BPD: Backstory Bullet Points

How long has BPD been around? How did it appear in society over the last 100 years? How did syptoms present and how were they interpreted and/or treated? These are all excellent and interesting questions!

Borderline Personality Disorder is a relatively young diagnosis, but we see it appearing in different ways as early as the 1930's. However, it was not published as an official diagnosis in the Dianostic Manual until the 80's. In this way, the illness is both young and old. Here are some bullet points on the history of BPD:

*Descriptions of individuals demonstrating the symptoms of borderline disorder were first mentioned in the medical literature almost 3000 years ago.4

*In 1938, the American psychoanalyst Adolph Stern first described most of the symptoms that are now considered as diagnostic criteria of borderline disorder.5 He suggested the possible causes of the disorder, and what he believed to be the most effective form of psychotherapy for these patients. Finally, he named the disorder by referring to patients with the symptoms he described as the border line group.

*The psychoanalyst Robert Knight, in the 1940s, introduced the concepts of ego psychology into his description of borderline disorder. Ego psychology deals with mental functions that enable us to realistically perceive events, successfully integrate our thoughts and feelings and to develop effective responses to life around us. He suggested that people with borderline disorder have impairments in many of these functions, and he referred to them as borderline states. 4

*The next major contribution in the field was made by the psychoanalyst Otto Kernberg. In the 1960s, he proposed that mental disorders were determined by three distinct personality organizations: psychotic, neurotic and borderline personality. Kernberg has been a strong proponent of modified psychoanalytic therapy for those patients with borderline disorder who are able to benefit from it. 4

*In 1968, Roy Grinker and his colleagues published results of the first research conducted on patients with borderline disorder, which he referred to as the borderline syndrome. 4

*The next major advance occurred in 1975 when John Gunderson and Margaret Singer published a widely read article that synthesized the relevant, published information on borderline disorder, and defined its major characteristics. Gunderson then published a specific research instrument to enhance the accurate diagnosis of borderline disorder. This instrument enabled researchers over the world to verify the validity and integrity of borderline disorder. Subsequently, borderline personality disorder first appeared in DSM-III as a bona fide psychiatric diagnosis in 1980. 4

*In 1979, John Brinkley, Bernard Beitman and Robert Friedel proposed that medications, specifically low doses of neuroleptics (now referred to as antipsychotic agents), are effective in reducing some of the symptoms of borderline disorder. 6 Friedels research team published support for this proposal in 1986 in one of the first two placebo-controlled studies of any medication in subjects with borderline disorder. A similar finding was reported in the same journal by Paul Soloffs research team with a different medication in the same class. Since then, other controlled studies of similar agents have supported and extended the original finding. In addition, medications in other classes have been reported to have efficacy in treating the symptoms of borderline disorder. 27

*In the 1980s, the first of a large number of neuroimaging, biochemical and genetic studies were published indicating that borderline disorder is associated with biological disturbances in those brain areas related to the symptoms of the disorder. 23

*In 1993, Marsha Linehan introduced Dialectical Behavior Therapy (DBT), a specific and now well documented form of psychotherapy for patients with borderline disorder prone to self injurious behavior and who require and request frequent, brief hospitalizations. 34 Since then, other forms of psychotherapy have been developed that are specifically designed for borderline disorder.

*Over the past decade, two lay advocacy groups have been founded, the Treatment and Research Advancements Association for Personality Disorder (TARA APD), and the National Education Alliance for Borderline Personality Disorder (NEA- BPD). The missions of these organizations are: to increase the awareness of borderline disorder and its treatments; provide support to those suffering from the disorder, and to their families and friends; enhance the federal and private research funding dedicated to borderline disorder; and to decrease the stigma associated with the disorder.7

Visit the Source: Borderline Personality Disorder Demystified by Robert O. Friedel, A Message of Realistic Hope