A Systematic Review of the Association Between Early Childhood Trauma and Borderline Personality Disorder.

Borderline personality disorder (BPD) is a debilitating clinical disorder associated with adverse impacts on multiple levels. While a high prevalence of childhood trauma has been noted, the ways such trauma impacts the development of BPD symptomatology remain unclear. In this systematic review, the authors examine the literature from 2000 to 2020, focusing on the association between trauma and BPD, and offer a comprehensive synthesis of possible etiological implications related to either one specific or multiple trauma types. In addition, results are analyzed based on commonly tested trauma parameters, including repeated exposure, polytrauma, onset, perpetrators, and gender. The authors also note some limitations in areas of sampling, measurement, causal inference methods, and data analyses. Results of this review point to several parameters of trauma that can be used to inform training for practitioners as well as enhance current interventions.

Dorsomedial prefrontal rTMS for depression in borderline personality disorder: A pilot randomized crossover trial.

BACKGROUND: Recently, a small literature has emerged suggesting that repetitive transcranial magnetic stimulation (rTMS) may offer benefit for MDD even in BPD patients, perhaps by enhancing cognitive control, and/or disrupting excessive 'non-reward' activity in right orbitofrontal regions. This study aimed primarily to assess the therapeutic effects of dorsomedial prefrontal cortex (DMPFC)-rTMS against MDD symptoms in BPD patients, and secondarily to assess whether the therapeutic effects ensued via mechanisms of reduced impulsivity and core BPD pathology on clinical scales (BIS-11, ZAN-BPD) or of reduced alpha- and theta-band activity on EEG recordings of right orbitofrontal cortex.. METHODS: In a crossover-design trial, 20 BPD patients with MDD underwent 2 × 30 session/15 day blocks of either active-then-sham or sham-then-active bilateral 20 Hz DMPFC-rTMS. RESULTS: Sixteen out of 20 patients completed treatment. A significant (p = 0.00764) crossover effect was detected, with overall reductions in HamD17 score from 23.1±SD3.1 to 10.75±SD5.8. Nine out of 16 (56.3%) treatment completers achieved response (>50% improvement) and 6/16 (37.5%) achieved remission (HamD≤7), maintained at 1 month followup. BIS-11 scores remained unchanged, and ZAN-BPD scores improved similarly in both groups with no significant crossover effect. Change in low-band power over right orbitofrontal regions correlated with clinical improvement. LIMITATIONS: This was a crossover study with a small sample size. A randomized controlled trial with larger sample size will be needed to establish the efficacy more definitively. CONCLUSIONS: The results suggest efficacy for DMPFC-rTMS in treating MDD in BPD, and provide a foundation for a larger future trial.

Childhood abuse and borderline personality disorder features in Chinese undergraduates: the role of self-esteem and resilience.

BACKGROUND: Although childhood abuse is considered to be related to borderline personality disorder (BPD), few studies have elaborated on the mediating role of self-esteem and resilience in it. Thus, the present study aimed to explore the potential mediating role of resilience and self-esteem between childhood abuse and BPD. METHODS: This cross-sectional study was conducted with 4034 college students in Anhui Province, China. Participants were asked to complete Chinese versions of the following instruments: Childhood Trauma Questionnaire-Short Form (CTQ-SF), Mclean Screening Instrument for Borderline Personality Disorder (MSI-BPD), Connor-Davidson Resilience Scale (CD-RISC), and Rosenberg Self-Esteem Scale (RSES). Structural equation modeling (SEM) was used to test the mediation effects. RESULTS: Resilience and self-esteem were found to be mediators of all three types of childhood abuse (emotional abuse, physical abuse and sexual abuse) when the types were examined separately; however, when all three types of childhood abuse were entered into the model simultaneously, neither the indirect effects nor direct effects of physical abuse or sexual abuse were found to be significant, only the association between emotional abuse and BPD features was partially mediated by resilience and self-esteem. CONCLUSIONS: Self-esteem and resilience mediate the links between childhood abuse and BPD features, and emotional abuse is uniquely associated with BPD features.

History of Childhood Trauma and Association With Borderline and Dissociative Features.

