Encore - What is borderline personality disorder? With Carla Sharp, PhD
Dec 25, 2024
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Carla Sharp, PhD, a leading expert in social cognition and psychiatric disorders at the University of Houston, shares her insights on borderline personality disorder (BPD). She discusses the complexities of diagnosing BPD, particularly in adolescents, and highlights the importance of nurturing environments. She also addresses the shift from categorical to dimensional models of understanding personality disorders, emphasizing the need for continuous empirical research. Carla offers practical strategies for family members to support loved ones affected by BPD.
Borderline Personality Disorder is characterized by intense emotions and chaotic relationships, complicating its diagnosis due to overlapping traits with other disorders.
The evolution of diagnostic criteria for personality disorders reflects a shift towards a dimensional understanding of personality functioning, emphasizing individuals' adaptive capabilities.
Borderline Personality Disorder is characterized by intense emotions, often manifesting as hostility, anger, or depression. Individuals with BPD may experience impulsive actions and chaotic interpersonal relationships, along with a profound fear of abandonment and a tendency to perceive situations in extreme terms, often as black or white. Notably, those with BPD can exhibit a façade of normalcy, making the disorder challenging to diagnose. This complexity leads to critical discussions about its distinctiveness from other personality disorders and how individuals can identify whether they or someone they know may be affected.
Shifts in Personality Disorder Diagnosis
The diagnostic criteria for personality disorders have transitioned from a categorical to a dimensional system over the years, highlighting limitations in the traditional approach. Historically, personality disorders were defined strictly, similar to the condition of pregnancy—one either had the disorder or did not. However, research now indicates significant overlap among the symptoms of various personality disorders, complicating accurate diagnosis. As a result, the DSM-5 includes both the categorical system with ten personality disorders and an alternative model emphasizing a broader, dimensional understanding of personality pathology.
Personal and Interpersonal Functioning
Emerging research suggests that all personality disorders, including BPD, share a common dimension referred to as personality functioning, which assesses an individual's ability to manage themselves in social contexts. A person's personality functioning can be viewed similarly to an intelligence quotient, where individuals fall on a continuum based on their adaptive or maladaptive behaviors in interpersonal contexts. Effective management of oneself and interactions with others is crucial, and significant challenges in this domain are indicative of personality disorders. Thus, understanding personality functioning as a spectrum may provide a more practical framework for diagnosis and treatment.
Identifying BPD in Adolescents
Diagnosing Borderline Personality Disorder in adolescents remains complex due to the tumultuous nature of adolescence, characterized by mood swings and impulsivity. Recent insights challenge previous beliefs that personality isn't stable until adulthood, indicating that children and adolescents may exhibit stable patterns early on. Clinicians now recognize that while many may show temporary increases in borderline traits during teenage years, a subset may develop persistent symptoms. Assessing protective factors in the adolescent's environment can help identify whether they are likely to outgrow symptoms or require further intervention.
Borderline personality disorder (BPD) is one of the most frequently diagnosed personality disorders, and one of the most misunderstood. Carla Sharp, PhD, of the University of Houston, discusses how BPD is diagnosed, defined and treated, how family members can help children and adults with BPD, and how the disorder fits in with researchers’ evolving understanding of personality disorders in general.