The Essential Nature of Borderline Psychopathology
Abstract
We suggest that the core features of borderline personality disorder (BPD) are the intense inner pain commonly reported by borderline patients and the awkward means they use to manage and express this pain. In this model, the pain has both affective and cognitive components. The awkward means of managing and expressing this pain are behavioral and interpersonal in nature. The etiology of these core features of BPD seems to lie in the interaction of a kindling event or events, which can be traumatic or normative in nature, and a vulnerable or hyperbolic temperament. The treatment and nosological implications of this model are discussed.
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The experience of intense inner pain out of keeping with the significance of the event may be a core feature of BPD, frequently associated with disturbed relationships, childhood abuse and neglect, and prompted by social situations involving rejection, abandonment, or isolation.
“the experience of intense inner pain out of keeping with the significance of the event may be a core feature of BPD (Zanarini & Frankenburg, 2007) frequently associated with disturbed relationships (Gunderson & Lyons-Ruth, 2008), and childhood abuse and neglect (Holm & Severinsson, 2008). It is commonly prompted by social situations that involve rejection, abandonment, and/or isolation”
From A developmental, mentalization-based approach to the understanding and treatment of borderline personality disorder (2009) · cites this paper as Zanarini & Frankenburg, 2007
Cites
Soler, J., Pascual, J. C., Campins, J., Barrachina, J., Puigdemont, D., Alvarez, E., & Pérez, V. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.6.1221 · Cited by 224 · see citing works
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Fonagy, P., & Luyten, P. (2009) · Development and Psychopathology · doi:10.1017/s0954579409990198 · Cited by 1,146 · see citing works
“Third, the experience of intense inner pain out of keeping with the significance of the event may be a core feature of BPD (Zanarini & Frankenburg, 2007) frequently associated with disturbed relationships (Gunderson & Lyons-Ruth, 2008), and childhood abuse and neglect (Holm & Severinsson, 2008).”
BackgroundAhern, T. H. (2009) · Frontiers in Behavioral Neuroscience · doi:10.3389/neuro.08.017.2009 · Cited by 239 · see citing works
Sharp, C., & Fonagy, P. (2015) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12449 · Cited by 237 · see citing works
Complex PTSD, affect dysregulation, and borderline personality disorder
Ford, J. D., & Courtois, C. A. (2014) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/2051-6673-1-9 · Cited by 182 · see citing works
Ferrer, M., Andión, Ó., Calvo, N., Ramos-Quiroga, J. A., Prat, M., Corrales, M., & Casas, M. (2017) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-016-0733-2 · Cited by 38 · see citing works
Fertuck, E. A., Karan, E., & Stanley, B. (2016) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-016-0036-2 · Cited by 40 · see citing works
Lengvenyte, A., Strumila, R., Courtet, P., Kim, S. Y. H., & Olié, E. (2020) · The Canadian Journal of Psychiatry · doi:10.1177/0706743720931237 · Cited by 13 · see citing works
MDMA-assisted therapy for borderline personality disorder
Inouye, A. M., Wolfgang, A. S., & Philhower, L. T. (2023) · Journal of Psychedelic Studies · doi:10.1556/2054.2023.00196 · Cited by 1 · see citing works
- Authors
- Zanarini, M. C., & Frankenburg, F. R.
- Affiliations
- Harvard University (US)
- ORCID
- Zanarini, Mary C.
- Venue
- Journal of Personality Disorders
- Publisher
- Guilford Publications
- Published
- 2007-10
- Volume
- 21
- Issue
- 5
- Pages
- 518-535
- ISSN
- 0885-579X (ISSN-L)
- OpenAlex
- W2054272395
- Cited by
- 146
- References
- 1
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 10 · 2023: 9 · 2022: 3 · 2021: 9 · 2020: 4 · 2019: 16 · 2018: 6 · 2017: 4 · 2016: 7 · 2015: 10 · 2014: 7 · 2013: 10 · 2012: 17
- FWCI
- 7.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Personality Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MH-62169, R29MH047588, R01MH062169, MH-47588)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- borderline personality disorder, affective pain, pain management, interpersonal functioning, temperament, etiology, disease classification, treatment
- MeSH terms
- Affective Symptoms, Borderline Personality Disorder, Defense Mechanisms, Humans, Human Development, Identity Crisis, Impulsive Behavior, Self Concept, Somatoform Disorders
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