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Borderline Personality Disorder: Toward Integration

Published online by Cambridge University Press:  07 November 2014

Dan J. Stein
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Abstract

Several psychiatric disorders, including borderline personality disorder (BPD), are characterized by emotional dysregulation and impulse dyscontrol. More specifically, symptoms in patients with BPD often occur within the context of disruptions in attachment and related distortions in cognitive-affective processing of the self and others. From a neurocircuitry perspective, findings include prefrontal hypoactivity, amygdala hyperreactivity, and alterations in prefrontal-limbic interaction. Molecular pathways relevant to these circuits include the serotonergic, noradrenergic, and dopaminergic systems, and there is some evidence that pharmacotherapy with agents that act on these systems may be useful. Given the disruptions in attachment and schemas of the self and others in BPD, establishing a therapeutic alliance is crucial while psychotherapy remains the cornerstone of an integrated approach to management.

Type
Pearls in Clinical Neuroscience
Information
CNS Spectrums , Volume 14 , Issue 7 , July 2009 , pp. 352 - 356
Copyright
Copyright © Cambridge University Press 2009

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