, After a patient suffering from BPD died, The National Health Service (NHS) in England was criticized by a coroner in 2014 for the lack of commissioned services to support those with BPD.  Among individuals diagnosed with BPD during adolescence, there appears to be one group in which the disorder remains stable over time and another group in which the individuals move in and out of the diagnosis. The HPA axis functions to maintain homeostasis when the body is exposed to stressors but has been found to be dysregulated among individuals with a history of childhood abuse.  The researchers concluded that "genetic factors play a major role in individual differences of borderline personality disorder features". , In addition to recovering from distressing symptoms, people with BPD also achieve high levels of psychosocial functioning. , There is a strong correlation between child abuse, especially child sexual abuse, and development of BPD.  Many adolescents experience these symptoms without going on to develop BPD, but those who experience them are 9 times as likely as their peers to develop BPD.  Short-term hospitalization has not been found to be more effective than community care for improving outcomes or long-term prevention of suicidal behavior in those with BPD. , Psychotherapy is the primary treatment for borderline personality disorder. Get the latest public health information from CDC: https://www.coronavirus.govGet the latest research information from NIH: https://www.nih.gov/coronavirusGet the latest shareable resources on coping with COVID-19 from NIMH: https://www.nimh.nih.gov/covid19. Natalie Humsi Week 4: Border Identity Question Case-Study Answer/Conclusion References What is the value of a "border identity" and how does it develop?  While movies and visual media often sensationalize people with BPD by portraying them as violent, the majority of researchers agree that people with BPD are unlikely to physically harm others. Diagnosis of borderline personality disorder is based on a clinical assessment by a mental health professional. 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 2008 study found that at some point in their lives, 75% of people with BPD meet criteria for mood disorders, especially major depression and bipolar I, and nearly 75% meet criteria for an anxiety disorder. And, finally, in these borderlands, identity is formed and re-formed among those who claim indigeneity and others who cannot.  Women with BPD are more likely to have eating disorders, mood disorders, anxiety and post-traumatic stress. , The hypothalamic-pituitary-adrenal axis (HPA axis) regulates cortisol production, which is released in response to stress. Families and caregivers of people with borderline personality disorder may also benefit from therapy.  The majority of individuals with BPD who are in treatment continue to use outpatient treatment in a sustained manner for several years, but the number using the more restrictive and costly forms of treatment, such as inpatient admission, declines with time. The Cluster as a whole affects about half, with schizotypal alone affecting one third. The treatments described on this page are just some of the options that may be available to a person with borderline personality disorder.  For someone with bipolar disorder, behavior suggestive of BPD might appear while experiencing an episode of major depression or mania, only to disappear once mood has stabilized.  Like other personality disorders, BPD is linked to increased levels of chronic stress and conflict in romantic relationships, decreased satisfaction of romantic partners, abuse, and unwanted pregnancy. Critics of the PTSD diagnosis argue that it medicalizes abuse rather than addressing the root causes in society. This keeps the world packaged in tidy little boxes. They report concerns that their self-destructive behavior is incorrectly perceived as manipulative and that the stigma surrounding this disorder limits their access to health care. , While people with BPD feel euphoria (ephemeral or occasional intense joy), they are especially prone to dysphoria (a profound state of unease or dissatisfaction), depression, and/or feelings of mental and emotional distress. Twice as many women as men in the community suffer from depression (Weissman & Klerman, 1985). , In early 2008, the United States House of Representatives declared the month of May Borderline Personality Disorder Awareness Month. 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. It involves the mind automatically redirecting attention away from that eventâpresumably to protect against intense emotion and unwanted behavioral impulses that such emotion might trigger. This type of therapy helps by: More information about finding a health care provider or treatment for mental disorders in general is available on our Help for Mental Illness webpage. Issues of particular note are suicidal ideations, experiences with self-harm, and thoughts about harming others.  