Japanese

Is Borderline a Personality Disorder ? Ken TAKAOKA 1 , Ayuko HIRTA 1 , Tetsushi KURISU 2 1Department of Psychiatry, Faculty of Medicine, Gifu University 2Department of Psychiatry, Hashima City Hospital Keyword: Borderline personality disorder , Histrionic personality disorder , Antisocial personality disorder , Multiple personality disorder , Dimension pp.753-760
Published Date 2000/7/15
DOI https://doi.org/10.11477/mf.1405902257
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 Background : The paradigm shift which occurred in American psychiatry in the 1960s, from ideology to scientific research and from pessimism to optimistic treatment, led psychiatrists to regard borderline as a personality disorder. However, two previous theories, the St. Louis group's critical study concerning hysteria and Blackburn's criticism of the myth of the sociopath, implied that the concept of borderline as a personality disorder should be abandoned.

 Design and Method : The authors hypothesized that borderline is not a personality disorder but a clinical feature exhibited by the collapse of various personality disorders during the patient's crisis. To verify this hypothesis, they considered current debates with respect to borderline.

 Result : The view put forward by researchers that multiple personality disorder is an extreme type of borderline state supports the authors' hypothesis because multiple personality disorder is regarded not as a personality disorder per se but as a type of clinical feature. Furthermore, debates regarding the comorbidity of borderline have revealed a contradiction in DSM criteria, namely, borderline is classified as an axis-II personality disorder while the concept and criteria of borderline overlap those of several axis-I diseases. This contradiction also supports the authors' hypothesis because it indicates the questionability of regarding borderline as a personality disorder. Finally, even recent dimension theories concerning temperament and character have been unable to explain some features of borderline, such as micropsychosis, prompting psychiatrists to revisit Kretschmer's multipledimension diagnosis, in which character, environment and experience bring about psychotic features. This view coincides with the authors' hypothesis in terms of regarding borderline as a clinical feature exhibited by collapse of personality disorders during the patient's crisis.

 Conclusion : Borderline patients are not regarded as having a personality disorder. Practitioners should treat their condition not as a personality disorder but as a clinical feature.


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電子版ISSN 1882-126X 印刷版ISSN 0488-1281 医学書院

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