43 Genetics edit The heritability of bpd has been estimated. 44 That is, 40 percent of the variability in liability underlying bpd in the population can be explained by genetic differences. Twin studies may overestimate the effect of genes on variability in personality disorders due to the complicating factor of a shared family environment. 45 Nonetheless, the researchers of this study concluded that personality disorders "seem to be more strongly influenced by genetic effects than almost any axis I disorder. G., bipolar disorder, depression, eating disorders, and more than most broad personality dimensions." 46 Moreover, the study found that bpd was estimated to be the third most-heritable personality disorder out of the 10 personality disorders reviewed. 46 Twin, sibling, and other family studies indicate partial heritability for impulsive aggression, but studies of serotonin -related genes have suggested only modest contributions to behavior. 47 Families with twins in the netherlands were participants of an ongoing study by Trull and colleagues, in which 711 pairs of siblings and 561 parents were examined to identify the location of genetic traits that influenced the development of bpd.
Dialectical Behaviour Therapy
36 Although the mind's habit of blocking out intense painful emotions may provide temporary relief, it can also have the unwanted side effect of blocking or blunting the experience of ordinary emotions, reducing the access of people with bpd to development the information contained in those. 36 Sometimes, it is possible for another person to tell when someone with bpd is dissociating, because their facial or vocal expressions may become flat or expressionless, or they may appear to be distracted; at other times, dissociation may be barely noticeable. 36 Disability edit many people with bpd are able to work if they find appropriate jobs and their condition is not too severe. People with bpd may be found to have a disability in the workplace, if the condition is severe enough that the behaviors of sabotaging relationships, engaging in risky behaviors, or intense anger prevent the person from functioning in their professional role. 37 As is the case with other mental disorders, the causes of bpd are complex and not fully agreed upon. 38 evidence suggests that bpd and post-traumatic stress disorder ( ptsd ) may be related in some way. 39 Most researchers agree that a history of childhood trauma can be a contributing factor, 40 but less attention has historically been paid to investigating the causal roles played by congenital brain abnormalities, genetics, neurobiological factors, and environmental factors other than trauma. 38 41 Social factors include how people interact in their early development with their family, friends, and other children. 42 unreliable medical source? Psychological factors include the individual's personality and temperament, shaped by their environment and learned coping skills that deal with stress. These different factors together suggest that there are multiple factors that may contribute to the disorder.
30 bpd, like other personality disorders, is linked to increased levels of chronic stress and conflict in romantic relationships, decreased satisfaction on the part of romantic partners, abuse, and unwanted pregnancy. 34 Sense of self edit people with bpd tend to have trouble seeing a clear picture of their identity. In particular, they tend to have difficulty knowing what they value, believe, prefer, and enjoy. 35 They are often unsure about their long-term goals for relationships and jobs. This difficulty with knowing who they are and what they value can cause people with bpd to experience feeling "empty" and "lost". 35 Cognitions edit The often intense emotions experienced by people with bpd can make it difficult for them to control the focus of their attention—to concentrate. 35 In addition, people with bpd may tend to dissociate, which can be thought of as an intense form of "zoning dates out". 36 Dissociation often occurs in response to experiencing a painful event (or experiencing something that triggers the memory of a painful event). It involves the mind automatically redirecting attention away from that event, presumably to protect against experiencing intense emotion and unwanted behavioral impulses that such emotion might otherwise trigger.
18 Sexual abuse can be a particular trigger for suicidal behavior in adolescents with bpd tendencies. 29 quantify interpersonal relationships edit people with bpd can be very sensitive to the way others treat them, by feeling intense joy and gratitude at perceived expressions of kindness, and intense sadness or anger at perceived criticism or hurtfulness. 30 Their feelings about others often shift from admiration or love to anger or dislike after a disappointment, a threat of losing someone, or a perceived loss of esteem in the eyes of someone they value. This phenomenon, sometimes called splitting, includes a shift from idealizing others to devaluing them. 31 Combined with mood disturbances, idealization and devaluation can undermine relationships with family, friends, and co-workers. 32 Self-image can also change rapidly from healthy to unhealthy. While strongly desiring intimacy, people with bpd tend toward insecure, avoidant or ambivalent, or fearfully preoccupied attachment patterns in relationships, 33 and they often view the world as dangerous and malevolent.
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4 Self-harming or suicidal behavior is one of the core diagnostic criteria in the dsm-5. 5 Self-harm occurs in 50 to 80 of people with bpd. The most frequent method of self-harm is cutting. 24 Bruising, burning, head banging or biting are not uncommon with bpd. 24 The lifetime risk mary of suicide among people with bpd is between 3 and. 10 25 There is evidence that men diagnosed with bpd are approximately twice as likely to die by suicide as women diagnosed with bpd. 26 There is also evidence that a considerable percentage of men who die by suicide may have undiagnosed bpd.
27 The reported reasons for self-harm differ from the reasons for suicide attempts. 18 nearly 70 of people with bpd self-harm without trying to end their life. 28 reasons for self-harm include expressing anger, self-punishment, generating normal feelings (often in response to dissociation and distracting oneself from emotional pain or difficult circumstances. 18 In contrast, suicide attempts typically reflect a belief that others will be better off following the suicide. 18 Both suicide and self-harm are a response to feeling negative emotions.
