or other qualified diagnostician through clinical assessment. This profile may be supported and/or corroborated by long term patterns of behavior as reported by family members, friends or co-workers. The list of criteria that must be met for diagnosis is outlined in the DSM-IV-TR.[2] For other uses, see Psychiatrist (disambiguation). ... Clinical psychology is the application of psychology to mental illness or mental health problems. ... The Diagnostic and Statistical Manual published by the American Psychiatric Association The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a handbook for mental health professionals that lists different categories of mental disorder and the criteria for diagnosing them, according to the publishing organization the American Psychiatric Association. ...


An initial assessment generally includes a comprehensive personal and family history, and may also include a physical examination by a physician. Although there are no physiological tests that confirm borderline personality disorder, medical tests may be employed to exclude any co-occurring medical conditions that may present with psychiatric symptoms. These include blood tests measuring TSH to exclude hypo- or hyperthyroidism, basic electrolytes and serum calcium to rule out a metabolic disturbance, full blood count including ESR to rule out a systemic infection or chronic disease, and serology to exclude syphilis or HIV infection; two commonly ordered investigations are EEG to exclude epilepsy, and a CT scan of the head to exclude brain lesions. Thyroid-stimulating hormone (also known as TSH or thyrotropin) is a hormone synthesized and secreted by thyrotrope cells in the anterior pituitary gland which regulates the endocrine function of the thyroid gland. ... This article or section does not cite its references or sources. ... Hyperthyroidism (or overactive thyroid gland) is the clinical syndrome caused by an excess of circulating free thyroxine (T4) or free triiodothyronine (T3), or both. ... Blood tests are laboratory tests done on blood to gain an appreciation of disease states and the function of organs. ... For other uses, see Calcium (disambiguation). ... Schematics of shorthand for complete blood count commonly used by physicians. ... The erythrocyte sedimentation rate(ESR), also called a sedimentation rate, sed rate or Biernacki Reaction, is a non-specific measure of inflammation that is commonly used as a medical screening test. ... Serology is the scientific study of blood serum. ... Syphilis is a sexually transmitted disease caused by Treponema pallidum. ... Species Human immunodeficiency virus 1 Human immunodeficiency virus 2 Human immunodeficiency virus (HIV) is a retrovirus that causes acquired immunodeficiency syndrome (AIDS, a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections). ... “EEG” redirects here. ... negron305 Cat scan redirects here. ...


DSM-IV-TR criteria

The latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), the widely-used American Psychiatric Association guide for clinicians seeking to diagnose mental illnesss, defines Borderline Personality Disorder (BPD) as: "a pervasive pattern of instability of interpersonal relationships, self-image and affects, as well as marked impulsivity, beginning by early adulthood and present in a variety of contexts."[3] BPD is classed on "Axis II", as an underlying pervasive or personality condition, rather than "Axis I" for more circumscribed mental disorders. A DSM diagnosis of BPD requires any five out of nine listed criteria to be present for a significant period of time. There are thus 256 different combinations of symptoms that could result in a diagnosis, of which 136 have been found in practice in one study.[4] The criteria are:[2] The Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, is the handbook used most often in diagnosing mental disorders in the United States and other countries. ... Due to the epidemic of medical errors, readers are cautioned to be aware that the American Psychiatric Association isnt immune to this. ... A mental illness or mental disorder refers to one of many mental health conditions characterized by distress, impaired cognitive functioning, atypical behavior, emotional dysregulation, and/or maladaptive behavior. ... Italic text This article does not cite any references or sources. ... It has been suggested that this article or section be merged into Self-concept. ... In psychology, affect is the scientific term used to describe a subjects externally displayed mood. ... Deferred gratification is the ability of a person to wait for things they want. ...

  1. Frantic efforts to avoid real or imagined abandonment such as lying, stealing, temper tantrums, etc. [Not including suicidal or self-mutilating behavior covered in Criterion 5]
  2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
  3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
  4. Impulsivity in at least two areas that are potentially self-damaging (e.g., promiscuous sex, eating disorders, binge eating, substance abuse, reckless driving, overspending, stealing). [Again, not including suicidal or self-mutilating behavior covered in Criterion 5]
  5. Recurrent suicidal behavior, gestures, threats, or self-mutilating behavior.
  6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
  7. Chronic feelings of emptiness, worthlessness.
  8. Inappropriate anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
  9. Transient, stress-related paranoid ideation or severe dissociative symptoms

Look up abandonment in Wiktionary, the free dictionary. ... A tantrum is an emotional outburst wherein higher brain functions are unable to stop the emotional expression of the lower (emotional and physical) brain functions. ... Italic text This article does not cite any references or sources. ... // Idealization is the process by which scientific models assume facts about the phenomenon being modeled that are certainly false. ... Look up Identity in Wiktionary, the free dictionary. ... It has been suggested that this article or section be merged into Self-concept. ... Identity in psychological terms relates to self-image, self-esteem and individuation. ... Impulse control disorder is a set of psychiatric disorders including intermittent explosive disorder (hot-headedness), kleptomania (stealing), pathological gambling, pyromania (fire-starting) and trichotillomania (pulling ones hair out). ... Promiscuity is the practice of making relatively unselective, casual and indiscriminate choices. ... Binge eating is a pattern of disordered eating which consists of episodes of uncontrollable overeating. ... Also see Alcoholism and Drug addiction. ... Reckless driving, in the United States, is a serious moving traffic violation. ... For other uses, see Suicide (disambiguation). ... http://www. ... In psychology, affect is the scientific term used to describe a subjects externally displayed mood. ... Look up mood in Wiktionary, the free dictionary. ... Look up dysphoria in Wiktionary, the free dictionary. ... what up?? Anxiety is a physiological state characterized by cognitive, somatic, emotional, and behavioral components (Seligman, Walker & Rosenhan, 2001). ... For other uses, see Emptiness (disambiguation). ... This article is about the emotion. ... In medical terms, stress is the disruption of homeostasis through physical or psychological stimuli. ... For other senses of this word, see paranoia (disambiguation). ... Ideation is the process of forming and relating ideas. ... Dissociation is a state of acute mental decompensation in which certain thoughts, emotions, sensations, and/or memories are compartmentalized because they are too overwhelming for the conscious mind to integrate. ...

