Border-Line Personality Disorder

-


    1.    INTRODUCTION

Borderline Personality Disorder (BPD) was initially defined in 1978 followed up with the publication of diagnostic and statistical manual of mental disorder, Third Edition (DSM-III) in 1980 and the International classification of disease (ICD-10) ten years later (Kulacaoglu & Kose, 2018).

Borderline Personality Disorder is a severe mental disturbance suggested by a pattern of identity diffusion, chronic instability, interpersonal disturbances, with effective and spontaneous dyscontrol personality disorders (PD) do not suddenly develop in the adulthoods (Bozatello et al., 2019). Self-image disturbances marked suicide plans as the core dimension of psychopathology underlying the disorder. Across a wide range of conditions, BPD causes significant impairments. BPD is also more widely studied than any other personality disorder (Kulacaoglu & Kose, 2018).



2.   EPIDEMIOLOGY


The lifetime prevalence of BPD is 5.9% and the point prevalence of BPD is not higher than other personality disorders in the general population. The ratio of females to males with the disorder is also greater in the clinical population. About 80% of patients who receive treatment for BPD were reported to be women.



    3.    PATHOGENESIS


It is suggested that BD is the product of an interaction between, neurobiological, genetic, and psychological influences that affect brain development. However other studies reported that a common genetic influence has little contribution to the development of BPD as compared to environmental influences. According to neuro-biological research data, increased levels of stress hormones, such as Basal Cortisol were reported in BPD patients. Neuro-imaging studies that have compared BPD patients with healthy controls have reported a bilateral reduction in the hippocampus, amygdala, and medical temporary lobe. Impulsivity (emotional or involuntary impulsive) is a core feature of BPD. However, left amygdala hyperactivity was found in the unmediated patients with acute BPD. Childhood trauma is the most important risk factor for the development of BPD. Childhood trauma in BPD patients can take many forms in studies like physical abuse, neglect, verbal abuse, and early parental separations or loss. BPD patients can take many form studies like Physical abuse, neglect, verbal abuse, and early parental separation loss.



4.   CLINICAL FEATURES


Affective instability is the most specific, sensitive category BPD. Patients with BPD are emotionally weak, react strongly, and express depression, anxiety, and irritable mood. Patients with BPD have unstable relationships, they can easily become dependent on others and they also have a sudden change in their feelings towards others. Patients associated with BPD also show a lack of attention, planning, learning, and memory. Suicidal attempts are a common expression of BPD and the suicidal tendency is most common at the age of 20 and completed suicide attempts are more common after the age of 30 years in patients of BPD. The mood disorder is common in patients with BPD. According to the epidemiologic survey, 85% of BPD patients have at least one Comorbidity Psychiatric Disorder (presence of more than one disorder in an individual). Mood disorder especially anxiety, depression disorder presence in a patient with BPD. According to several large patient samples, the depress comorbidity ranges from 71% to 83% and anxiety disorder 88% in patients with BPD.



5.   TREATMENT FOR BPD


BPD causes a therapeutic challenge for clinicians. The first-line treatment for BPD is psychotherapy. Also, symptom targeted medication has been found effective. The psychotherapies that have been applied to treat patients with BPD are Metallization based therapy (MBT), transferase-focused therapy, Dialectical behavior therapy (DBT), and Schema-focused therapy (Kulacaoglu & Kose, 2018).


5.1.     Metalization Based Therapy (MBT)

MBT aims to stabilize the problems of BPD by strengthening the patient’s ability to mentalize. Under the stress of attachment activation, MBT therapists adopt a viewpoint of curiosity and “not knowing” to encourage patients to assess the then emotional and interpersonal situation through a grounded, flexible, and kindly contact. MBT therapist support patients to think through the abnormal active mind, rather than providing a conceptual explanation. It involves 50 minutes of weekly individual therapy and 75 minutes of group therapy.


5.2.     Transference-Focused Psychotherapy (TFP)

Transference-focused psychotherapy (TFP) is a manualized therapy. TFPs focused on problematic interpersonal dynamics in the patient’s life and emotional states. TFP is more compatible with treatments by individual clinicians rather than working in teams. It involves two weekly individual therapy sessions, without group therapy.


5.3.     Dialectical Behavioral Therapy (DBT)

DBT formulates the problem of BPD as a result of the transaction between individuals born with invalidating environment and high emotional sensitivity that is people or system for example families, schools, workplaces that cannot understand and respond effectively. DBT includes 1 hour of weekly individual therapy and 2 hours group skills training session.


