Initially, it was suggested that borderline disorder bordered on, or overlapped with schizophrenia, non-schizophrenic psychoses, and neuroses such as anxiety and depressive disorders. It also was observed initially that the disorder responded very poorly to treatment with psychotherapies, and to medications when they first became available.
Unfortunately, a large number of mental health professionals, even those in academic settings, apparently unfamiliar with the scientific literature published on borderline disorder over the past 50 years, still think that this is true. However, a substantial number of research studies have now shown that borderline disorder does have diagnostic validity and integrity.
Also, the disorder does appear to be a distinct diagnostic entity, although it co-occurs frequently with other mental disorders such as major depressive and bipolar II disorders, attention deficit hyperactivity disorder ADHD , substance use disorders, post-traumatic stress disorder PTSD , and with several other personality disorders.
The change in phenomenology could be made coherent if patients felt held attached by the clinician, rather than rejected. And it was becoming clear that nonpsychoanalytic modalities were often helpful eg, group or family therapies. Multimodal treatment was beginning to replace psychoanalytic therapy. The decade of the s marked several advances in BPD treatment. In this decade, BPD went from being an unwanted personality disorder to having some treatment specificity.
Larry Siever 4 proposed 2 psychobiological dispositions for BPD: affective disregulation hyperesponsivity of the neuroadrenergic system and behavioral discontrol with reduced serotonergic modulation. This concept provided a scientific structure for understanding the origins of BPD as well as a way to explain its comorbidities and spectrum relationship with other disorders. Based on these criteria, BPD would be recognized as primarily an impulse spectrum disorder or affective disregulation disorder.
This was an innovative departure from earlier therapies in that the primary focus of this therapy is the patient-therapist interaction. With this treatment, self-harm, suicidality, hospitalizations, and need for medication are diminished. It was a psychosocial intervention that had specificity and, thus, it had integrity and meaning. MBT is a psychoanalytic derivative with an emphasis on early childhood development. The treatment had to be applicable within different institutions.
This recognition legitimized BPD as a subject for scientific study and public awareness and resulted in 2 major research findings: that BPD is a disorder that is significantly heritable, and heritability helped establish BPD as a brain disease; and that BPD has an unexpectedly good prognosis. Contact us today for more information on our treatment offerings. Borderline personality disorder is a mental illness often misunderstood by society. The associations made with….
Contact Us: August 25, Current : Research continues to advance the field. Harrison G. Jonas, MD ; James I. Hudson, MD ; et al Bruce M. Gunderson, MD. Access through your institution. Add or change institution.
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