Comparable diagnoses

The World Health Organization's ICD-10 has a comparable diagnosis called Emotionally Unstable Personality Disorder - Borderline type (F60.31). This requires, in addition to the general criteria for personality disorder: disturbances in and uncertainty about self-image, aims, and internal preferences (including sexual); liability to become involved in intense and unstable relationships, often leading to emotional crisis; excessive efforts to avoid abandonment; recurrent threats or acts of self-harm; and chronic feelings of emptiness. The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) is a detailed description of known diseases and injuries. ... It has been suggested that this article or section be merged into Borderline personality disorder. ...


The Chinese Society of Psychiatry's CCMD has a comparable diagnosis of Impulsive Personality Disorder. A patient diagnosed as having IPD must display "affective outbursts" and "marked impulsive behavior", plus at least three out of eight other symptoms. The construct has been described as a hybrid of the impulsive and borderline subtypes of the ICD's Emotionally Unstable Personality Disorder, and also incorporates six of the nine DSM BPD criteria.[5] The Chinese Society of Psychiatry (CSP) is the largest organization for psychiatrists in China. ... The Chinese Classification of Mental Disorders (CCMD), published by the Chinese Society of Psychiatry (CSP), is a clinical guide used in China for the diagnosis of mental disorders. ...


Aspects of BPD

It has been noted that there is probably no other mental disorder about which so many articles and books have been written, yet about which so little is known based on empirical research.[6]


Studies suggest that individuals with BPD tend to experience frequent, strong and long-lasting states of aversive tension, often triggered by perceived rejection, being alone, or perceived failure.[7] Individuals with BPD may show lability (changeability) between anger and anxiety or between depression and anxiety[8] and temperamental sensitivity to emotive stimuli.[9] This article needs cleanup. ... Lability is constantly undergoing change or something that is likely to undergo change. ...


The negative emotional states particularly associated with BPD have been grouped into four categories: extreme feelings in general; feelings of destructiveness or self-destructiveness; feelings of fragmentation or lack of identity; and feelings of victimization.[10]


Individuals with BPD can be very sensitive to the way others treat them, reacting strongly to perceived criticism or hurtfulness. Their feelings about others often shift from positive to negative, generally after a disappointment or perceived threat of losing someone. Self-image can also change rapidly from extremely positive to extremely negative. Impulsive behaviors are common, including alcohol or drug abuse, unsafe sex, gambling, and recklessness in general.[11] Attachment studies suggest individuals with BPD, while being high in intimacy- or novelty-seeking, can be hyper-alert[6] to signs of rejection or not being valued and tend towards insecure, ambivalent, preoccupied or fearful attitudes towards relationships.[12] They tend to view the world generally as dangerous and malevolent, and themselves as powerless, vulnerable, unacceptable and unsure in self-identity.[6]


Individuals with BPD are often described, including by some mental health professionals (and in the DSM-IV),[3] as deliberately manipulative or difficult, but analyses and findings generally trace behaviors to inner pain and turmoil, powerlessness and defensive reactions, or limited coping and communication skills.[13][14][15] There has been limited research on family members' understanding of borderline personality disorder and the extent of burden or negative emotion experienced or expressed by family members.[16] Parents of individuals with BPD have been reported to show co-existing extremes of over-involvement and under-involvement.[17] BPD has been linked to somewhat increased levels of chronic stress and conflict in romantic relationships, decreased satisfaction of romantic partners, abuse, and unwanted pregnancy; these links may largely be general to personality disorder and subsyndromal problems,[18] but such issues are commonly raised in support groups and published literature for partners of individuals with BPD.


Suicidal or self-harming behavior is one of the core diagnostic criteria in DSM IV-TR, and management of and recovery from this can be complex and challenging.[19] The suicide rate is approximately eight to ten percent.[20] The most recognized form of self-injury is automutilation (cutting the self), usually of the arms, but often other areas such as the legs, chest, belly, and face. Self-injury attempts are highly common among patients and may or may not be carried out with suicidal intent.[21][22] BPD is often characterized by multiple low lethality suicide attempts triggered by seemingly minor incidents, and less commonly by high lethality attempts that are attributed to impulsiveness or comorbid major depression, with interpersonal stressors appearing to be particularly common triggers.[23] Ongoing family interactions and associated vulnerabilities can lead to self-destructive behavior.[17] Stressful life events related to sexual abuse have been found to be a particular trigger for suicide attempts by adolescents with a BPD diagnosis.[24] For other uses, see Suicide (disambiguation). ...


Mnemonic

A commonly used mnemonic to remember some features of borderline personality disorder is PRAISE: For other uses, see Mnemonic (disambiguation). ...

  • P - Paranoid ideas
  • R - Relationship instability
  • A - Angry outbursts, affective instability, abandonment fears
  • I - Impulsive behavior, identity disturbance
  • S - Suicidal behavior
  • E - Emptiness

Differential diagnosis

Borderline personality disorder often co-occurs with mood disorders. [citation needed] Some features of borderline personality disorder may overlap with those of mood disorders, complicating the differential diagnostic assessment.[25][26][27]


Both diagnoses involve symptoms commonly known as "mood swings". In bipolar disorder, the term refers to the cyclic episodes of elevated and depressed mood generally lasting weeks or months. In the rapid cycling variant of bipolar disorder there are more than four episodes in a year, but even then the swings are more sustained than in borderline personality disorder.[citation needed]


The term in borderline personality refers to the marked lability and reactivity of mood defined as emotional dysregulation. The behavior is typically in response to external psychosocial and intrapsychic stressors, and may arise and/or subside suddenly and dramatically and last for seconds, minutes, hours or days. Lability is constantly undergoing change or something that is likely to undergo change. ... Emotional dysregulation (or affect dysregulation) is a term used in the mental health community to refer to an emotional response that is not well modulated. ... Psychosocial refers to ones psychological development in the context of a social environment. ... Intrapsychic is a psychological term referring to internal psychological processes of the individual. ...


Bipolar depression is generally more pervasive with sleep and appetite disturbances, as well as a marked nonreactivity of mood, whereas mood with respect to borderline personality and co-occurring dysthymia remains markedly reactive and sleep disturbance not acute.[28]


The relationship between bipolar disorder and borderline personality disorder has been debated. Some hold that the latter represents a subthreshold form of affective disorder,[29][30] while others maintain the distinctness between the disorders, noting they often co-occur.[31][32]


Co-morbidity

Co-morbid (co-occurring) conditions in BPD are common. When comparing individuals diagnosed with BPD to those diagnosed with other kinds of personality disorders, the former showed a higher rate of also meeting criteria for:[33] In medicine and in psychiatry, comorbidity refers to: The presence of one or more disorders (or diseases) in addition to a primary disease or disorder. ...

