BORDERLİNE KİŞİLİK BOZUKLUĞUNDA EMPATİ

Year 2022, , 1294 - 1313, 30.09.2022

Haydeh Faraji , Betül İpek

https://doi.org/10.48070/erciyesakademi.1097395

Cited By: 7

Abstract

Borderline Kişilik Bozukluğu (BKB), duygulanımda dalgalanmaların, kişilerarası ilişkilerde dengesizliğin ve benlik karmaşasıyla beraber dürtüsel davranışların olduğu bir psikiyatrik bozukluktur. BKB tanısı almış olan bireylerin, tutarsız davranışlarının varlığı kişiler arası ilişkilerdeki işlev kaybı ve zorlanmalara neden olmaktadır. Bireyin kendisini karşısındaki bireyin yerine koyarak, ilgili durum ve yaşantıya karşısındaki bireyin penceresinden bakması ve karşısındaki bireyin duygu, düşüncesini hissetmesi empati olarak tanımlanır. BKB üzerine yapılan çalışmalara bakıldığında kişilerarası ilişkilerde önemli bir rolü olan empatinin BKB söz konusu olduğunda farklılaşabildiği görülmektedir. Bu çalışmada BKB’de empatinin değerlendirilmesini sağlamak amacıyla borderline kişilik bozukluğunda empati olgusu üzerine yapılan araştırmalara ilişkin araştırma bulgularına yer verilmiş, araştırma, konuyla ilgili yayınların retrospektif taranması biçiminde gerçekleştirilmiştir. Yapılan çalışmalar ışığında BKB tanısı almış olan bireylerin kişiler arası ilişkilerinde empati yetilerindeki farklılaşmanın rolü olabileceği görülmektedir. BKB tanısı alan bireylerin ebeveyn ilişkileri, aile tutumları ve travmatik ve/veya olumsuz çocukluk dönemi yaşantılarının empati becerisinde azalma özellikle de bilişsel empati becerisinde azalma ile ilişkili olduğu belirtilmektedir.

Keywords

Borderline kişilik bozukluğu, Borderline kişilik bozukluğu, Empati, Duygusal empati, Bilişsel empati

EMPATHY IN BORDERLINE PERSONALITY DISORDER

Abstract

Borderline Personality Disorder (BPD) is a psychiatric disorder in which there are fluctuations in affect, instability in interpersonal relationships, and impulsive behaviors with self-complexity. The presence of inconsistent behaviors of people who are borderline personality disorder causes loss of function and difficulties in interpersonal relations. Empathy is defined as the individual's putting himself in the place of the other individual, looking at the relevant situation and experience from the window of the individual opposite, and feeling the feelings and thoughts of the other individual. When the studies on BPD are examined, it is seen that empathy, which has an important role in interpersonal relations, can differ when it comes to BPD. In this study, the findings of research on the phenomenon of empathy in borderline personality disorder were included in order to evaluate empathy in BPD, and the research was carried out as a retrospective review of publications on the subject. The individuals who are being BPD have superficial and weak interpersonal relationships, which associated with poor empathy skills. In the light of the studies, it is seen that the differentiation in empathy skills may play a role in the interpersonal relations of individuals diagnosed with BPD. It is stated that the parental relations, family attitudes, and traumatic or adverse childhood experiences of individuals diagnosed with BPD are associated with a decrease in empathy skills, especially cognitive empathy skills.

