Skip to main content
SpringerLink
Log in

Borderline Personality Disorder

  • Chapter
  • First Online:
Principle-Based Stepped Care and Brief Psychotherapy for Integrated Care Settings

  • 1617 Accesses

Abstract

Borderlinepersonality disorder is one the most difficult clinical presentations facing primary care practitioners. Individuals with the disorder often present with severe symptoms, challenging interpersonal styles, and excessive demands for resources and time. As such, healthcare workers should be familiar with the disorder and the evidence regarding its clinical presentation and treatment. This chapter provides a primer for healthcare workers in the theory, assessment, treatment, and management of the disorder within an integrated care setting, while also offering practical advice and tools to facilitate improved patient outcomes for this often challenging population.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Alden, L. E., Wiggins, J. S., & Pincus, A. L. (1990). Construction of circumplex scales for the inventory of interpersonal problems. Journal of Personality Assessment, 55, 521–536.

    Article  PubMed  Google Scholar 

  • American Psychological Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

    Book  Google Scholar 

  • Ansell, E. B., Sanislow, C. A., McGlashan, T. H., & Grilo, C. M. (2007). Psychosocial impairment and treatment utilization by patients with borderline personality disorder, and other personality disorders, mood and anxiety disorders, and a healthy comparison group. Comprehensive Psychiatry, 48, 329–336.

    Article  PubMed  Google Scholar 

  • Bateman, A., & Fonagy, P. (2010). Mentalization based treatment for borderline personality disorder. World Psychiatry, 9, 11–15.

    Article  PubMed  PubMed Central  Google Scholar 

  • Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.

    Article  PubMed  Google Scholar 

  • Bellino, S., Rinaldi, C., & Bogetto, F. (2010). Adaptation of interpersonal psychotherapy to borderline personality disorder: a comparison of combined therapy and single pharmacotherapy. The Canadian Journal of Psychiatry, 55(2), 74–81.

    Google Scholar 

  • Ben-Porath, D. D. (2004). Strategies for securing commitment to treatment from individuals with borderline personality disorder. Journal of Contemporary Psychotherapy, 34(3), 247–263.

    Article  Google Scholar 

  • Berenson, K. R., Gregory, W. E., Glaser, E., Romirowsky, A., Rafaeli, E., Yang, A., & Downey, G. (2016). Impulsivity, rejection sensitivity, and reactions to stressors in borderline personality disorder. Cognitive Therapy and Research, 40(4), 510–521.

    Article  PubMed  PubMed Central  Google Scholar 

  • Black, D. W., Blum, N., Pfohl, B., & Hale, N. (2004). Suicidal behavior in borderline personality disorder: Prevalence, risk factors, prediction, and prevention. Journal of Personality Disorders, 18(3), 226.

    Article  PubMed  Google Scholar 

  • Bourne, E. J. (2005). The anxiety and phobia workbook (4th ed.). New Harbinger: Oakland, CA.

    Google Scholar 

  • Chanen, A. M., Jovev, M., Djaja, D., McDougall, E., Yuen, H. P., Rawlings, D., & Jackson, H. J. (2008). Screening for borderline personality disorder in outpatient youth. Journal of Personality Disorders, 22(4), 353–364.

    Article  PubMed  Google Scholar 

  • De Panfilis, C., Marchesi, C., Cabrino, C., Monici, A., Politi, V., Rossi, M., & Maggini, C. (2012). Patient factors predicting early dropout from psychiatric outpatient care for borderline personality disorder. Psychiatry Research, 400, 422–429.

    Article  Google Scholar 

  • de Reus, R. J. M., van den Berg, J. F., & Emmelkamp, P. M. G. (2011). Personality diagnostic questionnaire 4+ is not useful as a screener in clinical practice. Clinical Psychology and Psychotherapy, 20, 49–54.

    Article  PubMed  Google Scholar 

  • Deffenbacher, J. L., Oetting, E. R., & DiGisueppe, R. A. (2002). Principles of empirically interventions to applied anger management. The Counseling Psychologist, 30, 262–280.

    Article  Google Scholar 

  • Dimidjian, S., Martell, C. R., Addis, M. E., & Herman-Dunn, R. (2008). Behavioral activation for depression. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders: A step-by-step treatment manual (4th ed., pp. 328–364). Guilford Press: New York, NY.

    Google Scholar 

  • Distel, M. A., Trull, T. J., Willemsen, G., Vink, J. M., Derom, C. A., Lynskey, M., … Boomsma, D. I. (2009). The five-factor model of personality and borderline personality disorder: A genetic analysis of comorbidity. Biological Psychiatry, 66(12), 1131–1138.