Substance abuse is a common problem in BPD, whether due to impulsivity or as a coping mechanism, and 50% to 70% of psychiatric inpatients with BPD have been found to meet criteria for a substance use disorder.[34] Anxiety disorder is a blanket term covering several different forms of fear, phobia and nervous condition, that come on suddenly and prevent pursuing normal daily routines including: general anxiety disorder social anxiety, sometimes known as social phobia or social anxiety disorder (SAD) specific phobias agoraphobia claustrophobia panic disorder separation anxiety... A mood disorder is a condition where the prevailing emotional mood is distorted or inappropriate to the circumstances. ... On the Threshold of Eternity. ... For other uses, see Bipolar. ... For the symphonic black metal band, see Anorexia Nervosa (band) For other uses, see Anorexia Anorexia nervosa is a psychiatric diagnosis that describes an eating disorder characterized by low body weight and body image distortion with an obsessive fear of gaining weight. ... Bulimia nervosa, more commonly known as bulimia, is a psychological condition in which the subject engages in recurrent binge eating followed by intentionally doing one or more of the following in order to compensate for the intake of the food and prevent weight gain: vomiting inappropriate use of laxatives, enemas... Also see Alcoholism and Drug addiction. ...


Prevalence

Figures from surveys of the prevalence of diagnosable BPD in the general population vary, ranging from approximately 1% to 2%.[35][36] The diagnosis appears to be several times more common in (especially young) women than in men, by as much as 3:1 according to the DSM-IV-TR[37] although the reasons for this are not clear.[38] In epidemiology, the prevalence of a disease in a statistical population is defined as the total number of cases of the disease in the population at a given time, or the total number of cases in the population, divided by the number of individuals in the population. ...


BPDs are disproportionately represented in prison populations: 23 percent of incarcerated men and 20 percent of incarcerated women are diagnosed with BPD.[39]


Terminology

There is a debate as to whether BPD should be renamed. The term "borderline" started in clinical use in the 1930s, originating in the idea (now out of favor) of some patients being on the "borderline" between neurosis and psychosis. BPD only became an official Axis II (personality) diagnosis in 1980 with the publication of DSM-III.[35] In modern psychology, the term neurosis, also known as psychoneurosis or neurotic disorder, is a general term that refers to any mental imbalance that causes distress, but (unlike a psychosis or personality disorder) does not prevent rational thought or an individuals ability to function in daily life. ... Psychosis is a generic psychiatric term for a mental state often described as involving a loss of contact with reality. Stedmans Medical Dictionary defines psychosis as a severe mental disorder, with or without organic damage, characterized by derangement of personality and loss of contact with reality and causing deterioration...


Alternative suggestions for names include Emotional regulation disorder or Emotional dysregulation disorder. According to TARA, (Treatment and Research Advancement Association for Personality Disorders) this terminology has "the most likely chance of being adopted by the American Psychiatric Association."[40] Emotional regulation disorder is the term favored by Dr. Marsha Linehan, pioneer of one of the most popular types of BPD therapy. Impulse disorder and Interpersonal regulatory disorder are other valid alternatives, according to Dr. John Gunderson of McLean Hospital in the United States. Dyslimbia has been suggested by Dr. Leland Heller[41] and Mercurial disorder has been proposed by McLean Hospital's Dr. Mary Zanarini.[42] McLean Hospital (pronounced Mc-Lane) is a psychiatric hospital in Belmont, Massachusetts, USA. It is noted for its clinical staff expertise and ground-breaking neuroscience research. ...


Another term advanced (for example by psychiatrist Carolyn Quadrio) is Post Traumatic Personality Disorganisation (PTPD), reflecting the condition's status as (often) both a form of chronic Post Traumatic Stress Disorder (PTSD) and Personality Disorder and a common outcome of developmental or attachment trauma.[43] Posttraumatic stress disorder (PTSD), is a term for the psychological consequences of exposure to or confrontation with stressful experiences, which involve actual or threatened death, serious physical injury or a threat to physical integrity and which the person found highly traumatic. ... Personality disorder, formerly referred to as a Characterological disorder is a class of mental disorders characterized by rigid and on-going patterns of thought and action. ...


Significantly, the above proposals, if adopted, will probably result in the recognition of BPD as a trauma- and/or mood-related disorder, and should move BPD from Axis II to Axis I in the next DSM (DSM-V, due in 2012). As a three-letter acronym or abbreviation DSM or dsm can mean several things: // DSM (company), an international chemicals company based in the Netherlands Dependency Structure Matrix Deputy Stage Manager Design Structure Matrix The IATA airport code for Des Moines International Airport in Des Moines, Iowa, United States and issometimes...


Some who are labeled with "Borderline Personality Disorder" feel it is unhelpful and stigmatizing as well as simply inaccurate, supporting and adding to calls for a name change.[44] Criticisms have also come from a feminist perspective.[45] It has also claimed that, in some circles, "borderline" is used as a "garbage can" diagnosis for individuals who are hard to diagnose, or is interpreted as meaning "nearly psychotic" despite a lack of empirical support for this conceptualization, or is used as a generic label for difficult clients or as an excuse for therapy going badly.[46] It has been suggested that Labelling be merged into this article or section. ... Look up stigma on Wiktionary, the free dictionary. ... Feminism is a social theory and political movement primarily informed and motivated by the experience of women. ...


Etiology - causes and influences

Researchers commonly believe that BPD results from a combination that can involve a traumatic childhood, a vulnerable temperament, and stressful maturational events during adolescence or adulthood.[47] Otto Kernberg formulated the theory of Borderline Personality based on a premise of failure to develop in childhood. There are, according to Kernberg, 3 developmental tasks an individual must accomplish, and, when one fails to accomplish a certain developmental task, this often corresponds with an increased risk in developing certain psychopathologies. Failing the first developmental task of psychic clarification of self and other, can result in an increased risk to develop varieties of psychosis. Not accomplishing the second task, overcoming splitting, results in an increased risk to develop a borderline personality. [48] “Adolescent” redirects here. ... Otto F. Kernberg, was born in Vienna in 1928 and in 1939 his family left Germany to escape the Nazi regime and emigrated to Chile where he later studied biology and medicine and afterwards psychiatry and psychoanalysis with the Chilean Psychoanalytic Society. ...


