Running head: BORDERLINE PERSONALITY DISORDER: A GROWING CONCERN 1
BORDERLINE PERSONALITY DISORDER: A GROWING CONCERN 10
Borderline Personality Disorder: A Growing Concern
The University of Central Oklahoma
Ever since borderline personality disorder (BPD) was added to the DSM-III in 1980, a great deal of research and studies have emerged on this illness. BPD is a mental illness that tends to mimic other traits of mental illnesses, such as narcissistic, anti-social, and bipolar personality disorders. John Gunderson, who is a professor of psychiatry, published a book in 1975 to help further research and diagnose BPD patients. Gunderson and one of his colleagues, Perry Hoffman, state that the work on BPD is twenty to thirty years behind that on other major psychiatric disorders, such as depression and schizophrenia. This has made accurately diagnosing BPD rather difficult on psychologists and psychiatrists. Gunderson states that BPD represents a pattern of impulsivity and instability in interpersonal relationships, self-image, and affects (moods and emotions). As with all personality disorders, these problems usually have their onset by late adolescence or early adulthood, and are manifested in a variety of situations and life contexts (Skodol, 2006). More studies are needed to explore the role of gender in the diagnosis and treatment of BPD, as well as other variables, such as age, genetics, and environmental factors.
Keywords: Borderline personality disorder, bipolar disorder, Diagnostic and Statistical Manual, Transference-Focused Psychotherapy, Dialectal Behavior Therapy, Supportive Psychotherapy
Borderline personality disorder (BPD) constitutes one of the most important sources of long-term impairment in both treated and untreated populations (Widiger & Weissman, 1991). BPD is a prevalent, chronic, and debilitating syndrome associated with high rates of medical and psychiatric use of services (Gunderson et al. 2002). According to Skodal et al., approximately 11% of psychiatric outpatients and 19% of inpatients met the Diagnostic and Statistical Manual (4th edition) criteria for BPD; the majority of whom are women. Suicidal and self-injurious behavior is particularly prevalent with BPD patients, with rates ranging from 69% to 75% (Stone et al. 1993). BPD negatively affects the treatment efficacy for a number of Axis I disorders, and is less responsive to pharmacotherapy (Soloff, 2000). BPD is substantially more difficult to diagnose than other disorders because it tends to mimic several traits of well-known personality disorders, such as narcissistic, anti-social, and bipolar personality disorders.
Many of the BPD concepts date back more than sixty years ago. Kernberg (1967) explained the intrapsychic features of these patients as “borderline personality organization,” an intermediate level of internal personality organization that is more disturbed than seen in a neurotic disorder, but less disturbed t...