History of Borderline Personality Disorder by Will

At first Borderline Personality Disorder was thought to border on or overlap with schizophrenia, other types of psychoses, and neurotic conditions like anxiety and depression. Because of this frequent overlapping with other diagnoses it was thought to lack the precision and validity for diagnosis which was only useful for patients who did not fall into any other category. This disorder did not respond well to treatments and to this day, mental health professionals who seem to be unfamiliar with current scientific literature still think this to be true.

These days though, the disorder has been shown to have diagnostic validity. Many studies that have taken place indicate that the disorder does not overlap with schizophrenia and in fact appears to be a distinctive diagnostic entity.

The first description of the symptoms of the disorder were first mentioned in medical literature almost 3000 years ago. It wasn’t until 1938 when an American Psychoanalyst named Adolph Stern first described the symptoms that are now considered as diagnostic criteria of the borderline disorder. He also suggested some of the possible causes of the disorder and even described what he thought would be the most effective form of psychotherapy for the patients. He also was the one to name the disorder referring to patients with the symptoms as people who were on “the border line group”.

The next contribution occurred during the 1960s by a psychoanalyst named Otto Kernberg. During this time he thought that mental disorders were determined by three distinct personality types: the psychotic, the neurotic, and the so called “borderline personality.”

Next in 1968, Roy Grinker along with his colleagues published results of the first research that had been conducted on the patients with borderline disorder. At the time this was referred to by Roy as “borderline syndrome.”

More advancements in the field came about in 1975 when Margaret Singer and John Gunderson published a widely acclaimed article that brought together the relevant, published information on the borderline disorder and defined the major characteristics of the condition. After that, Gunderson then published a specific research instrument that was meant to enhance the accurate diagnosis of the borderline disorder. This enabled researchers around the globe to verify the integrity of the disorder. This eventually led to borderline personality disorder first appearing in the DSM-III as an actual psychiatric diagnosis in 1980.

Before it appeared in the DSM-III John Brinkley, Bernard Beitman, and Robert Friedel proposed in 1979 that medications like low doses of neuroleptics are effective in reducing the symptoms of the borderline disorder. Friedel’s research team later published support for the proposal in 1986 in a placebo-controlled study of any medication in subjects with the disorder. Similar findings were reported in a journal written by Paul Soloff and his research team. Since that time eight other studies of similar aspects have supported the original finding. More so, other medication classes have been found to have been efficient in treating the symptoms of the borderline disorder. A few of these studies have been replicated but they have not been done so as extensively as the first ones involving neuropleptics and antipsychotic agents.

In the 1980s neuroimaging was brought around and biochemical and genetic studies began to be published. These things indicated that borderline disorder is associated with biological disturbances in the functioning of the brain and that some of these might be genetically inherited.

During the early 1990s Marsha Linehan introduced Dialectical Behavior Therapy which was a specific well documented form of psychotherapy that was designed for patients with borderline disorder who were prone to self injuring behavior and required and requested frequent, brief hospitalizations. Since this time other forms of psychotherapy have been developed that have been designed for the borderline disorder.

Since then two different 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). These two organizations were founded in order to increase the awareness of borderline disorder and for its treatments, to offer support to those who suffer from it and to their families and friends should they need it, to enhance the federal and privately funded research dedicated to the disorder, and to decrease the stigma that is associated with the disorder.

What may come in the future of this disorder is still up in the air. One can hope that with continuing research and more in depth studies that perhaps one day better, faster, and more efficient ways to treat borderline disorder may come about. Only time can tell, but from where it has started it seems as if people are at least on the right path to helping people who suffer from the disorder.

Further information to the history of the condition and links to other information can be found here: History