ABSTRACT: Both borderline personality features and dissociative symptoms have been associated with different types of childhood trauma. The aim of this investigation was to analyze to what extent emotional, physical, and sexual child maltreatment predict borderline personality features and dissociative symptoms. For this purpose, we analyzed data from 86 consecutively admitted patients who completed the Borderline Symptom List, the Childhood Trauma Questionnaire, and the German version of the Dissociative Experiences Scale for differential diagnosis of a borderline personality disorder. Hierarchical regression analyses revealed that borderline features were mainly predicted by emotional abuse, whereas pathological dissociation was best predicted by sexual and physical abuse. This evidence supports the hypothesis that different kinds of maltreatment may lead to different psychopathological symptoms in adulthood and should be taken into account in the therapy.

Perspectives on person-centred care for borderline personality disorder: a critical research agenda.

Borderline Personality Disorder (BPD) is a highly contentious psychiatric diagnosis with ongoing tensions over nomenclature, aetiology and treatment recommendations. This article examines a number of these tensions and assesses how greater attention to the voices of people living with BPD may help inform the delivery of new modes of person-centred care. To this end, we present a critical social science research agenda for investigating the experiences, social contexts and support needs of people living with BPD. We canvass issues pertaining to the diagnosis of BPD (including its name), the strongly gendered dimensions of BPD, and the pressing need to improve support for people living with this condition. Throughout our analysis, we indicate how critical interdisciplinary inquiry may drive new responses to these challenges. Our analysis is illustrated with reference to experiences of BPD recounted in two Australia-wide surveys conducted in 2011 and 2017. We argue that greater progress towards person-centred care requires novel forms of evidence grounded in critical social inquiry into experiences of treatment and support among people living with BPD, and the varied social, cultural and political contexts underpinning these experiences.

The Experience of Maltreatment in Young Children Whose Mothers Have Borderline Personality Disorder: Reflections in Their Narrative Representations.

Child maltreatment is an etiological factor in borderline personality disorder (BPD), which may be transmitted to the children of mothers with BPD. We assessed maltreatment in 36 children aged 4-7 whose mothers have BPD and in 34 normative comparisons. Children whose mothers have BPD were more likely to have experienced sexual abuse, physical abuse, and neglect than were normative comparisons. Mothers' self-reported borderline features were significantly correlated with children's maltreatment. Neglect was associated with mothers' affective instability, identity disturbance, negative relationships, and self-harm; sexual abuse was associated with mothers' identity disturbance, and negative relationships; and physical abuse was associated with mothers' self-harm. Maltreatment mediated the relationship between all four of mothers' borderline features and children's narrative representations of the caregiver-child relationship, which included fear of abandonment, role reversal, and mother-child relationship expectations. The authors discuss results in the context of risk for developing BPD in early adulthood and early preventive interventions targeting children's representations.

Pathoetiology and pathophysiology of borderline personality: Role of prenatal factors, gut microbiome, mu- and kappa-opioid receptors in amygdala-PFC interactions.

The pathoetiology and pathophysiology of borderline personality disorder (BPD) have been relatively under-explored. Consequently, no targetted pharmaceutical treatments or preventative interventions are available. The current article reviews the available data on the biological underpinnings of BPD, highlighting a role for early developmental processes, including prenatal stress and maternal dysbiosis, in BPD pathoetiology. Such factors are proposed to drive alterations in the infant's gut microbiome, in turn modulating amygdala development and the amygdala's two-way interactions with other brain regions. Alterations in opioidergic activity, including variations in the ratio of the mu-and kappa-opioid receptors seem a significant aspect of BPD pathophysiology, contributing to its comorbidities with depression, anxiety, impulsivity and addiction. Stress and dysphoria are commonly experienced in people classed with BPD. A growing body of data, across a host of medical conditions, indicate that stress and mood dysregulation may be intimately associated with gut dysbiosis and increased gut permeability, coupled to heightened levels of oxidative stress and immune-inflammatory activity. It urgently requires investigation as to the relevance of such gut changes in the course of BPD symptomatology. Accumulating data indicates that BPD symptom exacerbations may be linked to cyclical variations in estrogen, in turn decreasing serotonin and local melatonin synthesis, and thereby overlapping with the pathophysiology of migraine and endometriosis, which also have a heightened association with BPD. Future research directions and treatment implications are indicated.

