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Does Your Loved One Have Borderline Personality
Disorder?
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Disorder.
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Borderline Personality Disorder
Recent Research Findings
National Institute of Mental Health
Although the cause of BPD is unknown, both environmental and genetic factors
are thought to play a role in predisposing patients to BPD symptoms and traits.
Studies show that many, but not all individuals with BPD report a history of
abuse, neglect, or separation as young children.8 Forty to 71 percent of BPD
patients report having been sexually abused, usually by a non-caregiver.9
Researchers believe that BPD results from a combination of individual
vulnerability to environmental stress, neglect or abuse as young children, and a
series of events that trigger the onset of the disorder as young adults. Adults
with BPD are also considerably more likely to be the victim of violence,
including rape and other crimes. This may result from both harmful environments
as well as impulsivity and poor judgment in choosing partners and lifestyles.
NIMH-funded neuroscience research is revealing brain mechanisms underlying
the impulsivity, mood instability, aggression, anger, and negative emotion seen
in BPD. Studies suggest that people predisposed to impulsive aggression have
impaired regulation of the neural circuits that modulate emotion.10 The amygdala,
a small almond-shaped structure deep inside the brain, is an important component
of the circuit that regulates negative emotion. In response to signals from
other brain centers indicating a perceived threat, it marshals fear and arousal.
This might be more pronounced under the influence of drugs like alcohol, or
stress. Areas in the front of the brain (pre-frontal area) act to dampen the
activity of this circuit. Recent brain imaging studies show that individual
differences in the ability to activate regions of the prefrontal cerebral cortex
thought to be involved in inhibitory activity predict the ability to suppress
negative emotion.11
Serotonin, norepinephrine and acetylcholine are among the chemical messengers
in these circuits that play a role in the regulation of emotions, including
sadness, anger, anxiety, and irritability. Drugs that enhance brain serotonin
function may improve emotional symptoms in BPD. Likewise, mood-stabilizing drugs
that are known to enhance the activity of GABA, the brain's major inhibitory
neurotransmitter, may help people who experience BPD-like mood swings. Such
brain-based vulnerabilities can be managed with help from behavioral
interventions and medications, much like people manage susceptibility to
diabetes or high blood pressure.7
References:
7Siever LJ, Koenigsberg HW. The frustrating no-mans-land of
borderline personality disorder. Cerebrum, The Dana Forum on Brain Science,
2000; 2(4).
8Zanarini MC, Frankenburg. Pathways to the development of
borderline personality disorder. Journal of Personality Disorders, 1997; 11(1):
93-104.
9Zanarini MC. Childhood experiences associated with the
development of borderline personality disorder. Psychiatric Clinics of North
America, 2000; 23(1): 89-101.
10Davidson RJ, Jackson DC, Kalin NH. Emotion, plasticity, context
and regulation: perspectives from affective neuroscience. Psychological
Bulletin, 2000; 126(6): 873-89.
11Davidson RJ, Putnam KM, Larson CL. Dysfunction in the neural
circuitry of emotion regulation - a possible prelude to violence. Science, 2000;
289(5479): 591-4.
NIH 2001
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