Borderline personality disorder - Wikipedia

Borderline personality disorder - Wikipedia, the free encyclopedia

Borderline personality disorder (BPD) (called emotionally unstable personality disorder, borderline type in the ICD-10) is a personality disorder marked by a prolonged disturbance of personality function, characterized by unusual variability and depth of moods. These moods may secondarily affect cognition and interpersonal relations.^{[n 1]}

The disorder typically involves an unusual degree of instability in mood and black-and-white thinking, or splitting. BPD often manifests itself in idealization and devaluation episodes and chaotic and unstable interpersonal relationships, issues with self-image, identity, and behavior; as well as a disturbance in the individual's sense of self. Self-harm and suicidal ideation often lead to the need for mental health aid centres.^[1] Disturbance in the sense of self can also lead to periods of dissociation.^[2] It is only recognized by the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) in individuals over the age of 18; however, symptoms necessary to establish the disorder can also be found in adolescents. Without treatment, symptoms may worsen, leading in some cases to suicide attempts.^{[n 2]}

There is an ongoing debate among clinicians and patients worldwide about terminology and the use of the word borderline,^[3] and some have suggested that this disorder should be renamed.^[4] The ICD-10 manual has an alternative definition and terminology to this disorder, called Emotionally unstable personality disorder. There is related concern that the diagnosis of BPD stigmatizes people and supports discriminatory practices.^[5]

Contents 1 Signs and symptoms 1.1 Behaviour 2 Diagnosis 2.1 Diagnostic and Statistical Manual 2.2 International Classification of Disease 2.3 Chinese Society of Psychiatry 2.4 Millon's subtypes 2.5 Family members 2.6 Adolescence 2.7 Differential diagnosis and comorbidity 3 Causes 3.1 Childhood abuse 3.2 Other developmental factors 3.3 Genetics 3.4 Research on mediating and moderating factors 4 Management 4.1 Psychotherapy 4.2 Medications 4.3 Services 5 Prognosis 6 Epidemiology 7 History 8 Controversies 8.1 Gender 8.2 Stigma 8.3 Terminology 9 Society and culture 9.1 Film and television 9.2 Literature 9.3 Awareness 9.4 Notable people 9.5 Notable people with comorbid diagnoses 10 Notes 11 References 12 Further reading 13 External links

Signs and symptoms

The primary features of BPD are unstable interpersonal relationships, affective distress, marked impulsivity, and unstable self-image.^[2]

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.^{[n 3]} They may show lability (changeability) between anger and anxiety or between depression and anxiety^[6] and temperamental sensitivity to emotive stimuli.^[7]

The negative emotional states specific to BPD fall into four categories: destructive or self-destructive feelings; extreme feelings in general; feelings of fragmentation or lack of identity; and feelings of victimization.^[8]