Borderline Personality Disorder: A Case Study and Theoretical Approaches to Therapy

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According to the DSM-5, Personality Disorders are characterized by “impairments in personality functioning and the presence of pathological personality traits”. Borderline Personality Disorder is one of ten personality disorders listed in the DSM-5. The DSM-5 lists several criteria that must be met in order for someone to be diagnosed with Borderline Personality Disorder. They are quoted as follows:

Borderline Personality Disorder (BPD) affects about 4% of the general population, and at least 20% of the clinical psychiatric population. (Kernberg and Michels, 2009) In the clinical psychiatric population, about 75% of those with the disorder are women. BPD is also significantly heritable, with 42-68% of the variance associated with genetic factors, similar to that of hypertension. BPD can also develop due to environmental factors such as childhood neglect and/or trauma, insecure attachment, and exposure to marital, family, and psychiatric issues. (Gunderson, 2011)

Some of the key components of BPD include self-harm, or suicidal thoughts and actions, dichotomous thinking, and low emotional granularity. People that present with reoccurring suicidal thoughts and actions, combined with a fear of abandonment, are commonly diagnosed with BPD. These two characteristics make BPD easily recognizable, but this diagnoses is often not used. The emotional volatility, recurrent crises, and self-injurious behaviors of those with BPD are often seen as willfully manipulative episodes, and not a sign of illness. (Gunderson, 2011) Yet, it is important to take these thoughts and actions seriously, as one never knows when someone may actually decide to end their life.

Beck believed that dichotomous thinking was a key cogni...

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