People with borderline personality disorder have been the inspiration for fictional characters in movies such as Fatal Attraction, Misery, Looking for Mr. Goodbar, and Single White Female (Sansone & Levitt, 2005). There is an interesting combination of characteristics, such as mood instability, intense fear of abandonment, self-damaging impulsivity, and intense unstable relationships that make for interesting dramatic characters. People suffering with this illness in real life have to face many difficulties due to this illness. They are avoided by others, even kept distant from their clinicians, and blamed for their own illness when others see it as an attitude or character flaw. They suffer through self-injury and suicide attempts, eating and substance use disorders. There is no cure, and only moderate relief from medication and therapy.
In the early nineteenth century, a common diagnosis among women was “hysteria.” This diagnosis was often given when the clinician was unsure how to label the mixture of psychological and neurotic symptoms. The diagnosis of borderline personality disorder was derived from this diagnosis, the term “borderline” referring to being on the border between psychological and neurotic disorder (Hodges, 2003).
There has been an increase in diagnoses of BPD. This could be due to changes in the DSM definition. BPD is now more likened to the affective disorders (Hodges, 2003). BPD has been seen as related to psychosis, depression, or post-traumatic stress disorder (Paris, 2004). Widiger and Weissman (1991) state that the prevalence in the community of BPD is 1.5 % and accounts for 15% of hospital admissions. This is fairly consistent with statements by Nehls (as cited by Meekings & O’Brien, 2004), where he states that BPD is found in 2% of the general population and accounts for 15-20% of reported psychological illness. According to Swartz (as cited by Meekings & O’Brien, 2004), 70-77% of borderline patients are women. Symptoms seen in borderline personality disorder (BPD) are impulsivity, suicidality, self-injury and uncontrolled anger. There is instability in interpersonal relationships and self-image. BPD patients create a social façade (Sansone & Levitt, 2005). They have an unstable intense affect, and a consistent dysphoria (Parker, Boldero & Bell, 2006). There are often symptoms of depression involved. Women with Borderline Personality Disorder tend to have histrionic features, self-harm incidents, and eating disorders. Men are more likely to have antisocial features and substance abuse. Men’s self-harm problems come in the way of risky behavior and external related self-harm such as fights (Sansone & Levitt, 2005).
Borderline personality patients report extremely negative assumptions about themselves and others. Studies say they also retrieve more negative memories than control subjects from the same prompts (Renneberg, Theobald &Nobbs, 2005). A key to studying BPD patients is looking at autobiographical memory, since this plays a major role in identity and emotional regulation (Renneberg et al., 2005). Autobiographical memory refers to memories of one’s personal life. Autobiographical memory is structured hierarchically with more general information (lifetime periods) at the top, intermediate knowledge (general events) and specific information at the lowest level (Kremers, Spinhoven & Van der Does, 2006). The ability to recall specific memories in parasuicidal and depressed people is positively correlated with problem solving aptitude. Difficulties in specific recall might make problem solving difficult and thus increase the hopelessness in BPD patients. Borderline personality patients tend to have an overgeneralized memory. Contrary to predictions prior to the study by Startup, Heard and Swades (2001), the tendency to produce overgeneralized memories is associated with less parasuicide incidents. This may be an adaptive response to protect the...
References: Agrawal, H., Gunderson, J. & Holmes, B. (2004). Attachment studies with borderline patients: A review. Harvard Review of Psychiatry, 12(2), 94-104.
American Psychiatric Association (2004). Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR (Text Revision). Washington, DC: American Psychiatric Association.
Aviram, R., Brodsky, B. & Stanley, B. (2006). Borderline Personality Disorder, Stigma, and Treatment Implications. Harvard Review of Psychiatry, 14(5), 249-256.
Berlin, H., Rolls, E.& Iversen, S. (2005). Borderline personality disorder, impulsivity, and the orbitofrontal cortex. American Journal of Psychiatry, 162(12), 2360-2373.
