Borderline Personality Disorder

Borderline personality disorder is a disordered behavior pattern that develops by early adulthood, and is characterized by multiple types of psychological instability and impulsiveness, often involves intense and frequent mood changes, fear of abandonment, and a risk of suicide according to Merriam-Webster.com. In Oldham’s article “Personality Disorders” he states that in many important ways, we are what we do. It is easier to determine the “what” of our personality rather than the “why”. We all have unique personalities and no two people are the same, for instance like our fingerprints. Individuals’ temperament is a key component of a person’s developing personality, along with the shaping and molding influences of family, caretakers, and environmental experiences. Personality disorders are diagnosed by a classical system of descriptive psychopathology within a framework adopted by the American Psychiatric Association (APA) and published in its Diagnostic and Statistical Manual of Mental Disorders (DSM) (). The DSM has had many revisions with the latest revision being published in 2000. The Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV-TR) is used to diagnose psychiatric illness. The DSM-IV TR has a multiaxial approach that includes five dimensions. Axis I: Clinical Syndromes, Axis II: Personality and Mental Retardation, Axis III: Medical Conditions, Axis IV: Psychosocial and Environmental Problems, and Axis V: Global Assessment of Functioning (PsychiatryOnline.org). Oldham places personality disorders on Axis II and this is also a general consensus in the United States.
Oldham stated that any comprehensive clinical evaluation of a patient should include Axis II personality disorder pathology. However, he mentions that before a systematic exploration of a possible personality disorder categorical diagnoses is performed, a general assessment must be made in order to determine if the patient present generic elements of a personality disorder.
The treatment for patients with a personality disorder usually involves multiple forms of psychosocial and psychopharmacological treatment extensively (Bender, Dolan, Skodol, Sanislow, Dyck, Gunderson, McGlashan, Shea, Zanarini, and Oldham, 158:295—302). Oldham states that psychotherapy is the primary or core treatment combined with system targeted adjunctive pharmacotherapy (Oldham, 3:372-382). He also states that the ultimate choice of therapy depends on variables such as the therapist training and preference, patient preference, patient motivation, and the nature of the personality psychopathology in question (Oldham, 3:372-382).
The researcher used the descriptive research method. The text states that descriptive research is about describing some phenomenon determining its basic dimension and defining what this thing is, how often it occurs, and so on (King, 29). Descriptive research methods include observation, surveys and interviews, and case studies (King, 29). The basis for this study is to determine “why” we behave the way we do and to ensure that clinicians have a thorough understanding of the diagnostic testing used to diagnosis personality disorders. The hypothesis was that once an individual has reached late adolescence or young adulthood, his or her personality is usually well established. Change is the variable to this theory. Whether we change because of life experiences or simply because we want to, it must be noted that change is possible. The researcher used the structural diagnostic system along with assessments to diagnose and treat his patients. He did not rely upon personal theories or beliefs, but used the tools that are in place to make a comprehensive diagnosis. The researcher found that along with other clinicians that personality disorders should be categorized under Axis II. This study was worthwhile and gave me a better understanding of how clinicians diagnose patients. I am glad to know that there is a system in place that seems to be working and has been revised to better meet the needs of the patients.