Childhood abuse, trauma or neglect

Numerous studies have shown a strong correlation between childhood abuse and development of BPD.[49][50][51][43] Many individuals with BPD report having had a history of abuse, neglect, or separation as young children.[52] Patients with BPD have been found to be significantly more likely to report having been verbally, emotionally, physically, and sexually abused by caretakers of either gender. They were also much more likely to report having caretakers (of both genders) deny the validity of their thoughts and feelings. They were also reported to have failed to provide needed protection, and neglected their child's physical care. Parents (of both sexes) were typically reported to have withdrawn from the child emotionally, and to have treated the child inconsistently. Additionally, women with BPD who reported a previous history of neglect by a female caretaker and abuse by a male caretaker were consequently at significantly higher risk for being sexually abused by a noncaretaker (not a parent).[53] These are also the same risk factors for reactive attachment disorder and it has been suggested that children who experience chronic early maltreatment and Reactive Attachment Disorder go on to develop a variety of personality disorders, including Borderline Personality Disorder.[54] Many of these children are violent[55] and aggressive[56] and as adults are at risk of developing a variety of psychological problems[57] such as borderline personality disorder.[54] It has been suggested that this article or section be merged with Attachment disorder. ...


According to Joel Paris,[58] "Some researchers, like Judith Herman, believe that BPD is a name given to a particular manifestation of post-traumatic stress disorder (PTSD): in Trauma and Recovery, she theorizes that when PTSD takes a form that emphasizes heavily its elements of identity and relationship disturbance, it gets called BPD; when the somatic (body) elements are emphasized, it gets called hysteria, and when the dissociative/deformation of consciousness elements are the focus, it gets called DID/MPD" (dissociative identity disorder or multiple personality disorder). Post-traumatic stress disorder (PTSD) is a term for certain severe psychological consequences of exposure to, or confrontation with, stressful events that the person experiences as highly traumatic. ... Dissociative Identity Disorder (DID), as defined by the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), is a mental condition whereby a single individual evidences two or more distinct identities or personalities, each with its own pattern of perceiving and interacting with the environment. ... Overview In psychiatry, Dissociative Identity Disorder (DID) is the current name of the condition formerly listed in the Diagnostic and Statistical Manual of Mental Disorders as Multiple Personality Disorder (MPD) and Multiple Personality Syndrome. ...


Other developmental factors

Some studies suggest that BPD may not necessarily be a trauma-spectrum disorder and that it is biologically distinct from the post traumatic stress disorder that could be a precursor. The personality symptom clusters seem to be related to specific abuses, but they may be related to more persistent aspects of interpersonal and family environments in childhood.[59]


There is evidence for the central role of family in the development of BPD, including interactions that are negative and critical rather than supportive and empathic, with parental and family behaviors transacting with the child's own behaviors and emotional vulnerabilities.[60]


Some findings suggest that BPD may lie on a bipolar spectrum, with a number of points of phenomenological and biological overlap between the affective lability criterion of borderline personality disorder and the extremely rapid cycling bipolar disorders.[61][62] Some findings suggest that the DSM-IV BPD diagnosis mixes up two sets of unrelated items—an affective instability dimension related to Bipolar-II, and an impulsivity dimension not related to Bipolar-II.[63] The complete bipolar spectrum includes the a range of mood disorders, ranging from recurrent unipolar depression all the way to bipolar disorder with psychotic features (or schizobipolar disorder). ...


Genetics

An overview of the existing literature suggested that traits related to BPD are influenced by genes, and since personality is generally quite heritable then BPD should also be, but studies have had methodological problems and the links are not yet clear.[64] A major twin study found that if one identical twin met criteria for BPD, the other also met criteria in around a third (35%) of cases.[65]


Twin, sibling and other family studies indicate a partially heritable basis for impulsive aggression, but studies of serotonin-related genes to date have suggested only modest contributions to behavior.[59]


Neurofunction

Neurotransmitters implicated in BPD include serotonin, norepinephrine and acetylcholine (related to various emotions and moods); GABA, the brain's major inhibitory neurotransmitter (which can stabilize mood change); and glutamate, an excitatory neurotransmitter. Neurotransmitters are chemicals that are used to relay, amplify and modulate electrical signals between a presynaptic and a postsynaptic neuron. ... Serotonin (pronounced ) (5-hydroxytryptamine, or 5-HT) is a monoamine neurotransmitter synthesized in serotonergic neurons in the central nervous system (CNS) and enterochromaffin cells in the gastrointestinal tract of animals including humans. ... Norepinephrine (INN)(abbr. ... The chemical compound acetylcholine, often abbreviated as ACh, was the first neurotransmitter to be identified. ... Gaba may refer to: Gabâ or gabaa (Philippines), the concept of negative karma of the Cebuano people GABA, the gamma-amino-butyric acid neurotransmitter GABA receptor, in biology, receptors with GABA as their endogenous ligand Gaba 1 to 1, an English conversational school in Japan Marianne Gaba, a US model... Chemical structure of D-aspartic acid, a common amino acid neurotransmitter. ... Glutamate is the anion of glutamic acid. ...


Enhanced amygdala activation in BPD has been identified as reflecting the intense and slowly subsiding emotions commonly observed in BPD in response to even low-level stressors.[citation needed] The activation of both the amygdala and prefrontal cortical areas can reflect attempts to control intensive emotions during the recall of unresolved life events.[66] Impulsivity or aggression, as sometimes seen in BPD, has been linked to alterations in serotonin function and specific brain regions in the cingulate and the medial and orbital prefrontal cortex.[59] Look up Amygdala in Wiktionary, the free dictionary. ... Grays FIG. 727– Medial surface of left cerebral hemisphere. ... “Prefrontal” redirects here. ...


