BORDERLINE

PERSONALITY
DISORDER
ABNORMAL PSYCHOLOGY
PSYCHOLOGICAL DISORDER &
MOVIE REVIEW PRESENTATION
KIMBERLY WEBB
 HISTORY
& EVOLUTION
H O W H A S O U R U N D E R S TA N D I N G O F B O R D E R L I N E
PERSONALITY DISORDER CHANGED OVER TIME?
Adolph Stren Gregory John Gunderson Marsha Linehan
first uses the Zilbo org outlines introduces
term borderline describes symptoms to Dialectical
i n p s y c h o l o g y, borderline diagnose Behavioral
referring to symptoms as a borderline Therapy as an
‘borderline mild form of personality e ffec tive

1938

1975

1993
1941
groups’. schizophrenia. d i s o r d e r. treatment.

1940s

1968

1980

2020
Robert Knight Roy Grinker Borderline
Publication of
presents the idea begins personality
the DSM-IV
of ‘borderline conducting the disorder is listed
further defines
states’, using first research in the DSM-III.
symptoms
borderline as a done on
required for
term to describe borderline
diagnosis.
atypical personality
presentation of d i s o r d e r.
various
psychological
disorders.
What does Borderline Personality Disorder look
Symptoms and presentation as outline by the DSM-5

like? Frantic efforts

to avoid
abandonment
Paranoia or Unstable and
severe intense
dissociative interpersonal
symptoms relationships

Unstable
Inappropriate
sense of self
anger
A pervasive or self-image
pattern of
instability

Impulsivity in
Chronic at least two
emptiness ways that are
self-damaging

Recurrent
suicidal
Mood
behavior or
instability
self-mutilating
behavior

An individual must exhibit at least 5 of the 9 listed behaviors

 It is clear that environmental factors heavily
influence the development of borderline
personality disorder. It’s estimated that 70%
of individuals presenting with this disorder
experienced severe childhood trauma.

Recent twin studies suggest that borderline

personality disorder has a hereditability rate
of around 50%. This indicates that has higher
hereditability than major depressive disorder.
ETIOLOGY Brain imaging scans have indicated structural
abnormalities in the brains of individuals with
borderline personality disorder. We can see
discernable differences in the amygdala,
hippocampus, and medial temporal lobes.

As with many other disorders, experts suggest

that the interaction between a genetic vulnerability
and a “chronically invalidating environment,’ leads
to the disorders development.
Borderline personality disorder is
one of the most common
personality disorders
IT’S MORE
COMMON
Borderline personality disorder
has a prevalence rate of 5.9% and
THAN YOU
an incidence rate of 1.6% THINK
DIFFERENTIAL DIAGNOSES

Bipolar Disorder

People often mistake borderline personality disorder with bipolar disorder due to the mood
irregularities. These are two very different disorders, and a key way to distinguish between the two
is by evaluating how quickly an individuals mood shifts occur. While the mood alterations can
appear similar, it is important to remember that borderline personality disorder is defined as a
cluster of symptoms. Extreme and shifting mood states is just one symptom that an individual with
borderline personality disorder possesses.
 BE CAREFUL OF COMORBITITY
Individuals with borderline personality disorder have high rates of comorbidity with other disorders. These are some of
the disorders that are most frequently comorbid. It is important that we watch for this comorbidity when diagnosing
and treating borderline personality disorder.

96% 88% 65%

Ha v e a c o m o r bi d H a ve a c om or bi d Ha ve a c om o r b i d
Mood Disorder Anxiety Disorder Substance Use Disorder
At s o m e po i nt i n t h e i r l i v e s A t s om e po i n t i n t he i r l i ve s At s o m e p oi nt i n t h e i r l i ve s
ASSESSMENT

McClean Personality
Clinical
Screening Diagnostic
Interview
Instrument Questionnaire

There is no one test that can be given to diagnose borderline personality disorder.
Clinical interviews, the MSI-BPD and the PDQ-4 have all been shown to be
equally accurate in predicting a diagnosis.
TREATMENT OPTIONS
Cognitive Behavioral- Therapy
CBT can be useful in the treatment of
individuals with borderline personality
disorder. This type of therapy can help
individuals identify and address unhealthy
relationship patterns. It has also been
shown to be effective in treating suicidal
behavior and self-mutilative behavior.
Medication
Medication is not used in most cases
of borderline personality disorder,
but can be effective in certain
circumstances. Medicinal
intervention may be recommended to
help combat intense mood swings or
to treat comorbid disorders.
TREATMENT OPTIONS CONTINUE
Dialectical Behavioral Therapy