Keywords

Borderline personality disorder, Empathy, Affective empathy, Cognitive empathy

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5). American Psychiatric Pub
• Armenti, N. A., & Babcock, J. C. (2018). Psychophysiological reactivity profiles of partner-violent men with borderline or psychopathic personality features: the role of empathy. International journal of offender therapy and comparative criminology, 62(11), 3337-3354.
• Baron Cohen, S., & Wheelwright, S. (2004). The empathy quotient: An investigation of adults with asperger syndrome or high functioning autism, and normal sex differences. Journal of Autism and Developmental Disorders, 34(2), 163–175. https://doi.org/10.1023/b:jadd.0000022607.19833.00
• Başçelik, E., Faraji, H., & Güler, K. (2022). Psikanalitik kuram ve şema teorisi çerçevesinde annelerimiz, babalarımız ve romantik ilişkilerimiz. Nobel Akademik Yayıncılık.
• Bazanis, E., Rogers, R. D., Dowson, J. H., Taylor, P., Meux, C., Staley, C., Nevinson- Andrews, D., Taylor, C., Robbins, T. W., & Sahakian, B. J. (2002). Neurocognitive deficits in decision-making and planning of patients with DSM-III-R borderline personality disorder. Psychological Medicine, 32(8), 1395–1405. https://doi.org/10.1017/s0033291702006657
• Beck, J. S., & Beck, A. T. (1995). Cognitive therapy: Basics and beyond. Guilford press.
• Birn, R. M., Roeber B. J., & Pollak S. D. (2017). Early childhood stress exposure, reward pathways, and adult decision making. Proceedings of the National Academy of Science, 114(51), 13549-13554. https://doi.org/10.1073/pnas.1708791114
• Bornovalova, M. A., Huibregtse, B. M., Hicks, B. M., Keyes, M., McGue, M., & Iacono, W. (2013). Tests of a direct effect of childhood abuse on adult borderline personality disorder traits: A longitudinal discordant twin design. Journal of Abnormal Psychology, 122(1), 180–194. https://doi.org/10.1037/a0028328
• Brück, C., Derstroff, S., Jacob, H., Wolf-Arehult, M., Wekenmann, S., & Wildgruber, D. (2017). Perception of verbal and nonverbal emotional signals in women with borderline personality disorder: evidence of a negative bias and an increased reliance on nonverbal cues. Joırnal of Personality Disorders, 31(2), 221–231.
• Brüne, M. (2005). Theory of mind in schizophrenia: A review of the literature. Schizophrenia Bulletin, 31(1), 2142. https://doi.org/10.1093/schbul/sbi002
• Bujalski, A. S., Chesin, M. S., & Jeglic, E. L. (2017). Cognitive empathy partially mediates the relationship between childhood physical abuse and borderline personality disorder features in college students. Current Psychology, 38(1), 121–127. https://doi.org/10.1007/s12144-017-9597-5
• Calhoun, L. G., Cann, A., Tedeschi, R. G., & McMillan, J. (2000). A correlational test of the relationship between growth, religion, and cognitive processing. Journal of Traumatic Stress, 13(5), 521−527. https://doi.org/10.1023/a:1007745627077
• Cattane, N., Rossi, R., Lanfredi, M., & Cattaneo, A. (2017). Borderline personality disorder and childhood trauma: Exploring the affected biological systems and mechanisms. BMC Psychiatry, 17(1). https://doi.org/10.1186/s12888-017-1383-2
• Clarke, P. (1984). What kind of discipline is most likely to lead to empathic behaviour in classrooms. History and Social Science Teacher, 19, 240-241.
• Cohen, D., & Strayer, J. (1996). Empathy in conduct-disordered and comparison youth. Developmental Psychology, 32(6), 988–998. https://doi.org/10.1037/0012-1649.32.6.988
