From the Guidelines
Borderline Personality Disorder (BPD) is a complex mental health condition characterized by unstable emotions, relationships, self-image, and behavior, with Dialectical Behavior Therapy (DBT) being the most effective treatment approach, as evidenced by its ability to reduce suicidality in adults with BPD 1. The characteristics of BPD include unstable emotions, relationships, self-image, and behavior, which can lead to significant distress and impairment in daily life.
- Key features of BPD include:
- Unstable relationships
- Emotional dysregulation
- Impulsivity
- Self-image disturbances DBT, developed by Linehan (1993a,b), is a biosocial theory-based treatment that aims to increase distress tolerance, emotion regulation, interpersonal effectiveness, and balanced decision-making.
- The treatment involves:
- Individual therapy sessions
- Group skills training
- Four components or modules: Core Mindfulness Skills, Interpersonal Effectiveness Skills, Distress Tolerance, and Emotion Regulation Skills A modified version of DBT, DBT-A, has been developed for adolescents with BPD, which involves the participation of a relative in the skills training group and has shown promise in reducing rates of psychiatric hospitalization 1. The most effective approach to managing BPD is a combination of DBT and medication, with a focus on reducing symptoms and improving quality of life, as supported by the American Academy of Child and Adolescent Psychiatry 1.
From the Research
Characteristics of Borderline Personality Disorder (BPD)
The characteristics of BPD include:
- Instability of self-image, interpersonal relationships, and affects 2
- Impulsivity, intense anger, feelings of emptiness, strong abandonment fears, suicidal or self-mutilation behavior, and transient stress-related paranoid ideation or severe dissociative symptoms 2
- Considerable functional impairment, intensive treatment utilization, and high societal costs 2
- High risk of self-mutilation and suicide 2
Prevalence of BPD
The prevalence of BPD is:
- 0.7 to 2.7% in the general adult population 2
- 12% in outpatient psychiatric services 2
- 22% in inpatient psychiatric services 2
- 1.8% of the general population, 10% of psychiatric outpatients, and 15%-25% of psychiatric inpatients 3
Comorbidities
BPD is significantly associated with other mental disorders, including:
- Depressive disorders 2
- Substance use disorders 2
- Post-traumatic stress disorder 2
- Attention-deficit/hyperactivity disorder 2
- Bipolar disorder 2
- Bulimia nervosa 2
- Other personality disorders 2
Etiology
The etiology of BPD involves the interaction between genetic factors and adverse childhood experiences 2