Current trends in BPD research as indicative of a broader sea-change in psychiatric nosology.

Abstract

The aim of the Special Section that this paper contributes to is to review current trends in borderline personality disorder (BPD) research. Three major trends were identified. First, there has been a marked increase in studies that attempt to locate BPD in the dimensional latent structure of psychopathology. Second, identifying the endophenotypic markers associated with BPD has become a focus of interest. Here, we focus on one endophenotype in the form of impaired self-other processing. Third, there has been an explosion of research into the developmental aspects of BPD specifically focused on uncovering complex Biology × Environment interactions in the development of BPD. This paper discusses how these trends (Dimensions, Biology, and Development) are challenging the nature and form of BPD as we know it, and may be indicative of a broader sea-change in psychiatric nosology. (PsycINFO Database Record

A Life Span Perspective on Borderline Personality Disorder

“…This research points out that BPD typically first manifests itself in adolescence, and that adolescent BPD symptoms can be distinguished reliably from normative adolescent development [ 17 ]. Moreover, adolescence can be considered a particular sensitive period for BPD pathology to emerge [ 7 •]. Two large longitudinal studies into the trajectory of BPD from childhood into young adulthood have shown that BPD pathology has its onset in the beginning of adolescence [ 18 , 19 ].…”

“…These risk factors predict not only BPD, but a wide range of mental disorders. Prognostic factors that are specifically associated with a BPD development in children have not yet been identified [ 7 •, 21 ].…”

“…A life span perspective on BPD also helps defining new research objectives. One such goal would be to stop examining distal risk factors that are indicative for later general psychopathology and shed light on which precursors in childhood and adolescence are specific for BPD [ 7 •], and what personal and contextual characteristics determine a ‘high-risk’ profile for chronic BPD. In doing so, we would be able to identify which children are at ultrahigh risk for the development of BPD.…”

“…The categorical DSM concept of BPD, and of personality disorders in general, has been criticized because of its heterogeneity, diagnostic overlap with other disorders, arbitrary threshold, low reliability, and poor empirical base [ 5 ]. Factor analytic studies found support for one general factor of personality pathology underlying the nine criteria of BPD [ 6 , 7 •]. Moreover, BPD presents with many comorbid disorders [ 8 ].…”

Interpersonal Problems in Borderline Personality Disorder: Associations With Mentalizing, Emotion Regulation, and Impulsiveness

“…Interpersonal problems have been suggested as the most characteristic and discriminative feature of the disorder (Fossati et al, 1999;Gunderson, 2007;Johansen, Karterud, Pedersen, Gude, & Falkum, 2004). Moreover, other cardinal symptoms of BPD, such as anger, affective instability, suicidal behavior, and impulsiveness, mainly manifest within interpersonal contexts (Sharp, 2016). Evidence has shown that interpersonal problems underlie subjective burden and behavioral deviations (e.g., self-harm and violence), and that they are related to neurobiological alterations (King-Casas et al, 2008;Lis & Bohus, 2013;Stepp, Smith, Morse, Hallquist, & Pilkonis, 2012).…”