《精神疾病诊断与统计手册》(DSM IV)将“边缘型人格障碍”定义为“边缘型人格障碍”
轴II紊乱，具有冲动和情绪化的症状“（Livesley 146）。有了BPD的人有遗弃和空虚的感情，并有“疯狂的努力来避免遗弃，以极端避免让某人离开”（汉堡300）。他或她情绪不稳定，形成强烈但不稳定的人际关系。他们表现出冲动的行为，例如花钱，性别，饮食和药物滥用。Borderlines从事自动操纵行为和经常发生的自杀企图和思想。“他们的行为可以被视为应对恒定情绪痛苦的不良方法”（Livesley 144）。“个性包括一个人的思想，情绪和行为的这些方面，影响他或她与他人的关系”（Livesley 98）。人格风格的差异（特征）为关系添加颜色和品种，但可能变得过于极端，不灵活或适应，显着损害了一个人的运作能力。当一个人无法应对环境的人或问题时，他或她据说有一个人格障碍（Livesley 99）。“最初，术语边界线用于指调整在正常和精神病之间的边界上的个人”（福尔摩斯393）。 Today borderline personality disorder is primarily marked by instability, showing different symptoms at different times. Most of the symptoms revolve around problems of mood, mild disturbance in thought processes, and impulsive self-injurious behavior (Holmes 393). All of this prevents the borderline to have interpersonal relationships. Individuals with the borderline personality disorder tend to have intense relationships that are very unstable. “Frequent interpersonal conflict, unstable, stormy relationships are characteristics of a borderline; Relationships usually have “love and hate characteristics” (Durand 334). Individuals with this disorder do not simply drift in and out of friendships, but instead show abrupt, frequent and dramatic changes between “intense love and equally intense hate” (Durand 334) in any one relationship. The fluctuations in their mood, involved with their anger; involved with their thought disturbances, and mixed with their paranoid thoughts about betrayal and abandonment by others; as well as their impulsiveness make it difficult to maintain relationships with others. Borderlines have problems with their mood. Their mood is not manic, but alternates between normal and flat to moderate or severe depression (Livesley 150). These individuals also go through periods of intense anger that can interfere with effective social functioning. Persons with borderline personality disorder are very vulnerable, and usually over-react to stress.
这些人通常形成不稳定和激烈的“爱情仇恨”的关系，一个人或情况是“全部”，或者有的话
问题发生了，“坏透了”(Durand 273)。“边缘型人的愤怒通常会疏远一段关系，但边缘型人会疯狂地努力避免真正或想象中的被抛弃”(Burger 299)。患有BPD的人会愤怒地害怕他们的朋友或所爱的人会抛弃他或她，他们会偶尔爆发愤怒，因为害怕那个人会抛弃他或她。最近的研究表明，当药物与心理治疗结合使用时，可以显著减轻边缘患者的痛苦(Livesley 145)。边缘型人格障碍患者会经历思维障碍。边缘性思维表现出“不寻常的感知”，包括幻觉、“错误或扭曲的感知”(卓别林220)和人格解体，“个体体验到自己或他的身体不真实的一种病理状态”(卓别林122)。患有这种疾病的人表现出“黑白思维”，在某些情况下很难看到“灰色”或妥协。”(杜兰139)。“边缘型人格障碍的特征是情绪、思想、人际关系和行为的不稳定性，这使得一些理论家相信，患有这种障碍的个体存在身份问题”(Holmes 222)。身份就是“个体的自我”(卓别林218)。也就是说，这种不稳定性反映了任何真正的自我意识或自我导向的缺乏，而且这些个体确实报告了一种空虚感(Durand 144)。 Individuals with BPD show self-mutilating and suicidal behavior. The self-mutilating is a serious symptom but not well understood. It involves “burning of one skin with a cigarette, carving up one’s body with a razor blade, making deep scratches with the finger nails, sandpapering the skin or pouring acid on oneself” (Durand 147). This behavior does not seem to want to result in death but self-mutilation is often done to feel or experience themselves as real (Durand 147). “Stress related dissociate symptoms such as paranoia; feeling as if they are losing touch with reality; feeling victimized; unable to accept responsibility” (Burger 562) can also cause a borderline to mutilate himself. The suicidal behavior stems from the feelings of depression and impulsively. Intense emotional instability, rapidly changing short-term moods and anxiety, chronic feelings of emptiness, sadness or depression may all lead to suicide attempts, or brief psychotic episodes.
