![]() ![]() Neuroimaging studies have identified differences in the amygdala, hippocampus, and medial temporal lobes in patients with borderline personality disorder. This inability to view others as having both positive and negative attributes impairs personal relationships. At any given time, the other person is viewed as entirely good or entirely bad. The term "splitting" refers to the defense mechanism in which the patient cannot form a realistic view of another person. This contradiction causes intense anxiety and, if not integrated into a more moderate unitary concept, ultimately leads to the development of splitting. ![]() Kernberg hypothesized that the infant experiences the maternal figure in a dichotomous framework, the loving and nurturing mother who provides for the child and the punishing, hateful mother who deprives the child. Otto Kernberg theorized that lack of integration in the early maternal relationship led to borderline personality disorder. ![]() In another theory, borderline personality disorder arises from the inability to regulate effect and the lack of formation of appropriate coping mechanisms in response to stress. Marsha Linehan, genetic vulnerability interacts with a "chronically invalidating environment" to produce the constellation of borderline personality disorder symptoms. In the biosocial model popularized by Dr. In this framework, Fonagy and Bateman define resilience as the ability to generate adaptive re-appraisal of negative events or stressors patients with impaired re-appraisal accumulate negative experiences and fail to learn from good experiences. In the mentalizing model of Peter Fonagy and Anthony Bateman, borderline personality disorder is the result of a lack of resilience against psychological stressors. ![]() There are many theories about the development of borderline personality disorder. Environmental factors that have been identified as contributing to the development of borderline personality disorder include primarily childhood maltreatment (physical, sexual, or neglect), found in up to 70% of people with BPD, as well as maternal separation, poor maternal attachment, inappropriate family boundaries, parental substance abuse, and serious parental psychopathology. Twin studies performed in 20 both demonstrated higher concordance of the rate of borderline personality disorder for monozygotic versus dizygotic twins. Twin studies show over 50% heritability (greater than that for major depression). This is perhaps the reason why borderline personality disorder has been studied more extensively than other personality disorders.īorderline personality disorder is multifactorial in etiology. Patients with borderline personality disorder have been shown to utilize extensive treatment resources and are at increased morbidity and mortality compared with the general population. In contrast, obsessive-compulsive personality disorder (OCPD) appears to be the most prevalent personality disorder, with rates around 5% of the general population in some studies. Surveys have estimated the prevalence of borderline personality disorder to be 1.6% in the general population and 20% of the psychiatric inpatient population. Borderline personality disorder causes significant impairment and distress and is associated with multiple medical and psychiatric co-morbidities. Borderline personality disorder (BPD) is characterized by hypersensitivity to rejection and resulting instability of interpersonal relationships, self-image, affect, and behavior. Borderline personality disorder (BPD) is 1 of 4 cluster-B disorders that include borderline, antisocial, narcissistic, and histrionic. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) lists ten personality disorders divided into the 3 clusters (A, B, and C). In the pediatric population, all personality disorders can be diagnosed, except antisocial personality disorder, as long as the pathologic behavior has been present for a year or more. Personality disorders are prevalent in the general population and more so in clinical populations. A personality disorder is a disorder involving a rigid and unhealthy pattern of thinking. ![]()
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