Borderline personality disorder: ontogeny of a diagnosis

Abstract

Objective: The purpose of this article is to describe the development of the borderline personality disorder diagnosis, highlighting both the obstacles encountered and the associated achievements.

Method: On the basis of a review of the literature, the author provides a chronological account of the borderline construct in psychiatry, summarizing progress in decade-long intervals.

Results: Borderline personality disorder has moved from being a psychoanalytic colloquialism for untreatable neurotics to becoming a valid diagnosis with significant heritability and with specific and effective psychotherapeutic treatments. Nonetheless, patients with this disorder pose a major public health problem while they themselves remain highly stigmatized and largely neglected.

Conclusions: Despite remarkable changes in our knowledge about borderline personality disorder, increased awareness involving much more education and research is still needed. Psychiatric institutions, professional organizations, public policies, and reimbursement agencies need to prioritize this need.

Figures

FIGURE 1. Books on Borderline Personality Disorder Published From 1968 to 2008a

aData from the Library of Congress database, October 2008.

FIGURE 2. Treatment Dilemmas Predicted by the Borderline Syndrome

FIGURE 3. Longitudinal Course of Borderline Personality Disorder

aData from the Collaborative Longitudinal Study of Personality Disorders (unpublished). bData from the McLean Study of Adult Development (see reference 95).

FIGURE 4. Future Directions for Borderline Personality Disorder