边缘个性障碍在女性中最常见于男性（Livesley 156）。在临界人格障碍研究中的一个问题是这是否是精神分裂症和心情障碍的一种疾病或组合。Livesley的一个争论是边缘紊乱可以是精神分裂症和情绪障碍的“低级”组合，这种情绪障碍因脉冲控制的问题进一步复杂化。BPD估计影响2 - 3％的一般人群，11％的患者在门诊诊所和住院精神病患者（住院患者）（Livesley 157）中多达20％。大约8 - 10％的人因自杀而死亡。“BPD，难以诊断，通常被误诊为斯派比尔或Schizo-情感障碍，抑郁症，双相情感障碍或反社会人格障碍”（汉堡600）。BPD在许多公共卫生问题中发挥着重要作用，如药物滥用，家庭暴力，赌博，商店提升，性成瘾，艾滋病，无家可归，虐待和成人和青少年自杀。在监狱或监狱（汉堡600）中可以找到大量拥有BPD的人。由于频繁的住院和急诊室访问，那些有BPD的沉重用户是心理健康服务的沉重用户，因为自杀速度频繁。可能需要简要使用抗焦虑药物来缓解临界患者的情节，强烈焦虑（Livesley 144）。 “Latest research indicates that BPD is a biologically based disorder of the emotional regulation system which may be due to genetic, the environment or a combination of these two factors” (Livesley 150). These biological “vulnerabilities” may place a person at increased risk for developing BPD given certain developmental factors such as prenatal stresses, infections, nutritional deficits or stressful events in the early family environment (Livesly 160). Other family members may often have BPD, Major Depression, Bipolar Illness, or problems with addiction that may affect a person’s personality. “Serotonin, a chemical messenger (neurotransmitter) in the brain, that is important in regulating mood and aggressive, impulsive, and suicidal behavior” (Livesley 162). Abnormal levels of serotonin in the brain may impair the ability to control one’s impulses and increase the chance of suicide (Durand 150). “Dopamine, a neurotransmitter in the brain, is involved in regulating awareness of the environment and other higher information processing tasks” (Livesley 165). Abnormal levels of dopamine in the brain may make it difficult in relating to other people, social isolation and sometimes in distorted perceptions of the world (Durand 150). Medications may reduce symptoms of depression, anxiety, irritability, and paranoid thoughts. “A single “one-size-fits-all” medication for BPD does not exist yet (Burger 603). Symptoms can be reduced with monitoring of the medication and psychoanalysis of the patient because the symptoms of a borderline are constantly changing. “Recent research studies have demonstrated the effectiveness of individual cognitive behavioral therapy along with group psychoeducation and skills training that teach emotional regulation skills, distress tolerance, improved interpersonal relationship behaviors and awareness (mindfulness); This, combined with careful medication management, may allow the patient to achieve significant progress” (Burger 603).
如果教会他们控制情绪和忍受痛苦的技巧，BPD患者可以做得更好。传统的心理治疗是一个长期的过程，可能会产生不确定的结果。重要的是要激励BPD患者改变长期的行为方式，并“在治疗期间能够忍受不舒服的感觉，并在治疗期间教授新的问题解决和沟通技巧”(Burger 604)。“在精神卫生系统中，BPD患者是目前最受歧视的”(Livesley 111)。显然，病人最大的罪过就是对治疗反应不佳。在治疗时，边缘性人格障碍患者的情况非常不稳定，因此许多医生选择不治疗这些患者。识别迹象和症状并不总是容易的。有时症状会被忽视或误解。“患有BPD的人可能经常被认为是控制欲强或寻求关注的人(Burger 134)。他们有时会“表现得好像”他们没事。 “People with BPD need validation and acknowledgment of the pain they struggle to live with as well as compassion without blame or judgments (Durand 99). Family members should always take suicidal statements and threats seriously and alert a mental health professional as soon as possible. “Education for family members cannot be stressed enough (Durand 99). Families need to learn all they can about BPD so that they can advocate for appropriate treatment for their loved ones. Informed families are then better able to deal with the stigma often encountered from mental health professionals. Instability might not even do borderlines justice, (Burger 199) chaotic is the best word to describe the life of a borderline. Their lives are intense their friendships abrupt. BPD is extremely painful to the patients, their families and to society. People with BPD experience intense emotions and are very vulnerable. They are among the most intensive and extensive utilizes of mental health services.
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