Skip to main content

Abstract

Progress in understanding borderline personality disorder has unfolded in the last decade, landing in a new COVID-19–influenced world. Borderline personality disorder is now firmly established as a valid diagnosis, distinct from its co-occurring mood, anxiety, trauma-related, and behavioral disorders. Further, it is also understood as a reflection of general personality dysfunction, capturing essential features shared among all personality disorders. Neuroimaging research, representing the vast neurobiological advances made in the last decade, illustrates that the disorder shares frontolimbic dysfunction with many psychiatric diagnoses but has a distinct signature of interpersonal and emotional hypersensitivity. This signature is the conceptual basis of the psychotherapies and clinical management approaches proven effective for the disorder. Medications remain adjunctive and are contraindicated by some guidelines internationally. Less invasive brain-based therapeutics show promise. The most significant change in the treatment landscape is a focus on briefer, less intensive formats of generalist management. Shorter variants of therapies, such as dialectical behavior therapy and mentalization-based treatment, are in the process of being shown to be adequately effective. Earlier intervention and greater emphasis on functional improvement are needed to more effectively curb the disabilities and risks of borderline personality disorder for patients and their families. Remote interventions show promise in broadening access to care.

Formats available

You can view the full content in the following formats:

Information & Authors

Information

Published In

History

Published in print: Fall 2022
Published online: 25 October 2022

Keywords

  1. Borderline personality disorder
  2. neuroimaging
  3. dimensional classification
  4. treatment planning
  5. psychotherapy
  6. psychopharmacology
  7. Treatment assessment & planning

Authors

Details

Lois W. Choi-Kain, M.D., M.Ed. [email protected]
Gunderson Personality Research Institute, McLean Hospital, Belmont, Massachusetts, and Faculty of Medicine, Harvard Medical School, Boston.
Zeynep Sahin, Ph.D.
Gunderson Personality Research Institute, McLean Hospital, Belmont, Massachusetts, and Faculty of Medicine, Harvard Medical School, Boston.
Jenna M. Traynor, Ph.D.
Gunderson Personality Research Institute, McLean Hospital, Belmont, Massachusetts, and Faculty of Medicine, Harvard Medical School, Boston.

Notes

Send correspondence to Dr. Choi-Kain ([email protected]).

Competing Interests

Dr. Choi-Kain receives book royalties from Springer Publishing and the American Psychiatric Association. Dr. Traynor is a coinvestigator on a Multidisciplinary Association for Psychedelic Studies (MAPS)-funded clinical trial of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy; she has also received compensation as an independent contractor for the role of study therapist on a MAPS-funded clinical trial of MDMA-assisted psychotherapy. Dr. Sahin reports no financial relationships with commercial interests.

Metrics & Citations

Metrics

Citations

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

For more information or tips please see 'Downloading to a citation manager' in the Help menu.

Format
Citation style
Style
Copy to clipboard

View Options

View options

PDF/EPUB

View PDF/EPUB

Full Text

View Full Text

Login options

Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.

Personal login Institutional Login Open Athens login
Purchase Options

Purchase this article to access the full text.

PPV Articles - Focus

PPV Articles - Focus

Not a subscriber?

Subscribe Now / Learn More

PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Media

Figures

Other

Tables

Share

Share

Share article link

Share