Borderline personality disorder triggers turmoil and rage
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Much of the misunderstanding surrounding borderline personality disorder comes from the name itself. Historically, BPD has been seen as lying on the border between psychosis (having a severely distorted view of reality) and neurosis (a nonpsychotic mental condition marked by anxiety and distress).
But people who have BPD are no longer considered to be on the border of anything, UBC psychiatry professor Kerry Jang explains.
Jang, who has contributed to more than 100 published studies on personality disorders and is also a Vancouver city councillor, says it’s no wonder people are confused about BPD. Researchers have defined five broad domains of personality (extraversion, openness to experience, conscientiousness, agreeableness, and neuroticism), yet at the same time, the current edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders lists 10 personality-disorder diagnoses (including narcissistic personality disorder, which is marked by a lack of empathy, and antisocial personality disorder, in which people have no regard for right and wrong). In fact, researchers from Michigan State University, among others, are proposing changes to the way personality disorders are classified in the next DSM, which comes out in 2013. To make matters worse, different researchers use different scales to measure those five personality dimensions, and diagnoses tend to overlap.
“Everyone has different levels of subtraits, and the severity of personality disorders varies,” Jang says during an interview in his City Hall office. “It’s a spectrum; it’s not so black-and-white.”
It can be hard for people to get help, Jang notes, because so many who have the disorder don’t recognize the symptoms.
“Many people who have the illness don’t think they’re ill,” he explains. “They can be the sweetest and nicest person in the world one minute, then mad as hell the next.”
In some medical circles, the term borderline personality disorder isn’t used; rather, the same set of symptoms goes by the name “emotionally unstable personality disorder”. This is the name used by the World Health Organization’s International Classification of Diseases, 10th Revision.
Jang’s current research is focusing on causes of BPD. Specifically, he’s been studying genetic and environmental factors, and the intersection thereof. He and a team of researchers from Harvard University recently had a paper accepted for publication by the Archives of General Psychiatry, an internationally renowned medical journal. In their study, the authors conclude that heredity has a role in the development of BPD.
“This large family study confirms that BPD is passed on within families,” Jang says. However, although genetic factors likely play a part in BPD, no specific genes associated with the condition have yet been identified.
UBC psychiatry professor Kerry Jang discusses genetic links to borderline personality disorder.
Other risk factors for BPD include sexual or physical abuse.
According to the National Institute of Mental Health, 40 percent to 71 percent of BPD patients report having been sexually abused as children. Jackson says her brother sexually assaulted her repeatedly when she was growing up, a fact she says her parents brushed off when she finally told them years later. She now has no contact with her immediate family.
Neuroscientific research funded by the NIMH suggests that people who are predisposed to impulsive aggression have impaired regulation of the neural circuits that control emotion.