Conceptual issues and research findings on borderline personality disorder: What every clinician should know

Abstract

Whereas the literature on borderline personality disorder (BPD) was once exclusively clinical and theoretical, today an accumulating body of research on the nature, etiology, prognosis, and treatment of BPD is of relevance to clinical practice. This article provides a “clinician's guide” to the empirical data on BPD. It begins with a discussion of the evolution of the borderline construct, from early descriptions of a type of patient on the border between psychosis and neurosis, through Kernberg's postulation of a level of disturbance called “borderline personality organization,” through the current DSM conceptualization. In the next section, we examine research on the etiology of BPD, focusing on genetic contributions, attachment histories, and physical and sexual abuse, after which we discuss prognosis, summarizing the results of longitudinal studies. Finally, we address treatment approaches, focusing on psychodynamic psychotherapy, dialectical behavior therapy, pharmacotherapy, and integrative treatment for BPD. © 1998 John Wiley & Sons, Inc.