Familial factors and the risk of borderline personality pathology: genetic and environmental transmission.

BACKGROUND: Parental characteristics and practices predict borderline personality disorder (BPD) symptoms in children. However, it is difficult to disentangle whether these effects are genetically or environmentally mediated. The present study examines the contributions of genetic and environmental influences by comparing the effects of familial risk factors (i.e. parental psychopathology and borderline traits, maladaptive parenting, marital discord) on child BPD traits in genetically related (biological) and non-related (adoptive) families. METHODS: Data are from 409 adoptive and 208 biological families who participated in the Siblings Interaction and Behavior Study (SIBS) and 580 twin families the Minnesota Twin Family Study (MTFS). Parent characteristics and practices included parental psychopathology (measured via structured clinical interviews), parental BPD traits, parenting behaviors, and marital discord. A series of multi-level regression models were estimated to examine the relationship of familial risk factors to child BPD traits and to test whether children's adoptive status moderated the association. RESULTS: Symptom counts of parents' conduct disorder, adult antisocial behavior, nicotine, alcohol, and illicit drug dependence, and paternal BPD traits substantially predicted child BPD traits only in biological offspring, implying genetic transmission. Maternal BPD traits and both maternal and paternal conflict, lack of regard, and lack of involvement predicted offspring BPD traits regardless of the adoptive status, implying environmental transmission. CONCLUSIONS: Parental externalizing psychopathology and father's BPD traits contribute genetic risk for offspring BPD traits, but mothers' BPD traits and parents' poor parenting constitute environmental risks for the development of these offspring traits.

Adult attachment anxiety moderates the relation between self-reported childhood maltreatment and borderline personality disorder features.

Childhood maltreatment is one of many risk factors for borderline personality disorder (BPD). However, not all individuals with BPD report histories of childhood maltreatment. Therefore, it is necessary to identify factors that contextualize the relation between childhood maltreatment and BPD features. With its emphasis on the developmental origins of emotion regulation, attachment theory provides a useful framework to understand how people are differentially affected by early life stress. The present study examined self-reported adult attachment as a moderator in the relation between childhood maltreatment and BPD features in a large undergraduate sample (n = 1 033). Attachment anxiety, but not attachment avoidance, moderated the relation between childhood maltreatment and BPD features, and this relation was non-significant among participants low (-1 standard deviation) in attachment anxiety. These results support the hypothesis that secure attachment in adulthood may buffer against the otherwise deleterious effects of distal risk factors on personality pathology. Future research should continue to examine this question across risk factors and across disorders. Furthermore, we suggest that researchers who have historically examined attachment as a mediator cross-sectionally should re-examine their data for evidence of a moderation effect. © 2019 John Wiley & Sons, Ltd.

Relations among maternal withdrawal in infancy, borderline features, suicidality/self-injury, and adult hippocampal volume: A 30-year longitudinal study.

The hippocampus plays an important role in stress regulation and has been the focus of research regarding the effects of early life stress on brain development. Much of this research has focused on severe forms of early adversity, particularly maltreatment. However, a handful of studies are now examining the effects of more subtle variations in quality of early caregiving on hippocampal development. In addition, both early caregiving and hippocampal volumes have been linked to psychopathology, particularly borderline personality disorder (BPD) and its associated features, such as suicidality. In the context of a 30-year longitudinal study, we assessed associations between maternal withdrawal in infancy, hippocampal volume, and BPD features in adulthood. Hippocampal volume was assessed among 18 adults (29.33 ±â€¯0.49 years) assessed for caregiving quality at 18 months (M =18.55 months, SD = 1.21 months) and followed longitudinally to age 29. Left hippocampal volume in adulthood was associated with maternal withdrawal in infancy, but not by other components of disrupted parenting. Other risk factors, including maternal psychosocial risk and severity of maltreatment in childhood, were not significantly related to left hippocampal volume. Left hippocampal volume was further associated with increased BPD features and suicidality/self-injury. In addition, left hippocampal volume partially mediated the association between early maternal withdrawal and later suicidality/self-injury. Results point to the importance of quality of early care for hippocampal development and suggest that the first two years of life may be an early sensitive period during which intervention could have important consequences for long-term psychological functioning into adulthood.