• Courtney-Seidler, E. A., Klein, D., & Miller, A. L. (2013). Borderline personality disorder in adolescents. Clinical Psychology: Science and Practice, 20(4), 425–444. https://doi.org/10.1111/cpsp.12051
• Daros, A. R., Zakzanis, K. K., Ruocco, A. C. (2013). Facial emotion recognition in borderline personality disorder. Psychological Medicine, 43(9), 1953–1963.
• Davidov, M., & Grusec, J. E. (2006). Untangling the links of parental responsiveness to distress and warmth to child outcomes. Child Development, 77(1), 44–58. https://doi.org/10.1111/j.1467- 8624.2006.00855.x
• Decety, J., & Jackson, P. L. (2013). A Social-neuroscience perspective on empathy. Current Directions in Psychological Science, 15(2), 54–58. https://doi.org/10.1111/j.0963- 7214.2006.00406.x
• Dimopoulou, T., Tarazi, F.I., & Tsapakis, E.M. (2017). Clinical and therapeutic role of mentalization in schizophrenia a review. CNS Spectrums, 22(6), 450–462. https://doi.org/10.1017/S1092852916000687
• Eidelman-Rothman, M., Goldstein, A., Weisman, O., Schneiderman, I., Zagoory-Sharon, O., Decety, J., & Feldman, R. (2016). Prior exposure to extreme pain alters neural response to pain in others. Cognitive Affective & Behavioral Neuroscience, 16(4), 662–671. https://doi.org/10.3758/s13415-016-0422-7
• Eisenberg, N., & Fabes, R. A. (1990). Empathy: Conceptualization, measurement, and relation to prosocial behavior. Motivation and Emotion, 14(2), 131–149. https://doi.org/10.1007/bf00991640
• Eisenberg, N., & Lennon, R. (1983). Sex differences in empathy and related capacities. Psychological Bulletin, 94(1), 100–131. https://doi.org/10.1037/0033-2909.94.1.100
• Ellison, W. D., Rosenstein, L. K., Morgan, T. A., & Zimmerman, M. (2018). Community and clinical epidemiology of borderline personality disorder. Psychiatric Clinics of North America, 41(4), 561–573. https://doi.org/10.1016/j.psc.2018.07.008
• Emery, E. J. (1987). Empathy: Psychoanalytic and client centered. American Psychologist, 42(5), 513–515. https://doi.org/10.1037/0003-066x.42.5.513.b
• Ersoy, E., & Köşger, F. (2016). Empati: Tanımı ve önemi. Osmangazi Tıp Dergisi, 38(2), 9-17.
• Faraji, H., & Tezcan, A. E. (2022). Borderline kişilik bozukluğu. Nobel Akademik Yayıncılık.
• Faraji, H., & Güler, K. (2021). Borderline personality traits and self handicapping. International Journal of Current Research, 13(6), 17683-17689.
• Faraji, H. (2021). Borderline kişilik bozukluğunun ergenlik döneminde belirlenmesine dair bir değerlendirme, OPUS Toplum Araştırmaları Dergisi, 18(43), 7141-7166.
• Flasbeck, V., Enzi, B., & Brüne, M. (2017). Altered empathy for psychological and physical pain in borderline personality disorder. Journal of personality disorders, 31(5), 689-708. doi:101521pedi201731276
• Flury, J. M., Ickes, W., & Schweinle, W. (2008). The borderline empathy effect: Do high BKB individuals have greater empathic ability or are they just more difficult to read. Journal of Research in Personality, 42(2), 312-332.
• Fonagy, P., & Bateman, A. (2008). The development of borderline personality disorder a mentalizing model. Journal of Personality Disorders, 22(1), 4–21. https://doi.org/10.1521/pedi.2008.22.1.4 7.
• Fonagy, P., Luyten, P., & Allison, E. (2015). Epistemic petrication and the restoration of epistemic trust: a new conceptualization of borderline personality disorder and its psychosocial treatment. Journal of Personality Disorders, 29(5), 575–609. https://doi.org/10.1521/pedi.2015.29.5.575
