Borderline Personality Disorder

While the DSM-IV lists tens categories of personality disorder, borderline personality disorder (BPD) is the one most frequently experienced in clinical practice. Roughly ten percent of the population suffers from BPD, individuals who suffer an emotional roller-coaster that motivates impulsive and self-destructive behaviors (Paris, 1996). Often, those with BPD come to the attention of a psychiatrist because of suicidal impulses, ideation or actual attempts. BPD originates in youth and affects young individuals but seems to ameliorate with age as most individuals with BPD tend to function more successfully in their thirties and forties. Nearly four out of five individuals whose personality is borderline are women, as eighty percent of patients are female (Paris, 1996). The causes of BPD are multidimensional with a review of the literature seeming to draw a consensus that its development includes factors across a socio-psycho-biogenetic perspective. While many researchers stress biogenetic factors as predominant, just as many others conclude it is environmental and social learning that most greatly impact the development of the disorder. Nearly all agree the disorder is caused by a combination or overlap of causal dimensions. Stone (1988; in Paris, 1993) supports the multidimensional approach in the development of BPD, “BPD appears to be the final common pathway of many influences: hered

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ymptoms in BPD, however, this suggest BPD is not covered in the spectrum of affective disorders. Nonetheless, there is evidence that suggests there is more vulnerability in individuals with low serotonin activity and other biological abnormalities for development of BPD. Siever and Davis (1991; in Paris 1994) have found that there is a suggestive link between serotonergic activity and affective instability to noradrenergic and cholinergic activity in personality-disordered patients, but there is no evidence of a direct link between these biological aspects and the development of BPD. There have also been many psychological factors implicated in the development of BPD, chief among them lack of superego integration. As noted in Paris (1993), “dissociative or splitting processes in the ego are reinforced by the absence of the normal integrative contribution of the superego so that contradictory internalized demands, together with the insufficiency of the ego’s repressive mechanisms, contribute to the establishment of contradictory, instinctually infiltrated, pathological character traits. This development is characteristic of borderline personality organization” (p. 176). The Causes of BPD: Environment While the biological a
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