CoChat
Sign Up
Cited by 315Personality Disorders and PsychopathologyPersonality Traits and PsychologyBipolar Disorder and Treatment

Borderline Personality Disorder: Ontogeny of a Diagnosis

Open access
Gunderson, John G.·2009·American Journal of Psychiatry
DOI 10.1176/appi.ajp.2009.08121825PMC PMC3145201
Open this paper in CoChat — free account

Abstract

OBJECTIVE: The purpose of this article is to describe the development of the borderline personality disorder diagnosis, highlighting both the obstacles encountered and the associated achievements. METHOD: On the basis of a review of the literature, the author provides a chronological account of the borderline construct in psychiatry, summarizing progress in decade-long intervals. RESULTS: Borderline personality disorder has moved from being a psychoanalytic colloquialism for untreatable neurotics to becoming a valid diagnosis with significant heritability and with specific and effective psychotherapeutic treatments. Nonetheless, patients with this disorder pose a major public health problem while they themselves remain highly stigmatized and largely neglected. CONCLUSIONS: Despite remarkable changes in our knowledge about borderline personality disorder, increased awareness involving much more education and research is still needed. Psychiatric institutions, professional organizations, public policies, and reimbursement agencies need to prioritize this need.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1176/appi.ajp.2009.08121825

Cites

118 of 118 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Previous literature has failed to link NSSI to mentalising deficits, although these are common in clinical populations notorious for self-injury.

    “previous literature has failed to link NSSI to mentalising deficits, although these are common in clinical populations notorious for self-injury [31–33]”

    From A 'choice', an 'addiction', a way 'out of the lost': Exploring self-injury in autistic people without intellectual disability (2019) · cites this paper as [33]

    In “The Present—Awareness” (page unavailable), the paper explicitly describes a borderline patient’s cutting as a possible breakdown in the ability to mentalize. It therefore makes the link the citing sentence says previous literature failed to make, although it presents that link as a conceptual explanation rather than an empirical finding. (LLM, conf=0.84)

    Checked by a reasoning model — may be wrong.

    Experimental — accuracy not yet measured

  • Mentalising impairments or differences are a feature of borderline personality disorder, which is strongly linked with self-injury.

    “Whilst mentalising impairments or differences have not been previously linked to self-injury as such, they are a feature of borderline personality disorder [27–30], which is itself strongly linked with self-injury [31–33].”

    From A 'choice', an 'addiction', a way 'out of the lost': Exploring self-injury in autistic people without intellectual disability (2019) · cites this paper as [33]

  • Borderline personality disorder affects only 2% to 6% of the population, but its mortality rate by suicide is one of the highest in the world among people with psychiatric disorders.

    “For instance, borderline personality disorder affects only 2% to 6% of the population [204,205], but its mortality rate by suicide is one of the highest in the world among people with psychiatric disorders [206].”

    From Smartphone Apps for the Treatment of Mental Disorders: Systematic Review (2020) · cites this paper as [204]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 5

  1. [21]Klein D Cole J Freeman A Friedhoff A Drug therapy as a means of syndrome identification and nosological revision Psychopathy and Psychopharmacology 1972 Johns Hopkins University Press Baltimore
  2. [28]Gunderson JG Links P Borderline Personality Disorder: A Clinical Guide 2008 American Psychiatric Press, Inc Washington, DC 2nd ed.
  3. [37]Grotstein JS Horton PC Gewirtz H Kreutter KJ Transitional phenomena and the dilemma of the me/not me interface The Solace Paradigm: An Eclectic Search for Psychological Immunity 1988 59 74 Conn, International Universities Press Madison
  4. [61]Kohut H The Analysis of the Self 1971 International Universities Press New York
  5. [65]Gunderson JG Borderline Personality Disorder 1984 American Psychiatric Press Washington, DC

Cited by

Sorted by citations

Related

Authors
Gunderson, J. G.
Affiliations
Harvard University (US)
Corresponding author
Gunderson, John G.
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
2009-05
Volume
166
Issue
5
Pages
530-539
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/appi.ajp.2009.08121825
PMC
PMC3145201
OpenAlex
W2126837733
Cited by
315
References
118
Citations by year
2026: 15 · 2025: 20 · 2024: 18 · 2023: 17 · 2022: 15 · 2021: 11 · 2020: 19 · 2019: 15 · 2018: 21 · 2017: 15 · 2016: 21 · 2015: 15 · 2014: 29 · 2013: 21 · 2012: 23
FWCI
2.84
Type
journal article
Language
en
Open access
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (MH400122, MH 400130, R01MH070377, R01MH050840)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
Keywords
borderline personality disorder, history of diagnosis, psychiatric classification, heritability, psychotherapy, stigma, public health burden
MeSH terms
Affect, Awareness, Borderline Personality Disorder, Countertransference, Diagnosis, Differential, Health Education, Humans, Psychoanalytic Therapy, Stress Disorders, Post-Traumatic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review