Borderline personality disorder and eating disorders: a trans-diagnostic approach to unravelling diagnostic complexity.

OBJECTIVES: This opinion paper considers co-morbid borderline personality disorder (BPD) and eating disorders and proposes that a trans-diagnostic approach looking at presenting problems and treatment approaches may be of value. CONCLUSIONS: Trans-diagnostic elements can be identified across the two syndromes. Trans-diagnostic elements appear to include some shared aetiological factors as well as some shared syndromal components. The shared syndromal components include problems with affect, interpersonal problems, problems with self-concept and impulsivity. The pathoplastic effects of culture, attitudes to fatness and the neurobiology of starvation and/or restriction of intake are crucial to integrate into the understanding of co-morbidity of these two disorders. Trans-diagnostic approaches to treatment lead to trans-diagnostic improvements across the two disorders.

Experiences of (young) women after out of home placement: An examination of personality disorder symptoms through the lens of child maltreatment.

BACKGROUND: Child maltreatment has been associated with the development of various mental health problems, including the development of personality disorders. OBJECTIVE: This study investigated the association between child maltreatment and personality disorder symptoms in 125 women who transitioned out of residential care. METHOD: The Child Trauma Questionnaire was used for the measurement of child maltreatment, and Personality disorder symptoms were measured using the Personality Diagnostic Questionnaire 4 + . The Psychological Distress Index was used to control for symptoms of distress. RESULTS: A Stepwise regression analysis showed that the majority of the associations were found between self-reported emotional abuse, neglect and personality disorder symptoms. Emotional abuse was significantly related to the Paranoid (ß = .42, p<0.001), Schizoid (ß = .18, p <0.05), Schizotypal (ß = .18, p<0.05), Histrionic (ß = .22, p<0.05), Avoidant (ß = .31, p < .001), Dependent (ß = 0.31, p < .001), Obsessive Compulsive (ß = 0.29, p = .001), Passive Aggressive (ß = 0.23, p<0.01) and the Depressive personality disorder (ß = .38, p < .001). Emotional neglect was significantly associated to the Borderline Personality Disorder (ß = .32, p<0.001) and the Paranoid Personality Disorder (ß =-0.22, p<0.05). CONCLUSIONS: The current study underlines the detrimental effects of childhood maltreatment, and in particular the effects of emotional abuse and neglect.

O paradoxo da unidade na dualidade: elementos para a clí­nica dos casos-limite / La paradoja de la unidad en la dualidad: elementos para la clí­nica de los casos lí­mite / The paradox of unity in duality: elements for the clinic of borderline cases

O artigo irá aprofundar o debate acerca dos primórdios da constituição psíquica e sua relação com a etiologia dos casos-limite. Assim, apesar de não se tratar de um artigo sobre a infância, eixo principal desta revista, ele aporta a uma discussão teórica sobre a constituição psíquica e sobre a importância das interações iniciais da vida na etiologia dos casos-limite. Em seu primeiro eixo, discutiremos os primórdios do psiquismo como fonte de subsídios para uma clínica dos casos-limite, já que estes casos são compreendidos como marcados por traumas no âmbito das primeiras relações de objeto. Observa-se, na relação transferencial com estes pacientes, mecanismos de defesa verticais, como cisões, mais frequentemente do que mecanismos de defesa horizontais, como o recalque. O recalque foi o conceito central para a constituição da técnica psicanalítica clássica. Este fato faz com que nos defrontemos com a necessidade de refinamento da técnica analítica para abordar de forma mais eficaz estes casos que desafiam a técnica clássica. Neste sentido, estudaremos, no segundo eixo deste trabalho, a contratransferência sob uma perspectiva da intersubjetividade e da valorização da qualidade da relação analítica.