DBT was created in the 1980s by Dr. Marsha Linehan specifically to help treat
individuals with borderline personality disorder. This type of treatment
focuses on controlling impulsivity, building healthy relationships with others,
reducing behaviors that are self-destructive, and coping with intense emotions.
It been shown to be extremely effective in helping treat individuals with
borderline personality disorder.
MYTHS & COMMON MISCONCEPTIONS
B orderlin e Personality
Disorder Can’t b e
Treated
Contrary to popular belief, there
are many treatment methods for
those with borderline
personality disorder. The
prognosis for those who seek
and undergo treatment is
actually very good.
Borderlin e Personality Disord er
is a Variation of Bi polar
Disorder
People often confuse the mood
instability seen in borderline
personality disorder with
bipolar disorder. In reality,
those with borderline
personality disorder experience
much more rapid changes in
their moods when compared to
those with bipolar disorder.
Everyon e with B ord erline
Personality Disord er was
Ab used
While many people with
borderline personality disorder
were abused as children, that is
not true for everyone with this
diagnosis. A large amount of
people dealing with borderline
personality disorder never
experienced childhood trauma.
 What the Movie Got Right

Unstable interpersonal relationships. All of Alice’s relationships in the film are unhealthy,
unstable, and switch from patterns of intense ideation to patterns of intense dismissal.

Impulsivity. Alice shows the impulsivity of an individual with borderline personality disorder at
multiple points in the film. We can see this both through sexual encounters and excessive
spending. By the end of the film Alice has nearly spent all of her lottery winnings, and ultimately
give away what she had left.

Excessive Anger. Alice shows extreme and uncontrolled anger at multiple points in the movie.
She screams at actors she has hired for a reenactment, and at one point gets so angry that she ends
up spilling hot food on herself, covering her torso in second degree burns.
 What the Movie Got Wrong
Treatment. Alice’s psychologist is incredibly concerned when she goes off of her medication,
Abilify. Medication is not generally used in the treatment of borderline personality disorder, and
when it is, clinicians will use a mood stabilizing drug. Abilify is an antipsychotic and would not
have been used in Alice’s treatment.

Symptom Presentation. Many of the symptoms Alice shows are not indicative of borderline
personality disorder and are more representative of other disorders like histrionic personality
disorder. This is not done in a way that could suggest comorbidity but rather just seems to be a
random conglomeration of symptoms from Cluster B personality disorders.
 Reducing the Stigma

Ultimately, people know very little about borderline personality disorder. A huge
part of reducing the stigma of this disorder will come from increasing the
education and information available. Being able to accurately portray this disorder
so that others can truly understand it is one of the first steps.
 Works Cited
American Psychiatric Association. (2013). Diagnostic and Statistical Manuel of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association.

Biskin, R. S., & Paris, J. (2013). Comorbidities in Borderline Personality Disorder. Psychiatric Times.

Chapman, J., Jamil, R. T., & Fleisher, C. (2020). Borderline Personality Disorder. StatPearls.

Durand, V. M., & Barlow, D. H. (2016). Essentials of Abnormal Psychology, Seventh Edition. Boston, MA: Cengage Learning.

Durand, V. M., & Barlow, D. H. (2016). Genetic Contributions to Psychopathology. In V. M. Durand, & D. H. Barlow, Essentials of Abnormal Psychology (pp. 28-64). Boston: Cengage Learning.

National Institute of Mental Health. (2017, December). Borderline Personality Disorder. Retrieved from National Institute of Mental Health: https://www.nimh.nih.gov/health/topics/borderline-personality-
disorder/

Optimum Performance Institute. (2018). The History of BPD. Retrieved from Optimum Performance Institute: https://www.optimumperformanceinstitute.com/bpd-treatment/the-history-of-bpd/

Paris, J. (2018). Differential Diagnosis of Borderline Personality Disorder. Psychiatric Clinics of North America, 575-582.

Salters-Pedneault, K. (2020, April 10). History of the Term 'Borderline' in Borderline Personality Disorder. Retrieved from Very Well Mind: https://www.verywellmind.com/borderline-personality-disorder-
meaning-425191

Salters-Pedneult, K. (2020, August 28). Screening for Borderline Personality Disorder. Retrieved from Very Well Mind: https://www.verywellmind.com/mclean-screening-instrument-borderline-personality-
disorder-425178#:~:text=There%20are%20no%20specific%20tests,be%20used%20to%20diagnose%20BPD.

Skodol, A. (2021, February 18). Borderline Personality Disorder: Epidemiology, Pathogenesis, Clinical Features, Course, Assessment, and Diagnosis. Retrieved from UpToDate:
https://www.uptodate.com/contents/borderline-personality-disorder-epidemiology-pathogenesis-clinical-features-course-assessment-and-diagnosis#:~:text=BPD%20is%20common%20in%20both,percent
%20%5B3%2C4%5D.

Timoshin, N. (2009, June 9). From Colloquialism to Full Recognition: The Evolution of BPD. Retrieved from Psychiatric Times: xhttps://www.psychiatrictimes.com/view/colloquialism-full-recognition-
evolution-bpd