Treatment

A recent study found that any of three types of psychotherapy stimulate substantial improvements in people with this disorder.[67] The three approaches studies were Dialectical behavior therapy, transference-focused therapy, and schema-focused therapy. "Psychotherapy that centers on emotional themes arising in the interaction between patient and therapist, known as transference-focused therapy, stimulates the most change in people with borderline personality disorder."[67]


Psychotherapy

There has traditionally been skepticism about the psychological treatment of personality disorders, but several specific types of psychotherapy for BPD have developed in recent years. The limited studies to date do not allow confident claims of effectiveness but do suggest that people with a diagnosis of BPD can benefit on at least some outcome measures.[68] Simple supportive therapy alone may enhance self-esteem and mobilize the existing strengths of individuals with BPD.[69] Specific psychotherapies may involve sessions over several months or, as is particularly common for personality disorders, several years. Psychotherapy can often be conducted either with individuals or with groups. Group therapy can aid the learning and practice of interpersonal skills and self-awareness by individuals with BPD[70] although drop-out rates may be problematic.[71] Personality disorders form a class of mental disorders that are characterized by long-lasting rigid patterns of thought and behaviour. ... Psychotherapy is an interpersonal, relational intervention used by trained psychotherapists to aid clients in problems of living. ...


Dialectical behavioral therapy

In the 1990s, a new psychosocial treatment termed dialectical behavioral therapy (DBT) became established in the treatment of BPD, having originally developed as an intervention for patients with suicidal behavior.[72] Dialectical behavioral therapy (DBT) is a psychosocial treatment developed by Marsha M. Linehan specifically to treat individuals with Borderline personality disorder. ...


Dialectical behavior therapy is derived from cognitive-behavioral techniques (and can be seen as a form of CBT) but emphasizes an exchange and negotiation between therapist and client, between the rational and the emotional, and between acceptance and change (hence dialectic). Treatment targets are agreed upon, with self-harm issues taking priority. The learning of new skills is a core component - including mindfulness, interpersonal effectiveness (e.g. assertiveness and social skills), coping adaptively with distress and crises; and identifying and regulating emotional reactions. Cognitive therapy or cognitive behavior therapy is a kind of psychotherapy used to treat depression, anxiety disorders, phobias, and other forms of psychological disorder. ... In classical philosophy, dialectic (Greek: διαλεκτική) is controversy, Viz. ... Look up Mindfulness in Wiktionary, the free dictionary. ... Assertiveness is a trait taught by many personal development experts and psychotherapists and the subject of many popular self-help books. ...


DBT can be based on a biosocial theory of personality functioning in which BPD is seen as a biological disorder of emotional regulation in a social environment experienced as invalidating by the borderline patient.[73]


Dialectical behavioral therapy has been found to significantly reduce self-injury and suicidal behavior in individuals with BPD, beyond the effect of usual or expert treatment, and to be better accepted by clients.[74][75] although whether it has additional efficacy in the overall treatment of BPD appears less clear.[68] Training nurses in the use of DBT has been found to replace a therapeutic pessimism with a more optimistic understanding and outlook.[76]


Schema Therapy

Schema Therapy (also called Schema-Focused Therapy) is an integrative approach based on cognitive-behavioral or skills-based techniques along with object relations and gestalt approaches. It directly targets deeper aspects of emotion, personality and schemas (fundamental ways of categorizing and reacting to the world). The treatment also focuses on the relationship with the therapist (including a process of "limited re-parenting"), daily life outside of therapy, and traumatic childhood experiences. It was developed by Jeffrey Young and became established in the 1990s. Limited recent research suggests that it is significantly more effective than Transference Focused Psychotherapy, with half of individuals with borderline personality disorder assessed as having achieved full recovery after 4 years, with two thirds showing clinically significant improvement.[77][78] Another very small trial has also suggested efficacy.[79] In psychodynamics, Object relations theory is the idea that the ego-self exists only in relation to other objects, which may be external or internal. ... Gestalt Therapy is a psychotherapy which focuses on here-and-now experience and personal responsibility. ... It has been suggested that Schemata theory be merged into this article or section. ... Transference is a phenomenon in psychology characterized by unconscious redirection of feelings for one person to another. ...


Cognitive behavioral therapy

Cognitive Behavioral Therapy (CBT) is the most widely used and established psychological treatment for mental disorders, but has appeared less successful in BPD, due partly to difficulties in developing a therapeutic relationship and treatment adherence. Approaches such as DBT and Schema-focused therapy developed partly as an attempt to expand and add to traditional CBT, which uses a limited number of sessions to target specific maladaptive patterns of thought, perception and behavior. A recent study did find a number of sustained benefits of CBT, in addition to treatment as usual, after an average of 16 sessions over one year.[80] A Cognitive Behavioral Therapy (CBT) is a psychotherapy based on modifying cognitions, assumptions, beliefs and behaviors, with the aim of influencing disturbed emotions. ...


Eye Movement Desensitization and Reprocessing (EMDR) is a treatment for PTSD, a condition closely associated to BPD in many cases. It is similar to CBT, and seen by some as a type of CBT, but also includes unique techniques intended to facilitate full emotional processing and coming to terms with traumatic memories. The references in this article would be clearer with a different and/or consistent style of citation, footnoting or external linking. ...


Marital or Family Therapy

Marital Therapy can be helpful in stabilizing the marital relationship and in reducing marital conflict and stress that can worsen BPD symptoms. Family Therapy or Family Psychoeducation can help educate family members regarding BPD, improve family communication and problem solving, and provide support to family members in dealing with their loved one's illness.


Two patterns of family involvement can help clinicians plan family interventions: overinvolvement and neglect. Borderline patients who are from overinvolved families are often actively struggling with a dependency issue by denial or by anger at their parents.


Interest in the use of psychoeducation and skills training approaches for families with borderline members is growing.[70]


Psychoanalysis

Traditional psychoanalysis has become less commonly used than in the past, both in general and in regard to BPD. This intervention has been linked to an exacerbation of BPD symptoms[81] although there is also evidence of effectiveness of certain techniques in the context of partial hospitalization.[82] pychoanalysis today comprises several interlocking theories concerning the functioning of the mind; the term also refers to a specific type of treatment where the analyst, upon hearing the thoughts of the analysand (analytic patient), formulates and then explains the unconscious bases for the patients symptoms and character problems. ...