El artículo busca profundizar en el debate acerca de los principios de la constitución psíquica y su relación con la etiología de los casos dudosos. Aunque su tema no es sobre la infancia, línea principal de esta revista, plantea una discusión teórica sobre la constitución psíquica y la importancia de los primeros años de vida en la etiología de los casos límite. En su primer eje central, se exponen los principios del psiquismo como una fuente de subvenciones para una clínica de casos límite, puesto que estos son marcados por traumas en el contexto de las primeras relaciones de objeto. Se observa en la relación de transferencia con estos pacientes los mecanismos de defensa vertical como divisiones más frecuentes que mecanismos de defensa horizontal, como la represión. La represión fue el concepto central para el establecimiento de la técnica psicoanalítica clásica. Este hecho nos hace abordar la necesidad de refinamiento de la técnica analítica para exponer más eficazmente estos casos que desafían a la técnica clásica. En este sentido, en el segundo eje de este trabajo, vamos a estudiar la contratransferencia bajo una perspectiva de la intersubjetividad y la apreciación de la calidad de la relación analítica.

The article will deepen the debate about the beginnings of psychic constitution and its relation to the etiology of borderline cases. So, although this is not an article about childhood, main axe of this journal, it brings a theoretical discussion about the psychic constitution and the importance of the early interactions of life in the etiology of borderline cases. In the first axe, early objects relationships and the reorganization of the initials attachments as a source of subsidies for a clinic of borderline cases will be discussed. These cases are understood as marked by early trauma in the context of the first object relationships. It is noted, in relation to transference with these patients, vertical defense mechanisms, such as splitting, emerge more frequently than horizontal defense mechanisms, such as repression. The repression was the central concept for the establishment of classical psychoanalytic technique. This fact makes us tackle the need for refinement of analytical technique for approaching more effectively these cases that challenge the classical technique. In this sense, we will study, in the second axis of this paper, the countertransference under a intersubjectivity perspective and the appreciation of the quality of the analytical relationship.

Precursors of the emotional cascade model of borderline personality disorder: The role of neuroticism, childhood emotional vulnerability, and parental invalidation.

The emotional cascade model proposes that the emotional instability and engagement in maladaptive behaviors within borderline personality disorder (BPD) may be linked to rumination. Previous research has established that BPD is highly related to neuroticism, childhood emotional vulnerability, and parental invalidation. Therefore, the purpose of the current study was to assess whether the constructs of the emotional cascade model relate to other constructs within the BPD nomological network. More specifically, neuroticism, childhood emotional vulnerability, and parental invalidation should relate to the ruminative process and engagement in maladaptive behaviors as described by the emotional cascade model. The current study investigated the relation between these factors using a cross-lagged panel design with data collected online at 3 time points in a student sample and an Amazon Mechanical Turk sample. Neuroticism predicted rumination 1 month later across both samples and for 3 measures of rumination. Childhood emotional vulnerability and parental invalidation predicted rumination 2 months later for 2 measures of rumination in the student sample only. Future studies should continue to investigate the potential role of personality traits and BPD vulnerability factors within the emotional cascade model. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Borderline Personality Disorder: Clinical Guidelines for Treatment.

Borderline personality disorder (BPD) is fundamentally a syndrome composed of symptoms (primarily of emotional dysregulation) and a number of true personality traits (such as inordinate anger, impulsivity, and a tendency to stress-related paranoid ideation). Whereas schizotypal personality disorder, with its cognitive peculiarities (ideas of reference, odd beliefs, eccentric speech), is closely linked as a genetic condition-"borderline" to the major condition schizophrenia-BPD is less closely linked to bipolar disorder. Some cases of BPD are linked genetically to and are in the "border" of bipolar disorder. But the condition can also arise from adverse post-natal factors: parental cruelty or neglect, or incest. In some BPD patients, both are present: risk genes for bipolar disorder and adverse conditions within the family. The genetic risk is often overlooked. To avoid this, initial evaluations should always include a careful and extensive family history for mood disorders, and should extend out to grandparents, aunts, uncles, and cousins. Where the history suggests a genetic link to bipolar disorder, a mood stabilizer such as lithium or lamotrigine, even in modest doses, may be particularly beneficial, more so than conventional antidepressants. In some patients, ADHD was present in childhood, BPD was diagnosed during or after puberty, and a form of bipolar disorder becomes apparent during their 20s. As for the psychotherapeutic component, the patient's cognitive style and capacity for introspection will help determine whether a primarily expressive (psychoanalytically oriented) technique is preferable or a primarily cognitive-behavioral technique. Flexibility is necessary, since during emotional crises, supportive and limit-setting interventions will be needed, along with psychotropic medications, and where necessary, programs to help combat substance abuse (which is common among patients with BPD).