Those affected typically use a high amount of healthcare resources. , A 2010 review by the Cochrane collaboration found that no medications show promise for "the core BPD symptoms of chronic feelings of emptiness, identity disturbance, and abandonment". , The stigma surrounding borderline personality disorder includes the belief that people with BPD are prone to violence toward others.  Their emotional instability has been found to correlate with differences in several brain regions. Social identity theory aims to specify and predict the circumstances under which individuals think of themselves as individuals or as group members. For example, an emotionally sensitive or impulsive child may be difficult to parent, exacerbating the invalidating environment; conversely, invalidation can make an emotionally sensitive child more reactive and distressed. ACTH binds to receptors in the adrenal cortex, which stimulates the release of cortisol.  Writing in the psychoanalytic tradition, Otto Kernberg argues that a child's failure to achieve the developmental task of psychic clarification of self and other and failure to overcome splitting might increase the risk of developing a borderline personality.. , The heritability of BPD is estimated to be between 37% to 69%. , Dialectical behavior therapy has similar components to CBT, adding in practices such as meditation. This type of therapy relies on changing people's behaviors and beliefs by identifying problems from the disorder. , 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. , Self-harming or suicidal behavior is one of the core diagnostic criteria in the DSM-5. , Long-term psychotherapy is currently the treatment of choice for BPD.  Assessing suicide risk can be a challenge for clinicians, and patients themselves tend to underestimate the lethality of self-injurious behaviors. Having a relative or loved one with the disorder can be stressful, and family members or caregivers may unintentionally act in ways that can worsen their loved oneâs symptoms.  There is also evidence that a considerable percentage of men who die by suicide may have undiagnosed BPD.  Their feelings about others often shift from admiration or love to anger or dislike after a disappointment, a threat of losing someone, or a perceived loss of esteem in the eyes of someone they value. Compared to those diagnosed with other personality disorders, people with BPD showed a higher rate of also meeting criteria for.  However, Marsha Linehan notes that doing so relies upon the assumption that people with BPD who communicate intense pain, or who engage in self-harm and suicidal behavior, do so with the intention of influencing the behavior of others. , Borderline personality disorder has previously been strongly associated with the occurrence of childhood trauma. By the end of the study, 73.5% of participants were found to be in remission. Cultural identity on the border often reinforces collective action closely linked to the class situation, as was the case with the Chicano movement in the '60s; or in a fundamental way, identity can define popular youth expressions, as exemplified by pachuquismo and cholismo. At the time, there were only a total of 60 specialized inpatient beds in England, all of them located in London or the northeast region. Read more on NIMHâs Suicide Prevention health topic page. The National Institute of Mental Health (NIMH) is part of the National Institutes of Health (NIH), a component of the U.S. Department of Health and Human Services. It is important that people with borderline personality disorder receive evidence-based, specialized treatment from an appropriately trained provider. Omega-3 fatty acid may ameliorate suicidality and improve depression. , Many people with borderline personality disorder also have mood disorders, such as major depressive disorder or a bipolar disorder. People with borderline personality disorder who are thinking of harming themselves or attempting suicide need help right away. Social identity theory, in social psychology, the study of the interplay between personal and social identities.  Some characteristics of BPD are similar to those of mood disorders, which can complicate the diagnosis. ) The Cluster A disorders, paranoid, schizoid, and schizotypal, are broadly the most common. , The films Play Misty for Me (1971) and Girl, Interrupted (1999, based on the memoir of the same name) both suggest the emotional instability of the disorder. The often intense emotions people with BPD experience can make it difficult for them to concentrate.  It is especially common for people to be misdiagnosed with bipolar disorder when they have borderline personality disorder or vice versa. These two neural networks are seen to be dysfunctionally operative in the limbic system, but the specific regions vary widely in individuals, which calls for the analysis of more neuroimaging studies.  There have also been associations identified with FKBP5 polymorphisms, rs4713902 and rs9470079 in individuals with BPD. , Families with twins in the Netherlands were participants of an ongoing study by Trull and colleagues, in which 711 pairs of siblings and 561 parents were examined to identify the location of genetic traits that influenced the development of BPD.
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