Borderline Personality Disorder

Borderline Personality Disorder

Borderline Personality Disorder

Borderline Personality Disorder

Synopsis

Addressing all aspects of borderline personality disorder (BPD) from the course, epidemiology, and history of the disease to the latest guidelines in patient diagnosis, pharmacotherapy, and psychotherapy, this reference serves as an all-encompassing reference for the mental health professional seeking authoritative coverage of BPD identification, development, and treatment.

Excerpt

Borderline personality disorder (BPD) is both a common and very serious psychiatric disorder. Recent studies have found that about 2% of American adults meet criteria for BPD. Perhaps more troubling is the fact that this diagnosis is associated with high levels of mental health service utilization, psychosocial impairment, and subjective distress.

The disorder was first described by Adolph Stern in 1938, but it did not enter the official nomenclature of the American Psychiatric Association until 1980. In the introductory chapter on History of the Concept, we will review the many psychoanalytic concepts that were used during the 1950s and 1960s to describe borderline patients (e.g., psychotic character, as-if personality). The chapter will also review the efforts of descriptive psychiatry to conceptualize BPD as a subsyndromal version of first schizophrenia, then mood disorders, impulse spectrum disorders, and finally, traumatic disorders.

Much of the recent research has focused on the etiology of BPD. This research has investigated four pathways to the development of BPD. The first of these areas of investigation is environmental factors. Kenneth Silk reviews the existing literature, which first focused on relatively subtle failures in early parenting, and more recently has focused on frank experiences of neglect and abuse. This chapter addresses the controversy of whether sexual abuse is either necessary or sufficient for the development of BPD.

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