Borderline Personality

Patients with borderline personality disorder or narcissistic personality disorder (or both) can feel entitled to special treatment and often seek only approving forms of attention from those who treat them.

Borderline personality disorder typically coexists with depression, anxiety, and substance abuse. Symptoms of these conditions may lead the clinician to miss the diagnosis of personality disorder entirely. Careful diagnosis of BPD and comorbid disorders is the first step.

Are patients with borderline personality disorder at a significantly increased risk for suicide when in the angry victim state? This question and more in this quiz.

A study of veterans at risk for suicide showed that single attempters did not differ from multiple attempters on any variable except a history of childhood physical abuse.

Neural underpinnings and symptom presentation in borderline personality disorder might explain similarities and differences in this symptom domain across the spectrum of personality disorders as well as in other disorders associated with impulsive symptoms.

BPD appears to be a neurodevelopmental disorder, influenced by the person’s genetics and brain development and shaped by early environment, including attachment and traumatic experiences.

Staying empathic and keeping the conflict within the patient instead of between the patient and health care provider, is a key to successful management.

Borderline Personality Disorder: New Reasons for Hope is one in a series being published by Johns Hopkins University Press on major psychiatric disorders.

Historically, borderline patients were considered “help-rejecting complainers.” Clinicians should actively treat both mood/anxiety symptoms and BPD symptoms.

Since the inclusion of the borderline personality disorder (BPD) diagnosis in DSM, there have been multiple efforts to recast the disorder as part of an Axis I illness category. While the initial focus was on the schizophrenia spectrum, more recent authors have attempted to link BPD to mood disorders.

Two randomized controlled trials have shown the Systems Training for Emotional Predictability and Problem Solving (STEPPS) program to be effective in reducing the intensity of core aspects of borderline personality disorder (BPD), Dr Donald Black and social worker Nancee Blum announced at the annual meeting of the American Psychiatric Association held recently in San Francisco. Black summarized, “Data from several studies show that STEPPS reduced global severity as rated by clinicians and patients, borderline personality disorder symptoms, and depressive symptoms.”

Success with new approaches to the psychotherapeutic treatment of borderline personality disorder (BPD) and other DSM-IV personality disorders has been reported in several studies recently, raising hopes that an intractable set of illnesses may not be as hopeless as once thought.

In working with adolescents, mental health care professionals often draw on their own developmental experiences to help guide their patients; however, nonsuicidal self-injury (NSSI) is not likely to be a personal experience that psychiatrists can often draw on.

DVD Aims to Educate Clinicians, Patients on Borderline Personality Disorder

Borderline personality disorder (BPD) and substance use disorder (SUD) often co-occur. Comorbid BPD and SUD is related to a variety of severe adverse outcomes.

Borderline personality disorder (BPD) is a serious illness involving multiple symptoms and mal adaptive behaviors. According to DSM-IV, “the essential feature of borderline personality disorder is a pervasive pattern of instability of interpersonal relationships, self-image, and affects” (p. 650). This pervasive pattern of instability also applies to behaviors that are impulsive and potentially damaging, including excessive spending, sexual promiscuity, reckless driving, binge eating, and substance misuse.

DSM-IV-TR emphasizes that patients with borderline personality disorder (BPD) show a "instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts," and any five out of nine listed criteria must be present for the diagnosis to be made.

After the recent decade of the brain and in the present era of evidence-based practice, psychoanalytic treatment of personality disorder is being challenged.

Splitting, archetypally imbedded in a patient's psychic structure, acts as a powerful unconscious force to protect against the ego's perception of dangerous anxiety and intense affects. Rather than providing real protection, splitting leads to destructive behavior and turmoil in patients' lives.

Suicidality in patients with borderline personality disorder is chronic. It is important to distinguish these patients from those with classic mood disorders, who are suicidal only when acutely depressed.

This article focuses on data concerning the efficacy of mood stabilizers in the treatment of BPD.

Mentalization-based treatment (MBT) and transference-focused psychotherapy (TFP) are relatively complex and specialized treatments for the treatment of borderline personality disorder.

With its focus on both behavior modification and mindfulness training, dialectical behavior therapy has proven quite effective in treating patients with borderline personality disorder. This article provides a primer on a modified version of this outpatient treatment for borderline patients with substance use disorders, a comorbid condition that may affect as many as two-thirds of patients with BPD.

There has been a significant shift from the view that personality disorder is untreatable; we do have treatments that have at least some efficacy and one of these is psychoanalytic psychotherapy. Evidence from randomized trials has shown that it is effective in treating borderline personality disorder, and follow-up studies confirm that the gains are robust.

Borderline personality disorder is a complex, disabling disorder. The chairperson for the American Psychiatric Association workgroup for the evidence-based practice guideline on its treatment gives an overview of this disorder's etiologies, neurobiology, longitudinal course and recommended treatments. Future directions for both treatments and research are also discussed.