5.4.     Schema-Focused Therapy (SFT)

SFT is an integrative cognitive therapy focused on generating structure changes to a patient’s personality. This therapy focuses on four schema models of BPD: detached protector, punitive parent, abused child, and an angry child if the mechanism of change occurs through changing negative patterns of thinking, behaving, and feeling and developing healthier alternatives (Choi-Kain et al., 2017).



6.      OTHER TIPS


  • It’s possible to change the way you think feel and react to situations. It just takes time and effort. Being consistent with your treatment, taking medications on schedule, follow your appointment is the best way to start.

  • Regular meal and sleeping times let your body known what to expect.

  • Try to exercise daily too. It keeps the stress level low.

  • Eat more fruit and vegetable and less junk food and avoid alcohol and drug.

  • Surround yourself with people you can trust, including family, friends, and your treatment team.

  • Build support for yourself and use it, having BPD is not your fault but you can change how it affects your life (Bhandari, 2019).


By: Fatimah Khursheed



REFERENCES

  1. Bhandari, S. (2019, April 19). Treatments for Borderline Personality Disorder (BPD). https://www.webmd.com/mental-health/treatment-borderline-personality-disorder.

  2. Bozatello, P., Bellino, S., Bosia, M., & Rocca, P. (2019). Early Detection and Outcome in Borderline Personality Disorder. Frontiers in Psychiatry. https://doi/10.3389/fpsyt.201900710

  3. Choi-Kain, L.W., Finch, E.F., Masland, S.R., Jenkins, J. A., & Unruh, B. T. (2017). What Works in the Treatment for Borderline Personality disorder. Current Behavioral Neuroscience Reports, 4(1), 21-30. https://doi.org/100.1007/s40473-017-0103-z

  4. Kulacaoglu, F., & Kose, S. (2018). Borderline Personality Disorder (BPD): In the Midst of Vulnerability, Chaos, and Awe. Brain sciences, 8(11), 201. https://doi.org/10.3390/brainsci8110201


Comments

Post a Comment

Popular posts from this blog

Innovations in Vaccinology: The Rise of Recombinant Genetic Shields

-
Image
Immune protection against infectious diseases is a crucial objective in both human and animal health. Currently, the focus of the vaccine landscape is primarily on COVID-19, which has required an unprecedented global effort to develop and deploy vaccines rapidly. Consequently, vaccination has become a dominant subject in scientific literature, and detailed discussions on specific immunization strategies and vaccine-induced immune responses are widespread in the media. This situation has underscored the challenges posed by emerging viral pandemics and the need for a universal approach to vaccine development, regardless of the pathogen-host combination. Traditional vaccine formulations, such as inactivated or attenuated versions of the whole infectious agent, have faced limitations, such as potential safety risks associated with chemical inactivation or the risk of reverting to virulence with attenuated strains. As a result, there is a growing interest in recombinant subunit vaccines. ...
Read more

miRNA-Based Therapies: Revolutionizing Cancer Treatment Strategies

-
Image
Micro RNAs (miRNAs) are small non-coding RNA molecules that play a pivotal role in regulating gene expression post-transcriptionally. Since their discovery in 1993, miRNAs have been identified as key players in various cellular processes, including development, proliferation, differentiation, apoptosis, and stress response [1] . In recent years, miRNAs have gained significant attention in the field of cancer research due to their involvement in tumorigenesis, metastasis, and treatment resistance. This article delves into the intricate relationship between miRNAs and cancer, highlighting their potential as therapeutic targets and exploring the challenges and opportunities of utilizing miRNA-based therapies. miRNAs function by binding to complementary sequences within the 3' untranslated regions (UTRs) of target mRNAs, leading to mRNA degradation or translational repression. This intricate interaction allows miRNAs to fine-tune the expression of numerous genes, ultimately influe...
Read more

Venturing PCR: principles, applications, innovations in DNA amplification for diagnostics, forensics, agriculture and beyond

-
Image
Polymerase Chain Reaction (PCR) is one of the top-most innovation and technique in the field of biotechnology and has aided to the success of different biotechnological and medical research and tests. The PCR technique, developed by Kary Mullis in 1980s, permits scientists to make multiple copies of a target DNA region, simplifying the analysis, and the manipulation of genetic material. A heat-resistant enzyme called DNA polymerase is used for replicating DNA in cycles of heating and cooling. Polymerase chain reaction is an amplification process through which a small amount of nucleic acid (DNA or RNA) can be multiplied and further tests can be performed. The machine in which the process is performed is termed as thermo-cycler and the process of PCR was first introduced by Kary Mullis, a renowned American Biochemist   (Plantsurfer, 2023) . Principles and working of PCR: Polymerase Chain Reaction (PCR) takes place in a series of 3 steps i.e.: Denaturation, Annealing, and El...
Read more