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Borderline Syndrom
Facts about the borderline personality disorder

Recent studies found that borderliners have a lower sensation of pain than healthy people. The reason for this is an active suppression of the perception of pain in the patient’s brain. The perception of heat was tested with the result that borderline personality disorder patients perceived a heat stimulus of 43 degrees Celsius as less painful as healthy individuals.

Different statements say that 1-2 % of the people are affected while some authors estimate the numbers a little bit higher. The spread blurs due to the varying specifications of the disorder. 70-75 % of the patients are female.

Facts about borderline personality disorder (BPD)

Pain perception of borderliners

Recent studies found that borderliners have a lower sensation of pain than healthy people. The reason for this is an active suppression of the perception of pain in the patient’s brain. The perception of heat was tested with the result that borderline personality disorder patients perceived a heat stimulus of 43 degrees Celsius as less painful as healthy individuals. It was also tested that their brain was activated far less and had to be increased by almost 3 degrees in order to have the same impact.

A brain region that is used for the cognitive pain judgement showed a higher activity after the heat stimulus than the healthy people’s counterpart. The affective judgement of pain was reduced at the same time. The conclusion, that borderliners show an increased cognitive control that leads to a lower estimation of pain, can explain the insensitivity to pain. A slow-down of brain systems that deals with the handling of emotions, caused by strong pain stimuli, can be suspected. In this way self-harm can be seen as a try for self-healing. The fact that the brain obviously is able to regulate the suppression of pain by effective neuronal networks leads to the possibility that patients who suffer from chronic pain can be helped more effectively in the future.

Devolution of borderline

Much research about the long-time devolution and consequences of a borderline personality disorder could not be done yet because the current classification according to the DSM has been defined only 1980 and only one long-term study has been carried out. Noticeable findings could be recovered in terms of the different devolutions of male and female borderliners.

Female borderline personality disorder patients show less symptoms medium-term but have stronger short-term break-downs. On a long-term basis their condition worsened compared to the beginning of the study what often stood in relation to the loss of a relative. Male patients, in contrast, often refused further therapy against medical advice which had a surprisingly positive impact onto the long-term devolution. Besides job-related, relational and social aspects they managed to develop individual support systems. All these readings only reflected the superficial situation and the external symptoms, though.

The results cannot be regarded as universal due to the fact that supposedly only certain types of male patients were studied because male borderliners are often rather imprisoned than stationary treated. The treated women were often caught in exactly those social relations that are the core of the borderline personality disorder, for example in terms of the social compulsion to marriage and the subordinate role of women.

Spread of borderline personality disorders

Different statements say that 1-2 % of the people are affected while some authors estimate the numbers a little bit higher. The spread blurs due to the varying specifications of the disorder. 70-75 % of the patients are female. The reasons for this fact are discussed because of the incertitude if the assumed spread coincides with the diagnosis rate. This could be verified with further, representative study groups.

A common characteristic is the patients’ urge for unhidden self-harm and suicide which is shown in a suicidal rate of 7-10 %. While at least 20 % have never shown self-harming behaviour, it is a sign that does not necessarily occur in a borderline personality disorder but is on a long-term basis a secure diagnosis criterion. 80 % of the patients are treated in a psychiatric way or in psychotherapy, around 60 % of them even stationary. In psychiatric departments, about 15 % of the patients suffer from a BPD.

Co-morbidity with borderline

According to experts, the possibility that a patient with a borderline personality disorder develops the criteria for at least one further personality disorder is high. In bad cases, up to seven personality disorders occur parallel due to their high co-morbidity to each other.

In retrospective, more than 50 % of the borderline personality disorder patients can be diagnosed with an attention deficit hyperactivity disorder (ADHD). In these cases, the social ability to integrate, especially with regard to participation in professional life, is in disorder. Both diseases show similar symptoms to the outside like mental absence, impulsivity, sensibility and imbalance and can sometimes be interchanged. Mental absence due to a borderline personality disorder is generally conditional on dissociations and turns up in phases in contrast to the easily distracted attention of ADHD patients. Regarded as genetically explainable, characteristics of ADHD, like increased sensitivity and impulsivity, commensurate with all models dealing with the origins of the borderline personality disorder, so that people suffering from ADHD can be regarded as predestined for borderline.

Barbara Kliem

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20. Oktober 2014
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10. Oktober 2014
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Universal statements about the origins of a borderline personality disorder (BPD) and its special conditions cannot be made. Factors that lead to the development of a borderline personality disorder cannot be defined generally but factors can be found that abet the disorder. A combination of these is mostly being held responsible in most cases.

Health professionals agree that a considerable impact can be found in the early childhood. Traumatic experiences like sexual abuse, disregard and violence can be held responsible for the development of a borderline personality disorder (BPD) in 35-70 % of the diagnosed cases.

For a long time, therapy was considered difficult for patients with borderline personality disorder. In the meantime, experts have developed psycho-analytic methods that match the requirements of borderliners. A specific treatment program is for example a so-called dialectical behaviour therapy that combines several behaviour therapy models and methods.

An important component of the therapy is the acquisition of certain abilities that are aimed to strengthen the patient by completing the five modules inner attentiveness, stress tolerance, conscious handling of emotions, interpersonal abilities and self-confidence.

 

It is difficult to diagnose the borderline personality disorder due to its various symptoms. Therefore criteria have been defined in order to alleviate the diagnosis and a form of therapy that changes the disorder-based persistent burden.

The difficulty in diagnosing the borderline personality disorder is the fact, that all typical symptoms can also occur with healthy individuals. A borderline disorder cannot be defined by a small number of signs that match every patient’s individual case but rather by very different criteria that do not necessarily occur.