A life span perspective on borderline personality disorder

Arjan C. Videler, Joost Hutsebaut, Julie E. M. Schulkens, Sjacko Sobczak, Sebastiaan P. J. Van Alphen*

*Corresponding author for this work

Research output: Contribution to journalReview articleScientificpeer-review

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Abstract

Purpose of review
To provide an update of a life span perspective on borderline personality disorder (BPD). We address the life span course of BPD, and discuss possible implications for assessment, treatment, and research.

Recent findings
BPD first manifests itself in adolescence and can be distinguished reliably from normal adolescent development. The course of BPD from adolescence to late life is characterized by a symptomatic switch from affective dysregulation, impulsivity, and suicidality to maladaptive interpersonal functioning and enduring functional impairments, with subsequent remission and relapse. Dimensional models of BPD appear more age neutral and more useful across the entire life span. There is a need for age-specific interventions across the life span.

Summary
BPD symptoms and impairments tend to wax and wane from adolescence up to old age, and presentation depends on contextual factors. Our understanding of the onset and early course of BPD is growing, but knowledge of BPD in late life is limited. Although the categorical criteria of DSM allow for reliable diagnosis of BPD in adolescence, dimensional models appear both more age neutral, and useful up to late life. To account for the fluctuating expression of BPD, and to guide development and selection of treatment across the life span, a clinical staging model for BPD holds promise.
Original languageEnglish
Article number51
JournalCurrent Psychiatry Reports
Volume21
Issue number7
DOIs
Publication statusPublished - 2019

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Keywords

  • AGE-NEUTRALITY
  • ALTERNATIVE MODEL
  • Assessment
  • Borderline personality disorder
  • COMMUNITY SAMPLE
  • Course
  • EARLY INTERVENTION
  • FOLLOW-UP
  • Life span
  • PATHOLOGY
  • PHARMACOLOGICAL-TREATMENT
  • PREVALENCE
  • SELF
  • STABILITY
  • Treatment

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