A Life Span Perspective on Borderline Personality Disorder

Springer Science and Business Media LLC - 2019
Arjan C. Videler1,2,3, Joost Hutsebaut4, Julie E. M. Schulkens5, Sjacko Sobczak5, Sebastiaan P. J. van Alphen6,5,7
1Clinical Centre of Excellence for Body, Mind and Health, Tilburg, The Netherlands
2Tranzo department, Tilburg University, Tilburg, The Netherlands
3Clinical Centre of Excellence for Personality Disorders and Autism Spectrum Disorders in Older Adults, PersonaCura, Tilburg, The Netherlands
4Viersprong Institute for Studies on Personality Disorders (VISPD), Bergen op Zoom, The Netherlands
5Clinical Center of Excellence for Personality Disorders in Older Adults, Mondriaan Hospital, Heerlen, The Netherlands
6Department of Medical and Clinical Psychology, School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
7Department of Clinical and Lifespan Psychology, Vrije Universiteit Brussel (VUB), Brussels, Belgium

Tóm tắt

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. 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. 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.

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