Comments on: BPD more prevelant than previously thought?

By: Amy Winehouse and BPD > Borderline Personality Disorder « Anything to Stop the Pain – BPD and Non-BPDs

Tue, 06 Dec 2011 16:20:08 +0000

[...] to generalize a bit. First of all, it is tragic that BPD is “little known” because it is much more prevalent than bipolar disorder. The article says: “Sufferers have feelings of anger, emptiness, shame and guilt and become [...]

By: Tormented

Tormented — Mon, 19 Jan 2009 10:33:13 +0000

Bon Dobbs,

It seems that BPD has a genetic component and recent research is backing up that assessment. As you know, fraternal twins have different genes, so that could provide some of the answer to your question.

A Missouri University research working with Dutch associates and their twin registry database came to the conclusion that chromosome 9 looks like it most likely has genetic linkage for BPD, but chromosomes 1, 4, and 18 might also have some involvement.

BPD Linked to Human Chromosome 9

By: Bon Dobbs

Bon Dobbs — Tue, 13 Jan 2009 00:14:15 +0000

No, it’s not a personality disorder. IMO it is a combo of three things – two of which can be attributed to biology and one of which can be attributed to environment – those are emotional dysregulation (biology), impulsiveness (biology) and shame (environment). But shame is only develops when the previous two are rejected as invalid by others. It is a biological disorder of emotional dysregulation and impulsiveness. And when those two collide, the behaviors that result are rejected as invalid by parents, peers and others – which spurs shame. I believe it is a biological disorder which is not recognized as such by current science. It is categorized as a personality disorder in error. Sure, it’s long-term – but IMO so is biploar I and epilepsy. Right? It is time to lay down the Axis II (for ALL the axis II disorders) and meet the challenges head on. I’m sorry (I’m just a lay person) but I can’t understand how I have two twin girls (fraternal), raised in the same environment, the same womb, the same room and with the same rules – and have one that is BPD-ish and one who is not. Explain that to me doctors, please.

Bon

By: Amanda

Amanda — Mon, 12 Jan 2009 22:27:13 +0000

Bon, you wrote: I was thinking about this 12 month vs. lifetime prevalence level – it’s this supposed to be a personality disorder? It would seem that the differences in those statistics would facilitate a discussion about taking the term “personality” out of the name of the disorder.

Exactly! I think that this is just another reason to eventually move BPD to an Axis I disorder. We know that BPD is highly treatable and that over 80% of patients no longer meet criteria for BPD after 10+ years. Add effective treatment, psychoeducation, and an excellent support system and you’ve got a really good prognosis.

We know that some BPD traits (feelings of emptiness, anger) may be more stubbornly enduring than others but, overall, I think you’re right—this isn’t always a lifetime “personality” issue.

By: Bon Dobbs

Bon Dobbs — Mon, 12 Jan 2009 20:59:09 +0000

It seems though that the opposite would make more sense for me. Let’s take bipolar disorder, which is Axis I and no “shorter in duration” than borderline personality disorder. Is it? It seems without medication, since it is a recognized organic disorder, that it would be just as long-lasting as BPD. Clinical Depression or Major Depressive Disorder also, untreated, seems like they would last longer. It seems that your argument can’t go both ways… I mean, if we compare life-time rates in this study of 35,000 individuals and comes up with 5.9% and then we compare 12 month prevalence and come up with 1.6%, how is that explained? To me it makes no sense unless the “personality” disorder falls off at some point, or do I have it wrong.

What I am saying here is that if you ask someone if they have EVER had BPD traits or behaviors (the 5 of 9 criteria) and they say “yes” and then if you ask, have these occurred in last 12 months and they say “no” – it appears that those responses would debunk the “personality” disorder part of the argument.

By: John Grohol

John Grohol — Mon, 12 Jan 2009 20:48:13 +0000

Good point, but I’d come at it from the opposite direction. Given that personality disorders are, by definition, long-lasting and not always easy to change, they aren’t like Axis I disorders which are typically shorter in duration. So I’m not sure it makes much sense to talk about a 12-month prevalence rate for a personality disorder, since for most people and most personality disorders, they tend to last a lot longer than 12 months.

By: Bon Dobbs

Bon Dobbs — Mon, 12 Jan 2009 17:44:24 +0000

You know though… I was thinking about this 12 month vs. lifetime prevalence level – it’s this supposed to be a personality disorder? It would seem that the differences in those statistics would facilitate a discussion about taking the term “personality” out of the name of the disorder.

By: Bon Dobbs

Bon Dobbs — Mon, 12 Jan 2009 17:38:07 +0000

Yes, that makes sense – lifetime vs. 12 month. I have always heard the 1.5-2% rate and didn’t know to which time frame it was related. Thanks for the comment!

By: John Grohol

John Grohol — Mon, 12 Jan 2009 17:36:01 +0000

I was struck by that number as well, and was doing a little more research on this issue. I wonder if the disconnect is looking at 12-month prevalence versus lifetime prevalence levels…

Another large-scale population survey with results published just a year earlier showed a 1.6% 12-month prevalence level:

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2044500