*BPD

Chapter 16: Psychological Disorders

Borderline Personality Disorder (BPD)

  • Core Emotional Dysregulation

    • Emotional dysregulation can occur at any point in the lifespan.

  • Instability

    • Behavior, identity, and relationships are characterized by significant instability.

    • Impulsivity:

    • Engaging in actions such as running away, binge eating, and drug use.

    • Self-destructive Behaviors:

    • Examples include self-harm (cutting) and suicide attempts.

    • Approximately 10% of individuals with BPD die by suicide.

  • Comorbidity

    • BPD is often comorbid with:

    • Post-Traumatic Stress Disorder (PTSD)

    • Mood Disorders

    • Substance Use Disorders

    • Childhood Trauma:

    • A common factor among individuals diagnosed with BPD.

Clinical Pattern

  • Relationships

    • Intense and unstable personal relationships are a hallmark of BPD.

    • Feelings of chronic emptiness and loneliness are frequently reported.

    • There is an alternating pattern of dependence and anger; individuals may exhibit clinging behavior that can lead to manipulative actions.

  • Splitting (Kernberg):

    • An important psychological defense mechanism in BPD.

    • Characterized by viewing individuals as either "all good" or "all bad."

    • Individuals with BPD struggle to integrate both positive and negative traits, leading to dramatic emotional reactions.

Causal Factors in BPD

Biological Factors

  • Individuals with close relatives who have BPD are five times more likely to develop the disorder.

  • Neurochemical Abnormalities:

    • Problems related to serotonin levels are noted in individuals with BPD.

    • Oxytocin, known for its role in bonding, may help reduce emotional volatility.

Environmental Factors

  • Early trauma, rejection, and abuse during childhood are significant contributors.

  • Parental Invalidation:

    • Can lead to low self-esteem and dependency issues in children.

  • Chaotic Upbringing:

    • Interpersonal instability experienced during formative years is common.

  • Family Expressed Emotion:

    • High levels of expressed emotions in the family environment can trigger relapse in individuals with BPD.

Sociocultural Factors

  • BPD is more prevalent in societies that are unstable or rapidly changing.

  • Social Instability:

    • Can lead to identity instability and fears of abandonment among individuals.

    • Common stressors include immediate environments, social stress, and complex interactions.