Borderline Personality Disorder Research Overview

Here is an overview/timeline highlighting some key moments in history for BPD research.

1938

  • The term “borderline” was first introduced. It was used to describe patients with conditions bordering on schizophrenia. These patients were considered untreatable.

1980’s

  • “Borderline Personality Disorder” became a diagnosis characterized by specific criteria in the DSM-III. However, borderline personality disorder (BPD) was still not well-understood, nor effectively treated with psychoanalysis or medication.

1990’s

  • Clinical research studies established the validity of BPD.
  • Highly effective BPD-specific treatments were developed such as Dialectical Behavior Therapy (DBT).
  • Two NIMH-funded longitudinal studies found a surprisingly good prognosis for BPD, i.e., 80% of those with BPD improved over time.
  • The “good-prognosis diagnosis” brought tremendous hope to many.
  • Later studies showed that although remission of symptoms is high, only 50% of BPD individuals achieve recovery, characterized by good social functioning and successful employment.

2000's - Present

  • Researchers began to focus on investigating the underlying biology of BPD.
  • A genetic study showed that BPD has a significant genetic component (68%), debunking the view that BPD is exclusively due to environmental causes, and helping to establish it as a “brain disease.”
  • Neurobiological studies have found that the emotion center of the brain (amygdala) is overactive in individuals with BPD, while the thought center of the brain (prefrontal cortex) is underactive. This inability to modulate different centers of the brain helps to explain the emotional dysregulation seen in those with BPD.

Looking Toward the Future...

Future areas of BPD Research could include:

  • Finding biomarkers and other tools for earlier and more accurate diagnosis
  • Establishing treatments that will lead from remission to recovery
  • Pursuing new and promising avenues generated from genetic, neuroscience and clinical research to better understand and treat BPD
  • Developing a BPD-specific medication
“There’s this overactive emotionality and no capacity to put the brakes on.”
Dr. John Oldham, former President of the American Psychiatric Association, explains BPD-related brain function. *
*Video segment from the Congressional Briefing on Borderline Personality Disorder in 2010 sponsored by the National Education Alliance for Borderline Personality Disorder and the National Alliance on Mental Illness.