Borderline Personality Disorder Case Study

Borderline personality disorder (BPD) is considered one of the most complex personality disorders, not only because of its presentation, but also because of the high co-morbidity with other mental disorders. The studies included in this report aimed to investigate the prevalence, aetiology, co-morbidity and neurobiological factors associated with the disorder.
Co-morbidity of Bipolar Disorder and Borderline Personality Disorder in a Large Community Sample
Background/purpose
The existent literature suggests that a person with BPD would be more likely to receive a diagnosis of another mental disorder compared to a person without the disorder. It seems, that bipolar disorder (BD) among BPD individuals is frequently reported. A recent study assessed

Structured interviews were conducted for all participants and BPD symptoms were assessed using the Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Nine DSM-IV BPD symptoms were included in the analysis: frantic efforts to avoid real/imagined abandonment, unstable/intense personal relationships, identity disturbance, impulsivity, suicidal/self-mutilation behaviour, affective instability, chronic feelings of emptiness, inappropriate/intense anger, and stress-related paranoid ideation.
A total of 1030 participants met criteria for DSM-IV BPD and analyses were carried out for this subsample. The prevalence rate of suicidal/self-mutilation behaviour, affective instability and chronic feelings of emptiness was higher in women. In contrast, the prevalence of frantic efforts to avoid real/imagined abandonment, identity disturbance, impulsivity and stress-related paranoid ideation was higher in men.
Statistical and clinical significant sex differences were found for four out of nine DSM-IV BPD symptoms. Analyses revealed that symptoms including suicidal/self-mutilation behaviour, affective instability and chronic feelings of emptiness were more discriminant for women than men (i.e. women were more likely to report these symptoms); while impulsivity was more likely to be reported by men.

Caution needs to be taken when generalising the findings of this research to men, as well as BPD patients without co-morbidities. However, it invites other researchers to expand the neuroimaging literature in order to understand the neurobiological basis of BPD.
Neurobiological correlates of Symptoms of Borderline Personality Disorder: The role of White Matter
Background/purpose
It is well known that white matter tissue connects brain regions and structures. Limited neuroimaging studies have highlighted the importance of connective paths in the brain in the pathogenesis of disorders such as BPD. As a consequence Whalley et al. (2015) explored whether three fronto-limbic tracts (i.e. white matter pathways) were correlated with measures of trauma-related childhood experiences and BPD symptomatology.
Methodology/results
All participants in the study (18 controls and 20 BPD patients) underwent magnetic resonance imaging. Additional measures included a pre-morbid intelligence assessment, self-report questionnaires for depression, mania, experiences of childhood trauma and BPD