Attempts to describe personality types, character traits, and temperaments have always amused people. Even though human personality has defied all attempts to categorize it into a few types, so many attempts have been made to do so. It was the Greeks who first attempted a description of human personality and character.
They categorized human personality under the scope of the four temperaments — sanguine, choleric, phlegmatic and melancholic. Today English language has a variety of words for describing people, their personality, character and temperament. Describing positive personality types: Appealing, elegant or neat outlook and behaviour. Describing negative personality types: unappealing, shabby or clumsy outlook and behaviour. By the end of the study, Patient personality can play an important role during the therapeutic process, leading to better clinical outcomes.
Recent research has shown that BPD patients undergoing dialectical behavior therapy DBT exhibit better clinical outcomes correlated with higher levels of the trait of agreeableness in the patient, compared to patients either low in agreeableness or not being treated with DBT. This association was mediated through the strength of a working alliance between patient and therapist; that is, more agreeable patients developed stronger working alliances with their therapists, which in turn, led to better clinical outcomes.
In addition to recovering from distressing symptoms, people with BPD also achieve high levels of psychosocial functioning. Vocational achievement was generally more limited, even compared to those with other personality disorders. However, those whose symptoms had remitted were significantly more likely to have good relationships with a romantic partner and at least one parent, good performance at work and school, a sustained work and school history, and good psychosocial functioning overall.
The prevalence of BPD was initially estimated to be 1 to 2 percent of the general population   and to occur three times more often in women than in men. Borderline personality disorder is estimated to contribute to 20 percent of psychiatric hospitalizations and to occur among 10 percent of outpatients.
The coexistence of intense, divergent moods within an individual was recognized by Homer , Hippocrates , and Aretaeus , the latter describing the vacillating presence of impulsive anger, melancholia, and mania within a single person. Other writers noted the same pattern, including the American psychiatrist Charles H. Hughes in and J. Rosse in , who called the disorder "borderline insanity".
Borderline personality disorder - Wikipedia
The first significant psychoanalytic work to use the term "borderline" was written by Adolf Stern in The s and s saw a shift from thinking of the condition as borderline schizophrenia to thinking of it as a borderline affective disorder mood disorder , on the fringes of bipolar disorder, cyclothymia , and dysthymia. In the DSM-II , stressing the intensity and variability of moods, it was called cyclothymic personality affective personality. After standardized criteria were developed  to distinguish it from mood disorders and other Axis I disorders, BPD became a personality disorder diagnosis in with the publication of the DSM-III.
Earlier versions of the DSM, prior to the multiaxial diagnosis system, classified most people with mental health problems into two categories, the psychotics and the neurotics. Clinicians noted a certain class of neurotics who, when in crisis, appeared to straddle the borderline into psychosis. The term stuck and evolved into the personality disorder diagnosis of today. The credibility of individuals with personality disorders has been questioned at least since the s.
Researchers disagree about whether dissociation , or a sense of detachment from emotions and physical experiences, impacts the ability of people with BPD to recall the specifics of past events. A study reported that the specificity of autobiographical memory was decreased in BPD patients. Some theorists argue that patients with BPD often lie. The belief that lying is a distinguishing characteristic of BPD can impact the quality of care that people with this diagnosis receive in the legal and healthcare systems.
Since BPD can be a stigmatizing diagnosis even within the mental health community, some survivors of childhood abuse who are diagnosed with BPD are re-traumatized by the negative responses they receive from healthcare providers. Critics of the PTSD diagnosis argue that it medicalizes abuse rather than addressing the root causes in society.
Joel Paris states that "In the clinic That may not be true in the community. The most probable explanation for gender differences in clinical samples is that women are more likely to develop the kind of symptoms that bring patients in for treatment.
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Men and women with similar psychological problems may express distress differently. Men tend to drink more and carry out more crimes. Women tend to turn their anger on themselves, leading to depression as well as the cutting and overdosing that characterize BPD. We have even more specific evidence that men with BPD may not seek help. In a study of completed suicides among people aged 18 to 35 years Lesage et al.