• Fonagy, P., & Bateman, A.W. (2016). Adversity, attachment, and mentalizing. Comprehensive Psychiatry, 64, 59– 66.
• Frank, H., & Hoffman, N. (1986). Borderline empathy: an empirical investigation. Comprehensive Psychiatry, 27(4), 387–395. https://doi.org/10.1016/0010-440x(86)90015-5
• Freud, S. (1920). Group psychology and the analysis of the ego. Hogart Press.
• Garber, J., Robinson, N. S., & Valentiner, D. (1997). The relation between parenting and adolescent depression. Journal of Adolescent Research, 12(1), 12–33. https://doi.org/10.1177/0743554897121003
• Gladstein, G. A., & Feldstein, J. C. (1983). Using film to increase counselor empathic experiences. Counselor Education and Supervision, 23(2), 125–131. https://doi.org/10.1002/j.1556-6978.1983.tb00596.x
• Goleman, D. (1999). Duygusal zekâ (13. Baskı). Varlık Yayınları.
• Golomb, A., Ludolph, P., Westen, D., Block, M. J., Maurer, P., & Wiss, F. C. (1994). Maternal empathy, family chaos, and the etiology of borderline personality disorder. Journal of the American Psychoanalytic Association, 42(2), 525–548. https://doi.org/10.1177/000306519404200209
• Grant, B. F., Chou, S. P., Goldstein, R. B., Huang, B., Stinson, F. S., Saha, T. D., Smith, S. M., Dawson, D. S., Pulay, A. J., Pickering, R. P., & Ruan, W. J. (2008). Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder. The Journal of Clinical Psychiatry, 69(4), 533–545. https://doi.org/10.4088/jcp.v69n0404
• Grimm, S., Wirth, K., Fan, Y., Weigand, A., Gartner, M., Feeser, M., Dziobek, I., Bajbouj, M. & Aust, S. (2017). The interaction of corticotropin releasing hormone receptor gene and early life stress on emotional empathy. Behavioural Brain Research, 329, 180-185. https://doi.org/10.1016/j.bbr.2017.04.047
• Grzegorzewski, P., Kulesza, M., Pluta, A., Iqbal, Z., & Kucharska, K. (2019). Assessing self-reported empathy and altruism in patients suffering from enduring borderline personality disorder. Psychiatry Research, 273, 798-807.
• Gunderson, J. G., Kolb, J. E., & Austin, V. (1981). The diagnostic interview for borderline patients. The American Journal of Psychiatry, 138(7), 896–903. https://doi.org/10.1176/ajp.138.7.896
• Guttman, H. A., & Laporte, L. (2000). Empathy in families of women with borderline personality disorder, anorexia nervosa and a control group. Family Process, 39(3), 345–358. https://doi.org/10.1111/j.1545-5300.2000.39306.x
• Herzberg, M. P., & Gunnar, M. R. (2020). Early life stress and brain function: Activity and connectivity associated with processing emotion and reward. NeuroImage, 209, 116493. https://doi.org/10.1016/j.neuroimage.2019.116493
• Hoffman, M. L. (1977). Sex differences in empathy and related behaviors. Psychological Bulletin, 84(4), 712–722. https://doi.org/10.1037/0033-2909.84.4.712
• Hoffman, N., & Frank, H. (1987). Borderline empathy and borderline pathology: constitutional considerations. Comprehensive psychiatry, 28(5), 412-415.
• Ickes, W., Buysse, A. N. N., Pham, H. A. O., Rivers, K., Erickson, J. R., Hancock, M., ... & Gesn, P. R. (2000). On the difficulty of distinguishing “good” and “poor” perceivers: A social relations analysis of empathic accuracy data. Personal Relationships, 7(2), 219-234. https://doi.org/10.1111/j.1475-6811.2000.tb00013.x
• Jeung, H., & Herpertz, S. C. (2014). Impairments of interpersonal functioning: Empathy and intimacy in borderline personality disorder. Psychopathology, 47(4), 220–234. https://doi.org/10.1159/000357191
