Research on borderline personality disorder: an update

PURPOSE OF REVIEWWe will summarize the recent literature on borderline personality disorder, a disorder that receives a great deal of clinical and research attention. RECENT FINDINGSBorderline personality disorder can be diagnosed reliably, and is quite prevalent in clinical and in non-clinical settings. Borderline personality disorder is co-morbid with a number of conditions, and recent research has focused on the co-morbidity with bipolar spectrum disorders. Recent etiological research has focused on childhood attachment, genetics, and neurobiological correlates of borderline personality disorder and underlying traits. As for course and treatment, the features of borderline personality disorder appear to be relatively stable in young adulthood and are associated with a wide range of impairment. Recent guidelines suggest that some combination of cognitive-behavioral therapy, psychodynamic therapy, and medication are likely to be most effective in treating borderline personality disorder symptoms. Finally, suicidal behavior is a common complication, and continues to be a chief concern in the clinical management of borderline personality disorder. SUMMARYMore studies are needed to explore the role of gender in the diagnosis and treatment of borderline personality disorder. Future etiological studies should be multivariate in nature, so that the relative contribution of putative etiological factors can be determined. More high-quality studies of different treatments for borderline personality disorder will shed light on issues such as efficacy and cost-effectiveness. Suicide is a chronic threat in those with borderline personality disorder. More studies exploring the reasons for engaging in suicidal behavior as well as the role of clinicians in managing this behavior are needed.