Cornelius, J., Soloff, P., Perel, J. & Ulrich, R. (1993). Continuation Pharmacotherapy of Borderline Personality Disorder with Haloperidol and Phenelzine. American Journal of Psychiatry, 150, 1843–8.
Feske, U., Tarter, R. & Kirisci, L. (2006). Borderline Personality and Substance Use in Women. The American Journal on Addictions, 15(2), 131-137.
Hodges, S. (2003). Borderline Personality Disorder and Posttraumatic Stress Disorder: Time for Integration? Journal of Counseling & Development, 81(4), 409-417.
Kremers, I., Spinhoven, P. & Van der Does, A. (2006). Autobiographical memory in depressed and nondepressed patients with borderline personality disorder after long-term psychotherapy. Cognition & Emotion, 20, 3-4.
LeGris, J., van Reekum, R. (2006). The Neuropsychological Correlates of Borderline Personality Disorder and Suicidal Behaviour. The Canadian Journal of Psychiatry/ La Revue canadienne de psychiatrie,, 51(3), 131-142.
Lewis G., Appleby L. (1988). Personality disorder: the patients psychiatrists dislike. British Journal of Psychiatry, 153, 44–9.
Magill, C. (2004). The Boundary Between Borderline Personality Disorder and Bipolar Disorder: Current Concepts and Challenges. The Canadian Journal of Psychiatry/ La Revue canadienne de psychiatrie, 49(8), 551-556.
Markham, D. (2003). Attitudes towards patients with a diagnosis of 'borderline personality disorder ': Social rejection and dangerousness. Journal of Mental Health, 12(6), 595-612.
Meekings, C. & O 'Brien, L. (2004). Borderline pathology in children and adolescents. International Journal of Mental Health Nursing, 13(3), 152-163.
Paris, J. (2004). Borderline or Bipolar? Distinguishing Borderline Personality Disorder from Bipolar Spectrum Disorders. Harvard Review of Psychiatry, 12(3), 140-145.
Paris, J. (2005). Recent Advances in the Treatment of Borderline Personality Disorder. The Canadian Journal of Psychiatry / La Revue canadienne de psychiatrie, 50(8), 435-441.
Parker, A., Boldero, J. & Bell, R. (2006). Borderline personality disorder features: The role of self-discrepancies and self-complexity. Psychology and Psychotherapy: Theory, Research and Practice, 79(3), 309-321.
Renneberg, B., Theobald, E. & Nobs, M. (2005). Autobiographical Memory in Borderline Personality Disorder and Depression. Cognitive Therapy and Research, 29(3), 343-358.
Rothschild, L., Cleland, C. & Haslam, N. (2003). A Taxometric Study of Borderline Personality Disorder. Journal of Abnormal Psychology, 112(4), 657-666.
Sansone, R. & Levitt, J. (2005). Borderline Personality and Eating Disorders. Eating Disorders: The Journal of Treatment & Prevention, 13(1), 71-83.
Startup, M., Heard, H., Swales, M. (2001). Autobiographical memory and parasuicide in borderline personality disorder. British Journal of Clinical Psychology, 40(2), 113-120.
Swinton, M. (2001). Clozapine in severe borderline personality disorder. Journal of Forensic Psychiatry, 12(3), 580-591.
Travers, C. & King, R. (2005). An Investigation of Organic Factors in the Neuropsychological Functioning of Patients with Borderline Personality Disorder. Journal of Personality Disorders, 19(1), 1-18.
Trippany, R., Helm, H. & Simpson, L. (2006). Trauma reenactment: Rethinking borderline personality disorder when diagnosing sexual abuse survivors. Journal of Mental Health Counseling, 28(2), 95-110.
Widiger T. & Weissman M. (1991). Epidemiology of borderline personality disorder. Hospital Community Psychiatry, 42, 1015–21.
Please join StudyMode to read the full document