Fast Five Quiz: Borderline Personality Disorder

Stephen Soreff, MD

Disclosures

March 09, 2021

Most theories about the cause or pathogenesis of borderline personality disorder include the notion of a biologic predisposition along with psychological and environmental factors. Neurobiological development may be affected by a combination of disruption of early attachments and subsequent trauma, leading to hyperresponsiveness of the attachment system. During emotional arousal, images of self and object are affected, and the individual begins to use primitive defense mechanisms. A history of abuse is very common. Although no significant difference in the rate of borderline personality disorder between females and males has been seen in the general population, a female-to-male ratio of 3:1 has been reported in the clinical setting. This finding may reflect that women are more likely than men to seek mental health treatment. No evidence suggests a relationship between race and the diagnosis of borderline personality disorder. Obsessive-compulsive personality disorder appears to be the most prevalent personality disorder, with rates as high as 5% in some studies (compared with around 1.6% for borderline personality disorder).

Symptoms of borderline personality disorder are usually present by late adolescence, but the diagnosis has been made in children. The initial diagnosis is rarely made in patients older than 40 years. The incidence of the disorder tends to decrease after age 40, partly because personality disorders often decrease with age and partly because some who have the disorder die by suicide and thus are no longer part of the population.

Read more about the background of borderline personality disorder.

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