Borderline Personality Disorder

A thorough analysis of BPD as well as its causes and symptoms

I. Disease Name
A. Borderline Personality Disorder

II. Overview
A. Definitions
1. Borderline Personality Disorder is a psychiatric syndrome that is
characterized by emotional dysregulation, impulsivity, risk-taking
behavior, irritability, feelings of emptiness, self-injury and fear of
abandonment, as well as unstable interpersonal relationships.
B. Statistics/ Demographics
1. BPD affects 1 to 2% of adults and 69-80% of patients that have BPD
engage in suicidal behavior such as suicide attempts or life threatening
actions.
2. Approximately 10% of patients that have BPD will eventually commit
suicide due to lack of concern by others and constant loneliness.
3. BPD is more prevalent in women than in men and is often rooted in
childhood abuse.
4. 75% of diagnostics for BPD are female patients.
C. Causes of Borderline Personality Disorder
1. Childhood trauma and abuse can cause major risk factors for developing
Borderline Personality Disorder. Studies show that patients who have gone
through sexual abuse are at high risk of developing such disorder.
2. Certain studies have reported that 81-91% of BPD patients have suffered
childhood abuse in forms such as being neglected, mentally/emotionally
abused, or physically abused.
3. People who experience Chronic emptiness and loneliness may develop
BPD. BPD has a higher risk of developing if patients have a history of
unstable relationships and abandonment.
4. Most scholars see BPD as a clinical type of syndrome which may be a
result of weak fronto-limbic connections which accounts for a patients
emotional dysregulation, impulsivity, and inability to cope with
interpersonal distress.
III. Signs and Symptoms of the Disease
A. In contrast to most psychiatric disorders, symptoms associated with BPD may
improve over time.
B. Individuals with Borderline Personality Disorder are prepared to feel rejected and
to read hostility into neutral comments and expressions.
C. Core characteristics of people with BPD include Impulsivity and mood-dependent
behavior.
D. Suicide attempts and self harm are generally caused by patients thinking that they
are a failure. It is also usually precipitated by a sense of intolerable loneliness.
E. Individuals with BPD may also develop eating disorders which may result in
rapid weight loss.
F. Unless taken care of, patients with BPD may develop panic disorders, generalized
anxiety, or posttraumatic stress disorder due to long durations of loneliness,
neglect by loved ones, and feelings of guilt.
G. The condition is diagnosed according to continued patterns of unstable:
1. Interpersonal relationships
2. Self-image
3. Striking impulsivity beginning late teen/early adulthood
H. Mood swings are generally triggered by external factors from the environment.
I. Patients with BPD may also develop high sensitivity to criticism and rejection.
J. If severe enough, people with BPD may have paranoia and delusions.
K. Depressive symptoms and risk-taking behaviors can occur simultaneously in the
same individual.

IV. Test for the Disease

A. Borderline personality disorder is often confused with Bipolar personality
disorder as the two disorders share many symptoms.
B. Generally Physicians will err the diagnostic as Bipolar disorder.
C. Generally a diagnosis of BPD is done through looking at a patients emotional as
well as behavioral instability. The Therapist must determine whether symptoms
are related to an acute or chronic issue.
1. Therapists my often assess the length of the symptoms as well as the
severity of it and ask questions such as:
a) Has the client experienced a demarcated episode of accelerated
mood, almost resembling amphetamine intoxication, with such
 symptoms as decreased need for sleep, pressured speech, or
grandiosity?
b) Equally important, do the symptoms persist for at least a week, or
does the client return to a normal emotional state within a few
days, or even hours?
2. The Counselor will also evaluate whether the patients problems with
emotional instability are explained better by the construction of affective
instability which is the propensity of a patient to become irritable,
depressed, aggressive, or anxious in response to environmental issues.
3. Therapists will also look to see if the patient has only an acute mood
disorder or a more chronic and persistent personality disorder.
4. Currently the DSM-IV-TR diagnosis method is being drafted to be used as
a outline for diagnosing Borderline Personality Disorder.

