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Borderline Personality Disorder: Ontogeny of a Diagnosis
Open accessAbstract
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.
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“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]
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“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]
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“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]
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Gammino, L., Pelizza, L., Emiliani, R., D'Adda, F., Lupoli, P., Pellegrini, L., Berardi, D., & Menchetti, M. (2024) · Early Intervention in Psychiatry · doi:10.1111/eip.13557 · Cited by 2
Allman, M. E., Barkauskienė, R., Gervinskaitė-Paulaitienė, L., & Sharp, C. (2025) · European Journal of Psychological Assessment · doi:10.1027/1015-5759/a000884 · Cited by 2
Emotional-instabile Persönlichkeitsstörung vom Borderline-Typ
Gahr, M. L., Fladung, A.-K., Freudenmann, R. W., Wolf, R. C., Schönfeldt‐Lecuona, C., & Schmid, M. M. (2013) · Nervenheilkunde · doi:10.1055/s-0038-1628506 · Cited by 2
Psychiatric Classification and Subjective Experience
Cooper, R. (2012) · Emotion Review · doi:10.1177/1754073911430139 · Cited by 3
Paris, J. (2014) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000041 · Cited by 3
Metadata
- Authors
- Gunderson, J. G.
- Affiliations
- Harvard University (US)
- Corresponding author
- Gunderson, John G.
- Venue
- American Journal of Psychiatry
- Published
- 2009-05
- Volume
- 166
- Issue
- 5
- Pages
- 530-539
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- 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
- green
- www.ncbi.nlm.nih.gov
- 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
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