Transference Focused Psychotherapy

Further information: Otto F. Kernberg#Transference-Focused Psychotherapy

Transference Focused Psychotherapy (TFP) is a form of psychoanalytic therapy dating to the 1960s, rooted in the conceptions of Otto Kernberg on BPD and its underlying structure (borderline personality organization). Unlike in the case of traditional psychoanalysis, the therapist plays a very active role in TFP. In session the therapist works on the relationship between the patient and the therapist. The therapist will try to explore and clarify aspects of this relationship so the underlying object relations dyads become clear. Some limited research on TFP suggests it may reduce some symptoms of BPD by affecting certain underlying processes,[83] and that TFP in comparison to Dialectical Behavior Therapy and supportive therapy results in increased reflective functioning (the ability to realistically think about how others think) and a more secure attachment style.[84] Furthermore, TFP has been shown to be as effective as DBT in improvement of suicidal behavior, and has been more effective than DBT in alleviating anger and in reducing verbal or direct assaultive behavior.[85] Limited research suggests that TFP appears to be less effective than schema-focused therapy, while being more effective than no treatment.[77] Otto F. Kernberg, was born in Vienna in 1928 and in 1939 his family left Germany to escape the Nazi regime and emigrated to Chile where he later studied biology and medicine and afterwards psychiatry and psychoanalysis with the Chilean Psychoanalytic Society. ... Otto F. Kernberg, was born in Vienna in 1928 and in 1939 his family left Germany to escape the Nazi regime and emigrated to Chile where he later studied biology and medicine and afterwards psychiatry and psychoanalysis with the Chilean Psychoanalytic Society. ... Object relations theory is the idea that the ego-self exists only in relation to other objects, which may be external or internal. ... Dialectical behavioral therapy (DBT) is a psychosocial treatment developed by Marsha M. Linehan specifically to treat individuals with Borderline personality disorder. ... Mother and child. ...


Cognitive Analytic Therapy

Cognitive Analytic Therapy (CAT) combines cognitive and psychoanalytic approaches and has been adapted for use with individuals with BPD with mixed results.[86] Cognitive Analytic Therapy (CAT) was developed by Anthony Ryle. ...


Medication

A number of medications are used in conjunction with BPD treatments, although the evidence base is limited. As BPD has been traditionally considered a primarily psychosocial condition, medication is intended to treat co-morbid symptoms, such as anxiety and depression, rather than BPD itself.[87]


Antidepressants

Selective serotonin reuptake inhibitor (SSRI) antidepressants have been shown in randomized controlled trials to improve the attendant symptoms of anxiety and depression, such as anger and hostility, associated with BPD in some patients.[87] According to Listening to Prozac, it takes a higher dose of an SSRI to treat mood disorders associated with BPD than depression alone. It also takes about three months for benefit to appear, compared to the three to six weeks for depression. SSRI redirects here; for other uses, see SSRI (disambiguation). ... Prozac, a selective serotonin reuptake inhibitor (SSRI) Serotonin-norepinephrine reuptake inhibitor, Venlafaxine An antidepressant, is a psychiatric medication or other substance (nutrient or herb) used for alleviating depression or dysthymia (milder depression). ... A randomized controlled trial (RCT) is a form of clinical trial, or scientific procedure used in the testing of the efficacy of medicine, used because of its record of reliability. ... Cover of Listening to Prozac Listening to Prozac: A Psychiatrist Explores Antidepressant Drugs and the Remaking of the Self is a book written by psychiatrist Peter D. Kramer. ...


Antipsychotics

The newer atypical antipsychotics are claimed to have an improved adverse effect profile than the typical antipsychotics. Antipsychotics are also sometimes used to treat distortions in thinking or false perceptions.[88] Use of antipsychotics has varied, from intermittent, for a brief psychotic or dissociative episode, to more general, particularly atypical antipsychotics, for both those diagnosed with bipolar disorder (BiP), as well as those diagnosed with borderline personality disorder (BPD). The atypical antipsychotics (also known as second generation antipsychotics) are a class of prescription medications used to treat psychiatric conditions. ... In medicine, an Adverse effect is an abnormal, harmful, undesired and/or unintended side-effect, although not necessarily unexpected, which is obtained as a result of a therapy or other medical intervention, such as drug/chemotherapy, physical therapy, surgery, medical procedure, use of a medical device, etc. ... Typical antipsychotics (sometimes referred to as conventional antipsychotics or conventional neuroleptics) are a class of antipsychotic drugs first developed in the 1950s and used to treat psychosis (in particular, schizophrenia), and are generally being replaced by atypical antipsychotic drugs. ...


One meta-analysis of 14 prior studies has suggested that several atypical antipsychotics, including olanzapine, clozapine, quetiapine and risperidone, may help BPD patients with psychotic-like, impulsive or suicidal symptoms.[89] A meta-analysis is a statistical practice of combining the results of a number of studies. ... Olanzapine (oh-LAN-za-peen, sold as Zyprexa®, Zyprexa Zydis®, or in combination with fluoxetine, as Symbyax®) was the third atypical antipsychotic to gain approval by the Food and Drug Administration (FDA) and has become one of the most commonly used atypical antipsychotics. ... Clozapine (sold as Clozaril®, Leponex®, Fazaclo®) was the first of the atypical antipsychotics to be developed. ... Quetiapine (IPA: , kwe-TYE-a-peen), marketed by AstraZeneca with the brand name Seroquel, belongs to a series of neuroleptics known as atypical antipsychotics, which have, over the last two decades, become increasingly popular alternatives to typical antipsychotics, such as haloperidol. ... Risperdal tablets Risperidone (pronounced Ris-PER-ǐ-dōn and sold under the trade name Risperdal in the United States, Canada, the United Kingdom, Portugal and several other countries, Risperdal or Ridal in New Zealand, Rispolept in Eastern Europe, and Belivon, or Rispen elsewhere) is an atypical antipsychotic medication developed by...


Long-term use of antipsychotics is particularly controversial. There are numerous adverse effects with the older medications, notably Tardive dyskinesia (TDK).[90] Atypical antipsychotics are also known for often causing considerable weight gain, with associated health complications.[91] Tardive dyskinesia is a serious neurological disorder caused by the long-term and/or high-dose use of dopamine antagonists, usually antipsychotics and among them especially the typical antipsychotics. ... The term antipsychotic is applied to a group of drugs used to treat psychosis. ...


