Borderline personality disorder

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Introduction

Borderline personality disorder (BPD) is a mental illness characterized by sharp variations in emotions, behavior, and self-image. These changes often result in impulsive behavior and unstable relationships of the affected individuals. People with BPD can experience depression, prolonged anxiety, and intense feelings of anger. Symptoms of BPD include mood swings, distorted and unstable self-image, patterns of intense and unstable relationships among other common characteristics of personality disorders (Dinsdale & Crespi, 2013). Patients also tend to view things from an extreme perspective, such as too good or all bad. BPD had been difficult to treat in the past due to the complexities involved. However, medical experts have developed intervention strategies intended to help in the management of BPD patients in order to provide the most effective treatment services.

Intervention Strategies for BPD

The borderline personality disorder is one of the most dangerous illnesses that can adversely affect the life of the victim. People suffering from BPD are usually impulsive and often develop suicide thoughts occasionally. In fact, suicidal behavior is a chronic problem for individuals suffering from BPD since it accounts for about 10% of total deaths of people diagnosed with the disorder. Hence, it is important to seek effective intervention strategies to treat and manage the condition before it worsens.

One of the most effective strategies for managing BPD involves psychological therapy by a professional psychiatrist or a person trained in addressing mental problems. In this way, patients are able to receive mental support and acquire relevant information about how to manage their feelings to prevent the negative impacts of uncontrolled emotions. However, people should be careful of victims of BPD since they tend to test boundaries, be seductive, and make false allegations. Additionally, medication can also be used as an intervention measure for the treatment of BPD. Although medication does not cure BPD, it can be used to treat other conditions that are associated with the disorder, such as impulsivity, depression, and anxiety.

Criteria Used to Diagnose BPD Using DSM-5

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is a diagnostic tool published in by the American Psychiatric Association to serve as the universal standard for psychiatric diagnoses. The fundamental characteristics of a personality disorder include impairments in both self and interpersonal contexts. Based on DSM-5, several criteria must be met in order to diagnose a borderline personality disorder.

For instance, the condition should be characterized by significant impairments in both personal and interpersonal functioning. Impairments in personality functioning can be both in identity and self-direction contexts. This case can include unstable self-image due to excessive self-criticisms and feelings of emptiness (American Psychiatric Association, 2012). However, impairments in interpersonal functioning can include loss of empathy on intimacy problems such as conflicts and unstable relationships with others. Additionally, the borderline personality disorder is also characterized by negative affectivity and disinhibiting. Negative affectivity can include emotional lability, anxiousness, separation insecurity, and depressively (American Psychiatric Association, 2012). Disinhibition can be characterized by impulsivity, risk-taking, and antagonism (American Psychiatric Association, 2012). The third criteria used in diagnosing BPD entails that an individual’s personality expression of traits and the personality functioning are comparatively consistent in across different situations and stable at all times (American Psychiatric Association, 2012). Moreover, impairments in both personality functioning and personality trait expression of an individual are not seen as normative in the person’s socio-cultural environment or developmental stage (American Psychiatric Association, 2012). Lastly, impaired personality functioning and trait expression are not entirely caused by physiological impacts of substances, such as drug abuse and medication, or a medical condition (American Psychiatric Association, 2012).

Borderline Personality Disorder (BPD) vs. Histrionic Personality Disorder (HPD)

Both BPD and HPD are personality disorders that affect the normal mental state of an individual, thus making it unstable. Typically, these two mental disorders are closely related since they share common characteristics in some aspects. For instance, both types of personality disorders are characterized by rapidly changing and reactive emotions. Furthermore, both are associated with impulsive behavior amongst the affected individuals. People affected by either of the two personality disorders have a strong expression of emotion.

However, the two mental disorders also differ in some aspects. The key difference is the primary factors that are used in identifying each condition. The borderline personality disorder is a mental syndrome in which individuals experience reckless and impulsive behavior, as well as unstable moods and relationships. On the contrary, histrionic personality disorder refers to a mental condition in which people feel emotionally vulnerable and an increased need for constant approval of peers.

Evaluation of Peer-Reviewed Research Studies

1. “Forgiveness in the Treatment of Borderline Personality Disorder: A Quasi-Experimental Study” by Sandage et al. (2015)

This article reviews a study that was conducted in order to assess the effectiveness of the practice of forgiveness in the treatment of BPD. According to Sandage et al. (2015), the results of the study indicated that increased levels of forgiveness decreased attachment insecurity and other psychiatric symptoms. However, these effects did not occur when the participants were in a distress condition (Sandage et al., 2015). Hence, the study deduced that forgiveness was an effective trait that helped reduce psychiatric symptoms in BPD victims.

2. “Borderline Personality Disorder in Young People: Are We There Yet?” by Chanen (2015)

In this article, Chanen (2015) argues that recent evidence from studies shows that BPD can be diagnosed before a person attains 18 years. However, diagnosis is usually delayed despite the fact that its onset is usually when people are still young. The author contends that access to evidence-based treatments should improve in order to translate the available evidence into practice to achieve effectiveness in the treatment of BDP. The variety of available treatments should also increase in order to match an individual’s needs based on the phase and stage of the disorder (Chanen, 2015).

3. “Dialectical Behavior Therapy (DBT) in the Treatment of Borderline Personality Disorder” by O’Connell, B., and Dowling, M (2013)

This research focuses on dialectical behavior therapy (DBT) as a treatment for borderline personality disorder. According to O’Connell and Dowling (2013), DBT is a multi-pronged intervention strategy that is usually delivered over a period of 12 months in outpatient settings. The study concluded that there is sufficient evidence showing that DBT is an effective treatment strategy. Hence, healthcare professionals should be trained how to use DBT as a treatment procedure for BPD patients.

Conclusion

To sum up, a borderline personality disorder is a mental condition in which a victim experiences sharp variations in moods, behavior, and perception of self-image. Notably, BPD might stimulate impulsivity that can damage the social relationships of the involved individuals and even risk their welfare due to increased suicidal thoughts. Hence, it is imperative for healthcare providers to seek effective intervention strategies to manage and treat individuals with BPD. For instance, the DSM-5 specifies the standard procedures that professionals should follow while diagnosing BPD in order to determine the best treatment approach in a particular context. Various research studies have also suggested different methods that medical practitioners can use in order to achieve maximum effectiveness while treating BPD patients. Hence, they should evaluate the most appropriate strategy based on the available evidence in order to develop an effective treatment plan in different circumstances.

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  1. American Psychiatric Association. (2012). DSM-IV and DSM-5 criteria for the personality disorders. Retrieved from http://www.psi.uba.ar/academica/carrerasdegrado/psicologia/sitios_catedras/practicas_profesionales/820_clinica_tr_personalidad_psicosis/material/dsm.pdf
  2. Chanen, A. M. (2015). Borderline personality disorder in young people: Are we there yet? Journal of Clinical Psychology, 71(8), 778-791.
  3. Dinsdale, N., & Crespi, B. J. (2013). The borderline empathy paradox: Evidence and conceptual models for empathic enhancements in borderline personality disorder. Journal of Personality Disorders27(2), 172-195.
  4. O’Connell, B. and Dowling, M. (2013). Dialectical behavior therapy (DBT) in the treatment of borderline personality disorder. Journal of Psychiatric and Mental Health Nursing, 21(6), pp. 518-525.
  5. Sandage, S. J., Long, B., Moen, R., Jankowski, P. J., Worthington, E. L., Wade, N. G., & Rye, M. S. (2015). Forgiveness in the treatment of borderline personality disorder: A quasi-experimental study. Journal of Clinical Psychology, 71(7), 625-640.
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