• Johnson, J. G., Cohen, P., Brown, J., Smailes, E. M., & Bernstein, D. P. (1999). Childhood maltreatment increases risk for personality disorders during early adulthood. Archives of General Psychiatry, 56(7), 600-606. https://doi.org/10.1001/archpsyc.56.7.600
• Kiliç, F., Demirdas, A., Isik, Ü., Akkus, M., Atay, I. M., & Kuzugüdenlioglu, D. (2020). Empathy, alexithymia, and theory of mind in borderline personality disorder. The Journal of Nervous and Mental Disease, 208(9), 736-741. doi: 10.1097/NMD.0000000000001196
• King-Casas, B., Sharp, C., Lomax-Bream, L., Lohrenz, T., Fonagy, P., & Montague, P.R. (2008). The rupture and repair of cooperation in borderline personality disorder. Science, 321, 806–810. DOI: 10.1126/science.1156902
• Knight, R. P. (1953). Borderline states. International Universities Press, 203–215. https://doi.org/10.1037/10633-012
• Kohn, A. (1991). Caring kids: The role of the schools. Phi Delta Kappa, 72, 496-506.
• Kohut, H. (1959). Introspection, empathy, and psychoanalysis an examination of the relationship between mode of observation and theory. Journal of the American Psychoanalytic Association, 7(3), 459–483. https://doi.org/10.1177/000306515900700304
• Kohut, H. (1977). The restoration of the self. Int.University Press.
• Krohn, A. (1974). Borderline" empathy" and differentiation of object representations: a contribution to the psychology of object relations. International Journal of Psychoanalytic Psychotherapy, 3(2), 142-165.
• Kutlu, M. (2018). Borderline kişilik bozukluğu: bir gözden geçirme . Medeniyet Araştırmaları Dergisi , 3(5), 11–20.
• Lazarus, S.A., Cheavens, J.S., Festa, F., & Zachary-Rosenthal, M. (2014). Interpersonal functioning in borderline personality disorder: a systematic review of behavioral and laboratory-based assessments. Clinical Psychol ogy, 34, 193– 205. https://doi.org/10.1016/j.cpr.2014.01.007
• Leichsenring, F., Leibing, E., Kruse, J., New, A. S., & Leweke, F. (2011). Borderline personality disorder. The Lancet, 377(9759), 74–84. https://doi.org/10.1016/s0140-6736(10)61422-5
• Lim, D., & De Steno, D. (2016). Suffering and compassion: the links among adverse life experience, empathy, compassion and prosocial behaviour. Emotion 16(2), 175-182. https://doi.apa.org/doi/10.1037/emo0000144
• Mark K., M., Stevelink S., A., M., Choi J., & Fear T., N. (2018). Post-traumatic growth in the military: a systematic review. Occupational and Environmental Medicine, 75(12), 904-915. https://doi.org/10.1136/oemed-2018-105166
• Matzke, B., Herpertz, S.C., Berger, C., Fleischer, M., & Domes, G. (2014). Facial reactions during emotion recognition in borderline personality disorder: a facial electromyography study. Psychopathology, 47(2), 101–110. https://doi.org/10.1159/000351122
• McLauglin, K., A., & Lambert, H., K. (2017). Child trauma exposure and psychopatology: mechanism of risk and resiliance. Current Opinion in Psychology, 14, 29-34. https://doi.org/10.1016/j.copsyc.2016.10.004
• Mehrabian, A., & Epstein, N. (1972). A measure of emotional empathy. Journal of Personality, 40(4), 525–543. https://doi.org/10.1111/j.1467-6494.1972.tb00078.x
• Michalska, K. J., Kinzler, K. D., & Decety, J. (2013). Age-related sex differences in explicit measures of empathy do not predict brain responses across childhood and adolescence. Developmental Cognitive Neuroscience, 3, 22–32. https://doi.org/10.1016/j.dcn.2012.08.001