14 people with bpd may feel emotional relief after cutting themselves. 19 While people with bpd feel euphoria (ephemeral or occasional intense joy they are especially prone to dysphoria (a profound state of unease or dissatisfaction depression, and/or feelings of mental and emotional distress. Recognized four categories of dysphoria that are typical of this condition: extreme emotions, destructiveness or self-destructiveness, feeling fragmented or lacking identity, and feelings of victimization. 20 Within these categories, a bpd diagnosis is strongly associated with a combination of three specific states:feeling betrayed and feeling out of control, and "feeling like hurting myself". 20 Since there is great variety in the types of dysphoria experienced by people with bpd, the amplitude of the distress is a helpful indicator of borderline personality disorder.
20 In addition to intense emotions, people with bpd experience emotional "lability or in other words, changeability. Although the term emotional lability suggests rapid changes between depression and elation, the mood swings in people with this condition actually fluctuate more frequently between anger and anxiety and between depression and anxiety. 21 Behavior edit Impulsive behavior is common, including substance or alcohol abuse, eating disorders, unprotected sex or indiscriminate sex with multiple partners, reckless spending, and reckless driving. 22 Impulsive behavior may also include leaving jobs or relationships, running away, and self-injury. 23 people with bpd act impulsively because it gives them the feeling of immediate relief from their emotional pain. 23 However, in the long term, people with bpd suffer increased pain from the shame and guilt that follow such actions. 23 A cycle often begins in which people with bpd feel emotional pain, engage in impulsive behavior to relieve that pain, feel shame and guilt over their actions, feel emotional pain from the shame and guilt, and then experience stronger urges to engage in impulsive. 23 As time goes on, impulsive behavior may become an automatic response to emotional pain. 23 Self-harm and suicide edit Scars from self-harm is a common sign in borderline personality disorder.
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15 In Marsha linehan 's view, the sensitivity, intensity, and duration with which people with bpd feel emotions have both positive and negative effects. 14 people with bpd are often exceptionally enthusiastic, idealistic, joyful, and loving. 16 However, they may feel overwhelmed by negative emotions anxiety, depression, guilt/shame, worry, anger, etc. experiencing intense grief instead of sadness, shame and humiliation instead of mild embarrassment, rage instead of annoyance, and panic instead of nervousness. 16 people with bpd are also especially sensitive to feelings of rejection, first criticism, isolation, and perceived failure. 17 Before learning other coping mechanisms, their efforts to manage or escape from their very reviews negative emotions may lead to emotional isolation, self-injury or suicidal behavior. 18 They are often aware of the intensity of their negative emotional reactions and, since they cannot regulate them, they shut them down entirely. 14 This can be harmful to people with bpd, since negative emotions alert people to the presence of a problematic situation and move them to address it which the person with bpd would normally be aware of only to cause further distress.
4 The disorder is often stigmatized in both the media and psychiatric field. 9 Contents Signs and symptoms edit borderline personality disorder may be characterized by the following signs and symptoms: The most distinguishing symptoms of bpd are marked sensitivity to rejection or criticism, and intense writing fear of possible abandonment. 10 overall, the features of bpd include unusually intense sensitivity in relationships with others, difficulty regulating emotions, and impulsivity. Fear of abandonment may lead to overlapping dating relationships as a new relationship is developed to protect against abandonment in the existing relationship. Other symptoms may include feeling unsure of one's personal identity, morals, and values; having paranoid thoughts when feeling stressed; depersonalization; and, in moderate to severe cases, stress-induced breaks with reality or psychotic episodes. Emotions edit people with bpd may feel emotions with greater ease, depth and for a longer time than others. 11 12 A core characteristic of bpd is affective instability, which generally manifests as unusually intense emotional responses to environmental triggers, with a slower return to a baseline emotional state. 13 14 people with bpd often engage in idealization and devaluation of others, alternating between high positive regard for people and great disappointment in them.
a given year. 4 Females are diagnosed about three times as often as males. 5 It appears to become less common among older people. 5 Up to half of people improve over a ten-year period. 5 people affected typically use a high amount of healthcare resources. 5 There is an ongoing debate about the naming of the disorder, especially the suitability of the word borderline.
4 6, it occurs about five times more often in a person who has an affected close relative. 4, adverse life events also appear to play a role. 8, the underlying mechanism appears to involve the frontolimbic network of neurons. 8 bpd is recognized by the diagnostic and Statistical Manual of Mental Disorders (DSM) as a personality disorder, literature along with nine other such disorders. 5 diagnosis is based on the symptoms while a medical exam may be done to rule out other problems. 4 The condition must be differentiated from an identity problem or substance use disorders, among other possibilities. 5 Borderline personality disorder is typically treated with therapy, such as cognitive behavioral therapy (CBT). 4 Another type, dialectical behavior therapy (DBT) may reduce the risk of suicide.
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Borderline personality disorder bpd also known as emotionally unstable personality disorder eupd 7 is a long-term pattern of abnormal behavior characterized by unstable relationships with other people, unstable sense of self, and unstable emotions. 4 5, there is frequent dangerous behavior and self-harm. 4, people may also struggle with a feeling of emptiness and a fear of abandonment. 4, symptoms may be brought on by seemingly normal events. 4, the behavior typically begins by early adulthood, and occurs across a variety of situations. Substance abuse, depression, and eating disorders are commonly associated with bpd. 4, approximately 10 of people affected die by suicide. 4 5, bPD's causes real are unclear, but seem to involve genetic, brain, environmental, and social factors.