    Article  PubMed  Google Scholar 

  • Grant, B. F., Chou, S. P., Goldstein, R. B., Huang, B., Stinson, F. S., Saha, T. D., … Ruan, W. J. (2009). Prevalence, correlates, disability and comorbidity of DSM-IV borderline personality disorder: Results from the wave 2 national epidemiologic survey on alcohol and related conditions. The Journal of Clinical Psychiatry, 69, 533–545.

    Article  Google Scholar 

  • Gross, R., Olfson, M., Gameroff, M., Shea, S., Feder, A., Fuentes, M., … Weissman, M. M. (2002). Borderline personality disorder in primary care. Archives of Internal Medicine, 162, 53–60.

    Article  PubMed  Google Scholar 

  • Gutheil, T. G. (2004). Suicide, suicide litigation, and borderline personality disorder. Journal of Personality Disorders, 18(3), 248–256.

    Article  PubMed  Google Scholar 

  • Hasler, G., Hopwood, C. J., Brandle, L. S., & Schute-Vels, T. (2014). Patient-reported outcomes in borderline personality disorder. Dialogues in Clinical Neuroscience, 16(2), 255–266.

    PubMed  PubMed Central  Google Scholar 

  • Hopwood, C. J., Newman, D. A., Donnellan, M. B., Markowitz, J. C., Grilo, C. M., Sanislow, C. A., … Morey, L. C. (2009). The stability of personality traits in individuals with borderline personality disorder. Journal of Abnormal Psychology, 118, 806–815.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hunter, C. L., Goodie, J. L., Oordt, M. S., & Dobmeyer, A. C. (2009). Integrated behavioral health in primary care: Step-by-step guidance for assessment and intervention. Washington, DC: American Psychological Association.

    Book  Google Scholar 

  • Hyler, S. E. (1994). PDQ-4+ manual. New York, NY: NiJo.

    Google Scholar 

  • Kroenke, K., & Spitzer, R. L. (2002). The PHQ-9: A new depression and diagnostic severity measure. Psychiatric Annals, 32, 509–521.

    Article  Google Scholar 

  • Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: The Guilford Press.

    Google Scholar 

  • Magill, M. K., & Garrett, R. W. (1987). Borderline personality disorder. American Family Physician, 35, 187–195.

    PubMed  Google Scholar 

  • McKay, M., Wood, J. C., & Brantley, J. (2007). The dialectical behavior therapy skills workbook. Oakland: New Harbinger.

    Google Scholar 

  • Morland, L. A., Greene, C. J., Rosen, C. S., Foy, D., Reilly, P., Shore, J., … Frueh, B. C. (2010). Telemedicine for anger management therapy in a rural population of combat veterans with posttraumatic stress disorder: A randomized noninferiority trial. Journal of Clinical Psychiatry, 71, 855–863. https://doi.org/10.4088/JCP.09m05604blu

    Article  PubMed  Google Scholar 

  • National Collaborating Centre for Mental Health. (2009). Borderline personality disorder: Treatment and management. National clinical practice guideline number 78. Leicester: The British Psychological Society and the Royal College.

    Google Scholar 

  • Nezu, A. M., Nezu, C. M., & D’Zurilla, T. (2013). Problem-solving therapy: A treatment manual. New York, NY: Springer.

    Google Scholar 

  • Oldham, K. M. (2006). Borderline personality disorder and suicidality. The American Journal of Psychiatry, 163, 20–26.

    Article  PubMed  Google Scholar 

  • Poreh, A. M., Rawlings, D., Claridge, G., Freeman, J. L., Faulkner, C., & Shelton, C. (2006). The BPQ: A scale for the assessment of borderline personality based on DSM-IV criteria. Journal of Personality Disorders, 20(3), 247–260.

    Article  PubMed  Google Scholar 

  • Reid, W. H. (2009). Borderline personality disorder and related traits in forensic psychiatry. Journal of Psychiatric Practice®, 15(3), 216–220.

    Article  Google Scholar 

  • Riihimaki, K., Vuorilehto, M., & Isometsa, E. (2014). Borderline personality disorder among primary care depressive patients: A five year study. Journal of Affective Disorders, 155, 303–306.

    Article  PubMed  Google Scholar 

  • Rollnick, S., Miller, W. R., & Butler, C. C. (2008). Motivational interviewing in health care: Helping patients change behavior. New York, NY: The Guilford Press.