• Miller, P. A., & Eisenberg, N. (1988). The relation of empathy to aggressive and externalizing/antisocial behavior. Psychological Bulletin, 103(3), 324–344. https://doi.org/10.1037/0033-2909.103.3.324
• Milton, D. E., Heasman, B., & Sheppard, E. (2018). Double empathy. Encyclopedia of Autism Spectrum Disorders, 1–8. https://doi.org/10.1007/978-1-4614-6435-8_102273-1
• Mitchell, A. E., Dickens, G. L., & Picchioni, M. M. (2014). Facial emotion processing in borderline personality disorder: a systematic review and meta-analysis. Neuropsychol Rev, 24, 166– 184. https://doi.org/10.1007/s11065-014-9254-9
• Montag, C., Gallinat, J., & Heinz, A. (2008). Theodor Lipps and the concept of empathy: 1851–1914. American Journal of Psychiatry, 165(10), 1261–1261. https://doi.org/10.1176/appi.ajp.2008.07081283
• Niedtfeld, I. (2017). Experimental investigation of cognitive and affective empathy in borderline personality disorder: effects of ambiguity in multimodal social information processing. Psychiatry Research, 253, 58-63. https://doi.org/10.1016/j.psychres.2017.03.037
• Németh, N., Mátrai, P., Hegyi, P., Czéh, B., Czopf, L., Hussain, A., Pammer, J., Szabó, I., Solymár, M., Kiss, L., PetraHartmann, P., Lilla, A., Szilágyik A.L., Kiss, Z., & Simone, M. (2018). Theory of mind disturbances in borderline personality disorder: A meta-analysis. Psychiatry Research, 270, 143–153. https://doi.org/10.1016/j.psychres.2018.08.049
• Padilla-Walker, L. M., & Christensen, K. J. (2010). Empathy and self-regulation as mediators between parenting and adolescents' prosocial behavior toward strangers, friends, and family. Journal of Research on Adolescence, 21(3), 545–551. https://doi.org/10.1111/j.1532-7795.2010.00695.x
• Plomin, R., DeFries, J. C., Craig, I. W., & McGuffin, P. (2003). Behavioral genetics. İçinde R. Plomin, J. C. DeFries, I. W. Craig, & P. McGuffin (Ed.), Behavioral genetics in the postgenomic era (s. 3–15). American Psychological Association. https://doi.org/10.1037/10480-001
• Porter C, Palmier-Claus J, Branitsky A, Mansell W, Warwick H, Varese F. (2020). Childhood adversity and borderline personality disorder: a meta-analysis. Acta Psychiatrica Scandinavica, 141(1), 6–20.
• Reich, R. B., Vera, S. C., Marino, M. F., Levin, A., Yong, L., & Frankenburg, F. R. (1997). Reported pathological childhood experiences associated with the development of borderline personality disorder. American Journal of Psychiatry, 154(8), 1101–1106. https://doi.org/10.1176/ajp.154.8.1101
• Ritter, K., Dziobek, I., Preißler, S., Rüter, A., Vater, A., Fydrich, T., Lammers, C. H., Heekeren, H. R., & Roepke, S. (2011). Lack of empathy in patients with narcissistic personality disorder. Psychiatry Research, 187(1-2), 241–247. https://doi.org/10.1016/j.psychres.2010.09.013
• Roepke, S., Vater, A., Preissler, S., Heekeren, H. R., & Dziobek, I. (2013). Social cognition in borderline personality disorder. Front Neurosci, 6, 195. https://doi.org/10.3389/fnins.2012.00195
• Rogers, C. R. (1957). Training individuals to engage in the therapeutic process. Psychology and Mental Health, 76–92. https://doi.org/10.1037/10791-006
• Rogers, C. R. (1983). Empatik olmak değeri anlaşılmamış bir varoluş şeklidir. Çev. Akkoyun, F. Ankara Üniversitesi Egitim Bilimleri Fakültesi Dergisi, 16, 103-124.
• Salgado, R. M., Pedrosa, R., & Bastos-Leite, A. J. (2020). Dysfunction of empathy and related processes in borderline personality disorder: A systematic review. Harvard Review of Psychiatry, 28(4), 238– 254. https://doi.org/10.1097/hrp.0000000000000260
