People with this disorder display great instability,
including major shifts in mood, an unstable self-image, and impulsivity
- Interpersonal relationships are also unstable
- People with borderline personality disorder are prone to bouts of anger, which sometimes result in physical aggression and violence
- Just as often, however, they direct their impulsive anger inward and harm themselves
Many of the patients who come to mental health emergency rooms are individuals with the disorder who have intentionally hurt themselves
- Their impulsive, self-destructive behavior can include:
- Alcohol and substance abuse
- Reckless behavior, including driving and unsafe sex
- Self-injurious or self-mutilation behavior
- Suicidal threats and actions
People with the disorder frequently form intense conflict-ridden relationships while struggling with recurrent fears of impending abandonment
Between 1% and 2.5% of the general population are thought to suffer from this disorder
- Close to 75% of those diagnosed are women
The course of the disorder varies
- In the most common pattern, the instability and risk of suicide reach a peak during young adulthood and then gradually wane with advancing age
How Do Theorists Explain Borderline Personality Disorder?
Because a fear of abandonment tortures so many people with the disorder, psychodynamic theorists look to early parental relationships to explain the disorder
- Object-relations theorists propose a lack of early acceptance or abuse/neglect by parents
- Research has found some support for this view, including a link to early sexual abuse
Some features of the disorder have also been linked to biological abnormalities, such as an overly reactive amygdala and an underactive prefrontal cortex
- In addition, sufferers who are particularly impulsive apparently have lower brain serotonin activity
- Close relatives of those with borderline personality disorder are 5 times more likely than the general population to have the disorder
A number of theorists currently use a biosocial theory, stating that the disorder results from a combination of internal and external forces
Some sociocultural theorists suggest that cases of borderline personality disorder are particularly likely to emerge in cultures that change rapidly
Treatments for Borderline Personality Disorder
It appears that psychotherapy can eventually lead to some degree of improvement for people with this disorder
- It is extraordinarily difficult, though, for a therapist to strike a balance between empathizing with a patient’s dependency and anger and challenging his or her way of thinking
Contemporary psychodynamic therapy has been somewhat more effective than traditional psychodynamic approaches when it focuses on the patient’s central relationship disturbance, poor sense of self, and pervasive loneliness and emptiness.
Over the past two decades, an integrative treatment approach, called “dialectical behavior therapy,” has received more research support than any other treatment for this disorder
- This approach grows largely from the cognitive-behavioral treatment model and borrows heavily from humanistic and psychodynamic approaches
- DBT is often supplemented by the clients’ participation in social skill-building groups
Antidepressant, antibipolar, antianxiety, and antipsychotic drugs have helped some individuals to calm their emotional and aggressive storms
- Given the numerous suicide attempts by these patients, their use of drugs on an outpatient basis is controversial
- Many clients seem to have benefited from a combination of psychotherapy and drug therapy
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