Borderline personality disorder (BPD) is a psychological condition marked by impulsivity, mood swings, and emotional instability. It affects somewhere between 0.7% to 2.7% of the general adult population. [3] The term “borderline personality disorder” has a unique history, but it is losing favor among both psychologists and patients today.
History of borderline personality disorder
The first known use of the term “borderline” was by psychologist Adolph Stern in 1938. [5] He used it to describe patients who were “on the border” between diagnoses of “neurosis” and “psychosis.” [5] It was characterized as a mild form of schizophrenia.
Then, in the late 1960s, psychoanalytic psychiatrist Otto Kernberg redefined it as “borderline personality organization.” [4] He believed it fell somewhere in between the neurotic and psychotic personality organizations. He recognized that it was not a type of schizophrenia but an enduring pattern of emotional irregularity. His work was vital in establishing many symptoms of BPD recognized today.
In 1980, borderline personality disorder was officially listed as a diagnosis in the DSM-III. [4] It is now recognized that BPD is not actually “on the border” of any other disorders. Instead, it is understood as a distinct pattern of emotions, thoughts, and behaviors.
Alternative names for borderline personality disorder
Today, borderline personality disorder is a controversial term that many psychologists believe is confusing and inaccurate. They also suggest that it adds to the stigma of the disorder. In fact, out of 400 leading personality disorder experts surveyed, 68.7% wanted to change the name within the DSM-V. [2]
Now that we know that it is not on the border of other disorders, clinicians have suggested other terms that more accurately reflect the emotional instability of BPD. One alternative name already used is emotionally unstable personality disorder (EUPD). While less common than BPD, this term is regularly used by the World Health Organization (WHO). [1]
Other suggested names include emotion dysregulation disorder and emotional intensity disorder (EID). [2]
- Bach, B., Kramer, U., Doering, S., di Giacomo, E., Hutsebaut, J., Kaera, A., De Panfilis, C., Schmahl, C., Swales, M., Taubner, S., & Renneberg, B. (2022). The ICD-11 classification of personality disorders: a European perspective on challenges and opportunities. Borderline Personality Disorder and Emotion Dysregulation, 9(1). https://doi.org/10.1186/s40479-022-00182-0
- Bernstein, D. P., Iscan, C., & Maser, J. (2007). Opinions of Personality Disorder Experts Regarding The DSM-IV Personality Disorders Classification System. Journal of Personality Disorders, 21(5), 536–551. https://doi.org/10.1521/pedi.2007.21.5.536
- Chanen, A., & McCutcheon, L. (2013). Prevention and early intervention for borderline personality disorder: Current status and recent evidence. British Journal of Psychiatry, 202(S54), S24-S29. doi:10.1192/bjp.bp.112.119180
- Gunderson, J. G. (2009). Borderline Personality Disorder: Ontogeny of a Diagnosis. American Journal of Psychiatry, 166(5), 530–539. https://doi.org/10.1176/appi.ajp.2009.08121825
- Stern, A. (1938). Psychoanalytic Investigation of and Therapy in the Border Line Group of Neuroses. The Psychoanalytic Quarterly, 7(4), 467–489. https://doi.org/10.1080/21674086.1938.11925367
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Danielle J. Harrison is writer and mental health counselor with a master's degree from The City College of New York.
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