• Seidel, E. M., Pfabigan, D. M., Keckeis, K., Wucherer, A. M., Jahn, T., Lamm, C., & Derntl, B. (2013). Empathic competencies in violent offenders. Psychiatry Research, 210(3), 1168–1175. https://doi.org/10.1016/j.psychres.2013.08.027
• Sesar, K., Dodaj, A., & Kovačević, M. (2022). Childhood maltreatment, aspects of emotional processing and borderline personality disorder. Mediterranean Journal of Clinical Psychology, 10(1), 1-28. https://doi.org/10.13129/2282-1619/mjcp-3373
• Smith, A. (2013). Autism, borderline personality disorder, and empathy. Emotion Review, 5(2), 223–224. https://doi.org/10.1177/1754073912469685
• Sperber, D., Clément, F., Heintz, C., Mascaro, O., Mercier, H., Origgi, G., & Wilson, D. (2010). Epistemic vigilance. Mind and Language, 25(4), 359–393. https://doi.org/10.1111/j.1468-0017.2010.01394.x
• Sperber, D., & Wilson, D. (2002). Pragmatics, modularity and mind-reading. Mind & Language, 17(1‐2), 3–23. https://doi.org/10.1111/1468-0017.00186
• Titchener, E. B. (1909). Lectures on the experimental psychology of the thought-processes. MacMillan Co. https://doi.org/10.1037/10877-000
• Torgersen, S. (2000). Genetics of patients with borderline personality disorder. Psychiatric Clinics of North America, 23(1), 1–9. https://doi.org/10.1016/s0193-953x(05)70139-8
• Wingenfeld, K., Duesenberg, M., Fleischer, J., Roepke, S., Dziobek, I., Otte, C., & Wolf, O. T. (2018). Psychosocial stress differentially affects emotional empathy in women with borderline personality disorder and healthy controls. Acta Psychiatrica Scandinavica, 137(3), 206-215.
• Winnicott, D. (2019). Oyun ve gerçeklik (4. Basım). Metis Yayınları.
• Wispé, L. (1987). History of the concept of empathy. İçinde N. Eisenberg & J. Strayer (Ed), Empathy and its development (s. 17–37). Cambridge University Press.
• Witt, S. H., Streit, F., Jungkunz, M., Frank, J., Awasthi, S., Reinbold, C. S., Treutlein, J., Degenhardt, F., Forstner, A. J., Heilmann-Heimbach, S., Dietl, L., Schwarze, C. E., Schendel, D., Strohmaier, J., Abdellaoui, A., Adolfsson, R., Air, T. M., Akil, H., Alda, M., Rietschel, M. (2017). Genome-wide association study of borderline personality disorder reveals genetic overlap with bipolar disorder, major depression and schizophrenia. Translational Psychiatry, 7(6), 1155. https://doi.org/10.1038/tp.2017.115
• World Health Organization (1992). International statistical classification of diseases and related health problems (ICD-10). World Health Organization, Geneva. https://www.scirp.org/reference/ReferencesPapers.aspx?ReferenceID=428773
• Yen, S., Peters, J. R., Nishar, S., Grilo, C. M., Sanislow, C. A., Shea, M. T., ... & Skodol, A. E. (2021). Association of borderline personality disorder criteria with suicide attempts: Findings from the collaborative longitudinal study of personality disorders over 10 years of follow-up. JAMA psychiatry, 78(2), 187-194.
• Zanarini, M. C. (2000). Childhood experiences associated with the development of borderline personality disorder.Psychiatric Clinics of North America, 23(1), 89–101. https://doi.org/10.1016/s0193- 953x(05)70145-3
• Zanarini, M. C., Frankenburg, F. R., Hennen, J., Reich, D. B., & Silk, K. R. (2006). Prediction of the 10-year course of borderline personality disorder. American Journal of Psychiatry, 163(5), 827–832. https://doi.org/10.1176/ajp.2006.163.5.827