V. Current Treatments and Research

A. Medication may help Borderline personality disorder in reducing depression and
anxiety, however it is unable to completely solve this disorder. Henceforth
therapy is required.
B. Cognitive Behavioral Therapy
1. Dialectic Behavioral Therapy
a) This form of therapy is based on the premise that the patient with
BPD is unable to regulate emotions. This inability to regulate
emotions is normally developed when someone who is
hypersensitive, is raised in a home that lacks emotional support or
validation. As a result the patient may be more at risk to
developing such interpersonal conflicts.
b) During this therapy, individuals learn more productive behaviors
and responses by joining sessions that involve problem solving,
mindfulness, meditation, breath training, and muscle relaxation.
c) Studies from the University of Washington have shown that this
form of therapy is effective in reducing self harm and suicide
attempts. Researchers found that patients who went through this
type of therapy are 50% less likely to attempt suicide or self harm.
2. Schema Focused-Therapy
a) This is based on the premise that the Borderline personality
disorder patient had four maladaptive life world views that
originated in their childhood.
(1) Abandoned/abused child
 (2) Angry/impulsive child
(3) Detached protector
(4) Punitive parent
b) The goal of this form of therapy is to help the patient get rid of
these schemas and find a new mode of behavior. Therapists use
forms of guided imagery, role playing, as well as assertiveness
training in order to help patients confront daily experiences and
past traumatic events.
c) Therapy must last 2 years to become effective.
C. Psychodynamic Therapy - a form of therapy that deals with unconscious mental
processes that originate during ones childhood and later interfere with the ability
of an individual to function during late teen years and adulthood.
1. Transference Focused-Therapy
a) Therapists and patients work together to understand the dynamics
of past relationships and associated emotions in order to
understand how they might affect current functioning.
b) TF therapys goals are to help patients better integrate the views
that they have on themselves and other people. Henceforth patients
should attend therapy at least 2 times a week.
c) This form of therapy is known to significantly reduce suicidal
behavior and improve anger issues. It is also known to reduce any
verbal and physical abuse that the patient may have on themselves
or other people.
2. Mentalization-based treatment
a) This form of therapy is based on the premise that BPD patients
have suffered from difficulties in their ability to develop a mental
picture of emotions, beliefs, or feelings of themselves and others.
b) This form of therapy is known to reduce antipsychotic use and
decreases intentions of suicide.
D. Systems training for emotional predictability and problem solving therapy
1. This form of therapy includes group treatment for 20 weeks followed by a
bimonthly group therapy that lasts for a year.
2. This form of therapy involves cognitive behavioral techniques and
techniques to help managing emotions.

VI. Future Research

A. Currently a new diagnosis plan called DSM-IV-TR is being drafted due to
criticism of current methods to diagnose Borderline personality Disorder.
 B. Research is being continued by the University of Cornell and the University of
Washington to this day.
C. There are no current attempts to develop a form of medication for Borderline
Personality Disorder as current antidepressants are often effective enough for
certain symptoms of BPD.

VII. Probable Prognosis

A. More research is being conducted on Borderline Personality disorder daily in
order to create a clear cut between BPD and Bipolar disorder. Since Borderline
Personality disorder is generally a very common disorder in psychiatric facilities,
expectations for finding more effective ways to cure this disorder future is likely
to be promising and fruitful.

VIII. Citations
"Borderline personality disorder: Treatment." Harvard Mental Health Letter, 1 July 2006.

Student Resources in Context,

link.galegroup.com/apps/doc/A207133147/SUIC?u=j057922001&xid=d87493aa.
Accessed 9 Oct. 2017.

Brune, Martin. "Borderline personality disorder: why 'fast and furious'?" Evolution, Medicine,

and Public Health, 2016, p. 52+. Academic OneFile,

go.galegroup.com/ps/i.do?p=AONE&sw=w&u=j057922001&v=2.1&id=GALE%7CA46
8772602&it=r&asid=49d9c99778ed9ea65e820d4c406c5efb. Accessed 9 Oct. 2017.

Hatchett, Gregory T. "Differential diagnosis of borderline personality disorder from bipolar

disorder." Journal of Mental Health Counseling, July 2010, p. 189+. Student Resources in
Context,
 link.galegroup.com/apps/doc/A233291357/SUIC?u=j057922001&xid=b7233db2.
Accessed 9 Oct. 2017.

"Treating borderline personality disorder." Harvard Mental Health Letter, 1 June 2010. Student

Resources in Context,
link.galegroup.com/apps/doc/A227294261/SUIC?u=j057922001&xid=66437ba0.
Accessed 9 Oct. 2017.

Young, Craig D. "Managing borderline personality disorder." Patient Care, 15 Dec. 2001, p. 60+.

Student Resources in Context,

link.galegroup.com/apps/doc/A81112825/SUIC?u=j057922001&xid=38688489.
Accessed 9 Oct. 2017.