Borderline Personality Disorder: A Comprehensive Review
Borderline personality disorder (BPD) is a serious mental health disorder that is characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. It affects approximately 1.6% of the general population, with women being more commonly affected than men (Coid et al., 2009). BPD is associated with a wide range of impairments in occupational, social, and psychological functioning (Torgersen et al., 2000). This article will provide a comprehensive review of the clinical features, etiology, assessment, and treatment of BPD.
Clinical Features
BPD is characterized by a pervasive pattern of instability in affect, interpersonal relationships, self-image, and impulsive and self-destructive behavior (American Psychiatric Association, 2013). The core features of BPD are emotional dysregulation, impulsivity, unstable relationships, and a sense of emptiness (Lieb et al., 2004). Individuals with BPD may also have difficulties controlling their anger, be sensitive to perceived abandonment, and have recurrent suicidal behavior (Gunderson et al., 2011).
Etiology
The etiology of BPD is complex and is thought to be the result of a combination of biological, psychological, and social factors (Loranger, 1999). Biological factors, such as genetic predisposition, neurobiological abnormalities, and temperamental differences, are thought to play a role in the development of BPD (Verheul et al., 2003). Psychological factors, such as early childhood trauma, interpersonal difficulties, and difficulties managing emotions, are also thought to contribute to the development of BPD (Bateman & Fonagy, 2008). Social factors, such as family environment, poverty, and social isolation, may also play a role in the development of BPD (Torgersen et al., 2000).
Assessment
The diagnosis of BPD is based on a clinical assessment by a mental health professional. The diagnosis is made by taking into account the individual’s clinical presentation, history, and symptoms (American Psychiatric Association, 2013). Diagnostic criteria for BPD include a pervasive pattern of instability in affect, interpersonal relationships, self-image, and behavior, as well as at least five of the following nine symptoms: frantic efforts to avoid abandonment; a pattern of unstable and intense interpersonal relationships; identity disturbance; impulsivity in two areas that are potentially self-damaging; recurrent suicidal behavior, gestures, or threats; affective instability; chronic feelings of emptiness; inappropriate, intense anger or difficulty controlling anger; and transient, stress-related paranoid ideation or dissociative symptoms (American Psychiatric Association, 2013).
Treatment
Treatment for BPD is usually a combination of psychotherapy and medication. Psychotherapy is the primary treatment for BPD, with research indicating that psychotherapy is more effective than medication in the long-term (Bateman & Fonagy, 2008). Dialectical behavior therapy (DBT) is the most widely studied psychotherapy for BPD and has been shown to be effective in reducing symptoms of BPD (Linehan et al., 1991). Medications, such as antidepressants, mood stabilizers, and antipsychotics, may also be used to treat symptoms of BPD (Lam & Van, 2015).
Conclusion
In conclusion, BPD is a serious mental health disorder that is characterized by a pervasive pattern of instability in affect, interpersonal relationships, self-image, and behavior. The etiology of BPD is complex and is thought to be the result of a combination of biological, psychological, and social factors. The diagnosis is made by taking into account the individual’s clinical presentation, history, and symptoms. Treatment for BPD is usually a combination of psychotherapy and medication, with research indicating that psychotherapy is more effective than medication in the long-term.
References
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