Starting from the entire concept of “borderline”, the current work focuses on probably the most areas of identification disease that comprise the fresh new health-related and you can diagnostic contexts, installing the newest foundations getting a proper differential diagnosis, in the place of neglecting new neural attributes developed by the newest scientific area. A different sort of class model of borderline personality ailment, considering four levels, is recommended. The fresh new dialogue concludes on greatest advised therapeutic steps.
Meaning, differential medical diagnosis and you will logical perspective away from borderline identification illness
Definition, addition and you will epidemiological character: The word “borderline” came into this world because the a label aimed at discussing an entire series of qualities and behaviors that are hard to define. Migone (1990) draws up a listing of the latest meanings various writers, and that refer mostly directly to this new borderline area, lower than specific: “borderline neurosis” (Clark, 1919), “parataxies in certain borderline mental states” (Moore, 1921), “natural reputation”, “incipient schizophrenia” (Glover, 1932), “atypical schizophrenia” otherwise “affective schizophrenia” (Kasanin, 1933), “outpatient schizophrenia” (Zilboorg, 1941), “personality since if” (Deutsch, 1942), “latent psychosis” (Federn, 1947), “pseudonevrotic schizophrenia” (Hoch & Polatin, 1949), “latent schizophrenia” (Bychowsky, 1953), “psychotic character” (Frosch, 1954, 1960), “attenuated schizophrenia” (Ekstein, 1955), “histeroids” (Easser & Reduced, 1965), “atypical psychosis”, “borderline schizophrenia” (Kety, et al. 1968), “hysteroid dysphoria” (Klein & Davis, 1969; Klein, 1977), “borderline psychosis”, “indescribable people” (Welner, ainsi que al. 1973), “subaffective problems” (Akiskal, 1981) .
Contents of the fresh manuscript
The usage of the phrase “borderline”, as you may know it, provides roots one rest during the early attempts to codify symptomatic categories from the psychiatric means. In reality, on the 50s of your history 100 years, several active psychotherapists and you can psychiatrists attempted to create a great symptomatic category getting a few intellectual disorders one to did not meet the criteria correct in order to neuroses otherwise psychoses, starting from the idea produced by Tight in 1938 towards pathology into the edging between neurosis and you may psychosis. Such people suffered with serious disposition instability, considerable trouble inside target affairs, and you may above all integration problems from inside the neighborhood. The fresh new breakdown of your own symptomatic routines created of numerous nosographic perplexities as such customers displayed a much more remarkable scientific picture of the fresh neuroses but without the regular functions for the diagnosis away from psychosis (especially regarding fragmented exposure to facts).
In this months, hence, special categories for it brand of illness blossomed, such as the “pre-schizophrenia” out-of Rapaport and Gill and/or “states/personalities in the limit” of Rangell. All the effective hypotheses one to unwrapped the door on most varied issues. With this character, regarding sixties of the identical 100 years, Kernberg, doctor and you may psychoanalyst, arranged a good psychoanalytic make of these types of conditions considering Klein’s “Theory out-of target interactions” as well as on this new “Therapy of Pride” away from A great. Freud and you may Hartmann. Kernberg, particularly, implies individuals symptoms, for example totally free and fluctuating anxiety, several phobias, dissociative responses, hypochondriac concerns, depraved polymorphic sexuality, and substance abuse. Believing, yet not, your diagnosis sugar daddy Dallas TX might be established not really much into the attacks located but regarding the clear presence of specific structural qualities you to determine the company off identification, prepared the term “Borderline Team regarding Character”, distinctive from neurotic teams and you can psychotic organizations currently codified because of the medical people, stating that the business try characterized by the new health-related use of a specific number of immune protection system and that Kernberg considered much more “primitive” than those of neurotic type, like breaking, devaluation, idealization, and you will projective identity, by which the individual classified differing people within his environment because “entirely a good” otherwise “totally crappy”, even if the wisdom towards a person you can expect to range between big date to-day if not each day.