History

Borderline Personality Disorder

Borderline personality disorder (BPD) is a personality disorder characterized by persistent disturbance of the personality function of the affected individual. Its main feature and manifestation is a pervasive pattern of instability of the emotions, moods, self-image and interpersonal relationships in the affected person. The disorder can also manifest in devaluation and idealization episodes. The disorder mainly occurs in early adulthood. The Diagnostic and Statistical Manual of Mental Disorders (DSM) has classified BPD as a personality disorder. Its specific criteria given by DSM IV-TR, is that the perception of impending loss of external structure, rejection or separation can lead to profound changes in the affect, cognition, self-image and behavior. These individuals experience intense inappropriate anger and abandonment fears even when faced with unavoidable changes in plans or realistic time-limited separation. They are extra sensitive to environmental circumstances. Historical context Since the existence of the earliest record of in the history of the medical field, writers such as Aretaeus, Hippocrates and Homer recognized the coexistence of intense, divergent moods within people. Aretaeus in particular described the vacillating presence of melancholia, mania and impulsive anger within a single person. The concept was revived by Theophile Bonet, a Swiss physician in 1684 after its medieval suppression. His observations were supported by other writers who realized the same patterns in people. These include writers like Hughes, the American psychiatrist in 1884 and Rosse in 1890 who in their writings, described borderline insanity. In 1921, Kraeplin identified an excitable personality which resemble with the borderline features described in the current concept of borderline. The first important psychoanalytic work to utilize the term borderline was written in 1938 by Adolf Stern. He used the term to refer to patients he thought were suffering from mild form of schizophrenia. This is a condition on the borderline between psychosis and neurosis. The term gained popularity for the next decade both in colloquial and popular use. In 1960s and 1970s, there was a shift from thinking of this syndrome as borderline schizophrenia into perceiving a borderline affective disorder, also called mood disorder, on the fringes of cyclothymia, manic depression and dysthymia. The term borderline was used psychoanalytics like by Otto Kernberg to refer to an intermediate level of personality organization that lies between psychotic and neurotic processes. A standardized criteria for distinguishing BPD from affective disorders was later developed. With the publication of DSM-III in 1980, BPD was made a personality disorder diagnosis. The final terminology that is currently used by DSM was decided by the DSM-IV Axis II Work Group that belongs to American Psychiatric Association. Causes of BPD There are various causes of BPD and history of childhood abuse and trauma is one of its possible causes. According to Aviram, Brodskyand Stanley (2006), many studies have shown that there is

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