Abnormal Psychology

Personality Disorders 605

Treating Borderline Personality Disorder: New Treatments

Borderline personality disorder is among the most challenging personality disor-

ders to treat (Robins, Ivanoff, & Linehan, 2001). In part, treatment is challenging

because of the patient’s parasuicidal or suicidal thoughts and behaviors. It can also

be challenging because of the intense anger that a patient may direct at the men-

tal health clinician. Let’s examine the various targets of treatment—neurological

factors, psychological factors, and social factors—paying particular attention to a

comprehensive psychological treatment that is the treatment of choice: dialectical

behavior therapy.

13.8 • Feedback Loops in Action: Borderline Personality Disorder

Figure 13.8g3

Mental Processes and

Mental Contents

Hypervigilance for

threats

Affect

Emotional

dysregulation

Behavior

Impulsivity

Stressful Life Events

Abuse or neglect

Unstable

interpersonal

relationships

Genetics

Inherited

tendency for

emotional

dysregulation

and impulsivity

Neural Communication

NeuroPsychoSocial

Serotonin

Cortisol

Brain Systems

Frontal lobes

Anterior cingulate

Amygdala

Hippocampus

Overresponsive

HPA axis

NeuroPsychoSocial NeuroPsychoSocial

Family

Invalidation

of patient’s

experiences

Gender/Culture

No known major

contribution