Most of the suicide completers were men, and very few were in treatment. In short, men are less likely to seek or accept appropriate treatment, more likely to be treated for symptoms of BPD such as substance abuse rather than BPD itself the symptoms of BPD and ASPD possibly deriving from a similar underlying aetiology , possibly more likely to wind up in the correctional system due to criminal behavior, and possibly more likely to commit suicide prior to diagnosis.
Among men diagnosed with BPD there is also evidence of a higher suicide rate: "men are more than twice as likely as women—18 percent versus 8 percent"—to die by suicide. There are also sex differences in borderline personality disorders. Manipulative behavior to obtain nurturance is considered by the DSM-IV-TR and many mental health professionals to be a defining characteristic of borderline personality disorder.
However, their frequent expressions of intense pain, self-harming, or suicidal behavior may instead represent a method of mood regulation or an escape mechanism from situations that feel unbearable. The features of BPD include emotional instability; intense, unstable interpersonal relationships; a need for intimacy; and a fear of rejection. As a result, people with BPD often evoke intense emotions in those around them. Pejorative terms to describe people with BPD, such as "difficult", "treatment resistant", "manipulative", "demanding", and " attention seeking ", are often used and may become a self-fulfilling prophecy, as the negative treatment of these individuals triggers further self-destructive behavior.
The stigma surrounding borderline personality disorder includes the belief that people with BPD are prone to violence toward others. In addition, adults with BPD have often experienced abuse in childhood, so many people with BPD adopt a "no-tolerance" policy toward expressions of anger of any kind. People with BPD are considered to be among the most challenging groups of patients to work with in therapy, requiring a high level of skill and training for the psychiatrists, therapists and nurses involved in their treatment. In psychoanalytic theory, the stigmatization among mental healthcare providers may be thought to reflect countertransference when a therapist projects his or her own feelings on to a client.
Thus, a diagnosis of BPD "often says more about the clinician's negative reaction to the patient than it does about the patient" and "explains away the breakdown in empathy between the therapist and the patient and becomes an institutional epithet in the guise of pseudoscientific jargon". Some clients feel the diagnosis is helpful, allowing them to understand that they are not alone and to connect with others with BPD who have developed helpful coping mechanisms.
However, others experience the term borderline personality disorder as a pejorative label rather than an informative diagnosis. They report concerns that their self-destructive behavior is incorrectly perceived as manipulative and that the stigma surrounding this disorder limits their access to healthcare.
Because of the above concerns, and because of a move away from the original theoretical basis for the term see history , there is ongoing debate about renaming borderline personality disorder. While some clinicians agree with the current name, others argue that it should be changed,  since many who are labelled with borderline personality disorder find the name unhelpful, stigmatizing, or inaccurate. Alternative suggestions for names include emotional regulation disorder or emotional dysregulation disorder. Impulse disorder and interpersonal regulatory disorder are other valid alternatives, according to John G.
Films and television shows have portrayed characters either explicitly diagnosed with or exhibiting traits suggestive of BPD. These may be misleading if they are thought to depict this disorder accurately. Robert O. Friedel has suggested that the behavior of Theresa Dunn, the leading character of Looking for Mr. Goodbar is consistent with a diagnosis of borderline personality disorder. The films Play Misty for Me  and Girl, Interrupted , based on the eponymous memoir both suggest the emotional instability of the disorder.
Nobody , Moksha , Cracks ,  Welcome to Me In particular, Bui points to the character's abandonment issues, uncertainty over his identity, and dissociative episodes. On television, The CW show Crazy Ex-Girlfriend portrays a main character with borderline personality disorder,  and Emma Stone's character in the Netflix miniseries Maniac is diagnosed with the disorder.
Martin 's A Song of Ice and Fire series and its television adaptation, Game of Thrones , have traits of borderline and narcissistic personality disorders. From Wikipedia, the free encyclopedia. Borderline personality disorder Other names Emotionally unstable personality disorder — impulsive or borderline type  Emotional intensity disorder  Idealization is seen in Edvard Munch's painting of his physician Daniel Jacobson per Harold Wylie.
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