INTERNATIONAL UNIVERSITY of the CARIBBEAN
COURSE: Guidance and Counseling / Psychology (year 3)
Borderline Personality Disorder
IN PARTIAL FULFILLMENT of the COURSE: Abnormal Psychology
MS. Loi Perry
Date: March 24, 2016
The current diagnostic criteria set for Borderline Personality Disorder (BPD) is taken from the American Psychiatric Association’s DSM-5 (APA, 2013). Patients must meet five of nine criteria in order to be diagnosed with BPD. Patients who partially, but incompletely, meet this criteria set may be considered to have borderline personality traits or features. ...view middle of the document...
6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
7. Chronic feelings of emptiness.
8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
9. Transient, stress-related paranoid ideation or severe dissociative symptoms.
Etiology of Borderline Personality Disorder
Although the cause of borderline personality disorder (BPD) is unknown, as with many other psychiatric disorders, it is widely regarded as the product of complex interactions among multiple factors, including; genetic, neurochemical, neuroanatomical, and psychological factors. Studies show that many but not all individuals with BPD report a history of abuse, neglect, or separation as young children. Forty to 71 percent of BPD patients report having been sexually abused, usually by a non-caregiver.
Neuroscience is revealing brain mechanisms underlying the impulsivity, mood instability, aggression, anger, and negative emotion seen in BPD. Studies suggest that people predisposed to impulsive aggression have impaired regulation of the neural circuits that modulate emotion.
Evidence suggests that BPD runs in families. Through the study of biological relatives of people with BPD, it has been proposed that BPD is 4 to 20 times more prevalent among relatives of those with BPD compared to relatives of individuals not diagnosed with BPD (Links et al. 1988; White at al. 2003). Torgersen and colleagues (2000) provided support for the genetic vulnerability of BPD by studying monozygotic and dizygotic twins. In their study, the concordance rate of BPD among monozygotic twins was 35% compared to a 7% concordance rate among dizygotic twins. The high concordance rate of BPD found in monozygotic twins is strongly suggestive of genetics playing a role in the etiology of BPD.
There is some support for neurochemical vulnerability in people with BPD. Specifically, two neurotransmitters have caught the attention of researchers: serotonin and norepinephrine. Serotonin has been found to be associated with aggression and impulsivity, whereby as levels of serotonin decrease, aggression and impulsive behaviours increase. Thus, it has been suggested that the characteristic aggressive and impulsive behaviours of BPD are the result of decreased or low levels of serotonin in the brain (Rinne et al. 2000). In much the same way, norepinephrine has been found to be related to aggressive behaviours in BPD. Coccaro et al. (2003) found that males with lower levels of norepinephrine were more likely to be diagnosed with BPD and more likely to have a lifetime history of aggression.
Researchers have also found anatomical and physiological brain differences between those with and without BPD. Hyperactivity of the...