    Google Scholar 

  • Samuel, D. B., & Widiger, T. A. (2008). A meta-analytic review of the relationships between the five-factor model and DSM-IV-TR personality disorders: A facet level analysis. Clinical Psychology Review, 28, 1326–1342.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sansone, R. A., Farukhi, S., & Wiederman, M. W. (2011). Utilization of primary care physicians in borderline personality. General Hospital Psychiatry, 33, 343–346.

    Article  PubMed  Google Scholar 

  • Sansone, R. A., Leung, J. S., & Wiederman, M. W. (2012). Litigious history and borderline personality symptomatology. The primary care companion for CNS disorders, 14(6).

    Google Scholar 

  • Sansone, R. A., & Sansone, L. A. (2010). Measuring self-harm behavior with the self-harm inventory. Psychiatry, 7(4), 16–20.

    Google Scholar 

  • Sansone, R. A., & Sansone, L. A. (2015). Borderline personality in the medical setting. The Primary Care Companion for CNS Disorders, 17(3), https://doi.org/10.4088/PCC.14r01743.

  • Sansone, R. A., & Wiederman, M. W. (2015). The self-harm inventory: A meta-analysis of its relationship to the personality diagnostic questionnaire-4 as a measure of borderline personality disorder. International Journal of Psychiatry in Clinical Practice, 19(4), 44–293. https://doi.org/10.3109/13651501.2015.1074708

    Article  Google Scholar 

  • Sansone, R. A., Wiederman, M. W., & Sansone, L. A. (1998). The self-harm inventory (SHI): Development of a scale for identifying self- destructive behaviors and borderline personality disorder. Journal of Clinical Psychology, 54, 973–983.

    Article  PubMed  Google Scholar 

  • Sinnaeve, R., Bosch, L., & Steenbergen‐Weijenburg, K. M. (2015). Change in interpersonal functioning during psychological interventions for borderline personality disorder—a systematic review of measures and efficacy. Personality and mental health, 9(3), 173–194..

    Google Scholar 

  • Soloff, P. H., Lynch, K. G., Kelly, T. M., Malone, K. M., & Mann, J. J. (2000). Characteristics of suicide attempts of patients with major depressive episode and borderline personality disorder: A comparative study. American Journal of Psychiatry, 157, 601–608.

    Article  PubMed  Google Scholar 

  • Stoffers, J. M., & Lieb, K. (2015). Pharmacotherapy for borderline personality disorde—Current evidence and recent trends. Current Psychiatry Reports, 17, 534.

    Article  PubMed  Google Scholar 

  • Stoffers, J., Vollm, B. A., Rucker, G., Timmer, A., Huband, N., & Lieb, K. (2010). Pharmacological interventions for borderline personality disorder. Cochrane Database of Systematic Reviews.

    Google Scholar 

  • Yoemans, F. E., Clarkin, J. F., & Kernberg, O. F. (2002). A primer for transference focused psychotherapy for the borderline patient. Northvale, NJ: Jason Aronson.

    Google Scholar 

  • Zanarini, M. C. (2009). Psychotherapy of borderline personality disorder. Acta Psychiatrica Scandinavica, 120, 373–377.

    Article  PubMed  Google Scholar 

  • Zanarini, M. C., Vujanovic, A. A., Parachini, E. A., Boulanger, J. L., Frankenburg, F. R., & Hennen, J. (2003). A screening measure for borderline personality disorder: The McLean screening instrument for BPD (MSI-BPD). Journal of Personality Disorders, 17, 568–573.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Psychology, Eastern Michigan University, Ypsilanti, MI, USA

    Eamonn Arble Ph.D.

  2. Rainbow Rehabilitation Centers, Livonia, MI, USA

    Laura Krasean Ph.D.

Authors
  1. Eamonn Arble Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Laura Krasean Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eamonn Arble Ph.D. .

Editor information

Editors and Affiliations

  1. Eastern Michigan University, Ypsilanti, Michigan, USA

    Alexandros Maragakis

  2. Department of Clinical Psychology, University of Nevada, Reno, Nevada, USA

    William T. O'Donohue

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Arble, E., Krasean, L. (2018). Borderline Personality Disorder. In: Maragakis, A., O'Donohue, W. (eds) Principle-Based Stepped Care and Brief Psychotherapy for Integrated Care Settings. Springer, Cham. https://doi.org/10.1007/978-3-319-70539-2_8

Download citation

Publish with us

Policies and ethics

Search

Navigation