Mental health services and recovery

Individuals with BPD sometimes need extensive mental health services and have been found to account for around 20% of psychiatric hospitalizations.[92] The majority of BPD patients continue to use outpatient treatment in a sustained manner for several years, but the number using the more restrictive and costly forms of treatment, such as inpatient admission, declines with time.[93] Experience of services varies.[94] Assessing suicide risk can be a challenge for mental health services (and patients themselves tend to underestimate the lethality of self-injurious behaviours) with typically a chronically elevated risk of suicide much above that of the general population and a history of multiple attempts when in crisis.[95]


Particular difficulties have been observed in the relationship between care providers and individuals diagnosed with BPD. A majority of psychiatric staff report finding individuals with BPD moderately to extremely difficult to "deal" with, and more difficult than other client groups.[96] On the other hand, those with the diagnosis of BPD have reported that the term "BPD" felt like a pejorative label rather than a helpful diagnosis, that self destructive behaviour was wrongly perceived as manipulative, and that they had limited access to care.[97] Attempts are made to improve public and staff attitudes.[98][99] It has been suggested that this article or section be merged with pejoration. ... It has been suggested that Labelling be merged into this article or section. ...


Combining pharmacotherapy and psychotherapy

In practice, psychotherapy and medication may often be combined but there are limited data on clinical practice[26] Efficacy studies often assess the effectiveness of interventions when added to 'treatment as usual' (TAU), which may involve general psychiatric services, supportive counselling, medication and psychotherapy.


One small study, which excluded individuals with a comorbid Axis 1 disorder, has indicated that outpatients undergoing Dialectical Behavioral Therapy and taking the antipsychotic Olanzapine show significantly more improvement on some measures related to BPD, compared to those undergoing DBT and taking a placebo pill,[100] although they also experienced weight gain and raised cholesterol. Another small study found that patients who had undergone DBT and then took fluoxetine (Prozac) showed no significant improvements, whereas those who underwent DBT and then took a placebo pill did show significant improvements.[101]


Difficulties in therapy

There can be unique challenges in the treatment of BPD, for example hospital care.[102] In psychotherapy, a client may be unusually sensitive to rejection and abandonment and may react negatively (e.g., by harming themselves or withdrawing from treatment) if they sense this. In addition, clinicians may emotionally distance themselves from individuals with BPD for self-protection or due to the stigma associated with the diagnosis, leading to a self-fulfilling prophecy and a cycle of stigmatization to which both patient and therapist can contribute.[103]


Some psychotherapies, for example DBT, developed partly to overcome problems with interpersonal sensitivity and maintaining a therapeutic relationship. Adherence to medication regimes is also a problem, due in part to adverse effects, with drop-out rates of between 50% and 88% in medication trials.[104] Comorbid disorders, particularly substance use disorders, can complicate attempts to achieve remission.[105] ...


Other strategies

Psychotherapies and medications form a part of the overall context of mental health services and psychosocial needs related to BPD. The evidence base is limited for both, and some individuals may forego them or not benefit (enough) from them. It has been argued that diagnostic categorisation can have limited utility in directing therapeutic work in this area, and that in some cases it is only with reference to past and current relationships that "borderline" behavior can be understood as partly adaptive and how people can best be helped.[106]


Numerous other strategies may be used, including alternative medicine techniques (see List of branches of alternative medicine), exercise and physical fitness, including team sports; occupational therapy techniques, including creative arts; having structure and routine to the days, particularly through employment - helping feelings of competence (e.g. self-efficacy), having a social role and being valued by others, boosting self-esteem.[107] Alternative medicine is defined as any of various systems of healing or treating disease (as chiropractic, homeopathy, or faith healing) not included in the traditional medical curricula taught in the United States and Britain.[1] Complementary medicine is defined as any of the practices (as acupuncture) of alternative medicine accepted... Branches of alternative medicine provides a master list of the articles included in this alternative medicine (CAM) series of articles. ... Self efficacy is an individuals estimate or personal judgment of his or her own ability to succeed in reaching a specific goal, e. ... In psychology, self-esteem or self-worth is a persons self-image at an emotional level; circumventing reason and logic. ...


Group-based psychological services encourage clients to socialize and participate in both solitary and group activities. These may be in day centers. Therapeutic communities are an example of this, particularly in Europe, although their usage has declined many have specialised in the treatment of severe personality disorder.[108] Therapeutic community is a term applied to a participative, group-based approach to long-term mental illness that includes group psychotherapy as well as practical activities, and which may or may not be residential with the clients and therapists living together. ...


Psychiatric rehabilitation services aimed at helping people with mental health problems, to reduce psychosocial disability, engage in meaningful activities, and avoid stigma and social exclusion may be of value to people who suffer from BPD. There are also many mutual-support or co-counseling groups run by and for individuals with BPD. A goal may be full recovery rather than reliance on services. Psychiatric rehabilitation, also known as Psychosocial rehabilitation, is the process of restoration of community functioning and wellbeing of an individual who has a psychiatric disability (been diagnosed with a mental disorder). ... Look up stigma on Wiktionary, the free dictionary. ... Social exclusion relates to the alienation or disenfranchisement of certain people within a society. ... Psychosocial recovery, or the Recovery Model, refers to the process of recovery from mental disorder or substance dependence, and/or from being labeled in those terms. ...


Data indicate that substantial percentages of people diagnosed with BPD can achieve remission even within a year or two.[35] A longitudinal study found that, six years after being diagnosed with BPD, 56% showed good psychosocial functioning, compared to 26% at baseline. Although vocational achievement was more limited even compared to those with other personality disorders, those whose symptoms had remitted were significantly more likely to have a good relationship with a spouse/partner and at least one parent, good work/school performance, a sustained work/school history, good global functioning and good psychosocial functioning.[109] Remission is the state of absence of disease activity in patients with known chronic illness. ...


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Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 5th day of the year in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 1998 (MCMXCVIII) was a common year starting on Thursday (link will display full 1998 Gregorian calendar). ... is the 286th day of the year (287th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 24th day of the year in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... is the 173rd day of the year (174th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 264th day of the year (265th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... is the 167th day of the year (168th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 100th day of the year (101st in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 283rd day of the year (284th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... is the 182nd day of the year (183rd in leap years) in the Gregorian calendar. ... Year 2004 (MMIV) was a leap year starting on Thursday of the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 266th day of the year (267th in leap years) in the Gregorian calendar. ...

Bibliography

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  • Linehan, M.M.; D.A. Tutek, H.L. Heard, et al. (December 1994). "Interpersonal Outcome of Cognitive Behavioral Treatment for Chronically Suicidal Borderline Patients". The American Journal of Psychiatry 151 (12): 1771.
  • Reynolds, S.K.; Lindenboim, N., Comtois, K.A., et al. (February 2006). "Risky Assessments: Participant Suicidality and Distress Associated with Research Assessments in a Treatment Study of Suicidal Behavior". Suicide & Life - Threatening Behavior 36 (1): 19.
  • Twemlow, S.W.; P. Fonagy, F. Sacco (2005). "A developmental approach to mentalizing communities: I. A model for social change". Bulletin of the Menninger Clinic 69 (4): 265.
  • Vinocur, D. (2005). Mental representations, interpersonal functioning and childhood trauma in personality disorders. Long Island University: The Brooklyn Center. AAT 3195364.
  • Zeigler-Hill, V.; J. Abraham (June 2006). "Borderline personality features: Instability of self-esteem and affect". Journal of Social & Clinical Psychology 25 (6): 668-687.

See also

Emotional dysregulation (or affect dysregulation) is a term used in the mental health community to refer to an emotional response that is not well modulated. ... Post-traumatic stress disorder (PTSD) is a term for certain severe psychological consequences of exposure to, or confrontation with, stressful events that the person experiences as highly traumatic. ... Complex Post-Traumatic Stress Disorder (C-PTSD) is a clinically recognized condition that results from prolonged exposure to prolonged social and/or interpersonal trauma, including instances of physical abuse, emotional abuse, sexual abuse, domestic violence, torture, chronic early maltreatment in a caregiving relationship, and war. ... Dialectical behavior therapy (DBT) is a psychosocial treatment developed by Marsha M. Linehan specifically to treat Borderline Personality Disorder. ... For other uses, see Bipolar. ... See also sedative. ... The Diagnostic and Statistical Manual published by the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, also known as DSM-IV-TR is a manual published by the American Psychiatric Association and includes all currently recognized mental health disorders. ... The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) is a semistuctured interview for making most of the major DSM-IV Axis I psychiatric diagnoses. ... Dissociative disorders are defined as conditions that involve disruptions or breakdowns of memory, awareness, identity and/or perception. ...

External links

  • NIMHPDF (241 KiB) National Institute of Health - Borderline Personality Disorder
  • MentalHealth.com - Borderline Personality Disorder Overview
  • [1] - Overcoming Tlp
v • d • e
DSM-IV Personality Disorders

Cluster A (Odd): Schizotypal, Schizoid, Paranoid “PDF” redirects here. ... A kibibyte (a contraction of kilo binary byte) is a unit of information or computer storage, commonly abbreviated KiB (never kiB). 1 kibibyte = 210 bytes = 1,024 bytes The kibibyte is closely related to the kilobyte, which can be used either as a synonym for kibibyte or to refer to... The Diagnostic and Statistical Manual published by the American Psychiatric Association The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a handbook for mental health professionals that lists different categories of mental disorder and the criteria for diagnosing them, according to the publishing organization the American Psychiatric Association. ... Personality disorder, formerly referred to as a Characterological disorder is a class of mental disorders characterized by rigid and on-going patterns of thought and action. ... Schizotypal personality disorder, or simply schizotypal disorder, is a personality disorder that is characterized by a need for social isolation, odd behaviour and thinking, and often unconventional beliefs such as being convinced of having extra sensory abilities. ... Schizoid personality disorder(SPD) is a personality disorder characterized by a lack of interest in social relationships, a tendency towards a solitary lifestyle, secretiveness, and emotional coldness. ... Paranoid personality disorder is a psychiatric diagnosis that denotes a personality disorder with paranoid features. ...


Cluster B (Dramatic): Antisocial, Borderline, Histrionic, Narcissistic Antisocial personality disorder (APD) is a psychiatric condition characterized by an individuals common disregard for social rules, norms, and cultural codes, as well as impulsive behavior, and indifference to the rights and feelings of others. ... Histrionic personality disorder (HPD) is a personality disorder characterized by a pattern of excessive emotionality and attention-seeking, including an excessive need for approval and inappropriate seductiveness, usually beginning in early adulthood. ... Narcissistic personality disorder (NPD), a term first used by Heinz Kohut in 1971[1], is a form of pathological narcissism acknowledged in the Diagnostic and Statistical Manual of Mental Disorders in 1980, in the edition known as DSM III-TR. Narcissistic personality disorder is characterized by extreme focus on oneself...


Cluster C (Anxious): Dependent, Obsessive-Compulsive, Avoidant Dependent personality disorder (DPD), formerly known as asthenic personality disorder, is a personality disorder that is characterized by a pervasive psychological dependence on other people. ... Obsessive compulsive personality disorder (OCPD), or anankastic personality disorder, is a personality disorder that is characterized by a general psychological inflexibility, rigid conformity to rules and procedures, perfectionism, moral code, and/or excessive orderliness. ... Avoidant personality disorder (APD or AvPD) [1] or Anxious personality disorder (APD) [2], is a personality disorder characterized by a pervasive pattern of social inhibition, feelings of inadequacy, extreme sensitivity to negative evaluation and avoidance of social interaction. ...


  Results from FactBites:
 
Borderline personality disorder - Wikipedia, the free encyclopedia (4173 words)
Borderline personality disorder (BPD) is defined within psychiatry and related fields as a disorder characterized primarily by emotional dysregulation, extreme "fl and white" thinking (believing that something is one of only two possible things, and ignoring any possible "in-betweens"), and turbulent relationships.
BPD often occurs together with other psychiatric problems, particularly bipolar disorder, depression, attention deficit disorder, anxiety disorders, substance abuse, eating disorders and other personality disorders.
Researchers believe that BPD results from a combination of individual genetic vulnerability and environmental stress, neglect or abuse as young children, and maturational events that trigger the onset of the disorder during adolescence or adulthood.
eMedicine - Personality Disorder: Borderline : Article by Elizabeth A Finley-Belgrad, MD (5375 words)
Although the literature on BPD in the adult patient is vast, the continuity between the adult disorder and the childhood disorder, which is often referred to as borderline disorder or borderline syndrome, remains unclear.
The person with a personality disorder is frequently dissatisfied with his or her marked and sustained impairment in social, occupational, or academic functioning.
The pathogenesis of borderline personality is complex and probably multifactorial, as in the theory of Linehan et al stating that borderline pathology results from the interaction of a biologic emotional vulnerability and a pervasively invalidating environment.
  More results at FactBites »


 

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