Respiratory Sinus Arrhythmia Mediates Links Between Borderline Personality Disorder Symptoms and Both Aggressive and Violent Behavior.

Although emotion dysregulation (ED) is a core symptom of borderline personality disorder (BPD), tests of associations between ED and aggression and violence-which are common to BPD-are sparse. The authors evaluated mediating effects of an autonomic vulnerability to ED on links between BPD symptoms and (a) reactive aggression, (b) proactive aggression, and (c) histories of interpersonal violence in a sample of young adults (N = 104), ages 18-22 years. Low baseline respiratory sinus arrhythmia (RSA) mediated the association between BPD symptoms and reactive aggression. In contrast, although BPD symptoms were correlated with proactive aggression, no mediational effect was found. In addition, low RSA mediated the association between BPD symptoms and histories of interpersonal violence. Collectively, these findings add evidence that neurobiological vulnerability to ED contributes to aggressive and violent behavior among those with BPD.

Differential Susceptibility to the Environment and Borderline Personality Disorder.

Evolutionary models of psychopathology can shed light on gene-environment interactions. Differential susceptibility to the environment means that heritable traits can have positive or negative effects, depending on environmental context. Thus, traits that increase risk for mental disorders when the environment is negative can be adaptive when the environment is positive. This model can be applied to borderline personality disorder, with predictors such as emotional dysregulation and impulsivity seen as temperamental variations leading to negative effects in an unfavorable environment but to positive effects in a favorable environment. This model may also be useful in conceptualizing the mechanisms of effective therapy for borderline personality disorder.

¿Trastorno límite de personalidad, trastorno por inestabilidad emocional o trastorno por desequilibrio emocional?: una actualización para la Atención Primaria de Salud / Is it a borderline personality disorder, an emotional instability disorder or an emotional imbalance disorder? An update for Primary Health Care / Trastorn límit de la personalitat, trastorn per inestabilitat emocional o trastorn per desequilibri emocional?

El trastorno límite de personalidad es uno de los trastornos más debatidos de la psiquiatría y la psicopatología contemporáneas. Además, es un problema que en atención primaria manifiesta una prevalencia y una frecuentación mayor y más grave que otros muchos tipos de problemas, tanto orgánicos como emocionales. Sin embargo, es uno de los cuadros de la psicopatología actual que resulta más urgente replantearse, al menos desde las perspectivas teóricas, etiopatogénicas y terapéuticas

The borderline personality disorder is one of the most debated disorders in contemporary psychiatry and psychopathology. In addition, in primary care, it represents a more severe problem, with higher and more frequent prevalence compared to other types of problems, both organic and emotional. However, it is one of the icons of the current psychopathology that is most urgent to reconsider, at least from the theoretical, etiopathogenic and therapeutic perspectives

El trastorn límit de la personalitat és un dels trastorns més debatuts de la psiquiatria i la psicopatologia contem-porànies. A més, és un problema que a l'atenció primária manifesta una prevalença i una freqüentació més gran i més greu que molts altres tipus de problemes, tant orgánics com emocionals. No obstant, és un dels quadres de la psicopatologia actual que resulta més urgent replantejar-se, almenys des de les perspectives teóriques, etiopatogéniques i terapéutiques

Current Knowledge on Gene-Environment Interactions in Personality Disorders: an Update.

PURPOSE OF REVIEW: We review the existing literature on gene-environment interactions (G×E) and epigenetic changes primarily in borderline personality disorder (BPD) but also in antisocial, schizotypal, and avoidant personality disorders. RECENT FINDINGS: Research supports that susceptibility genes to BPD or its underlying traits may be expressed under certain environmental conditions such as physical or childhood sexual abuse. Epigenetic modifications of neurodevelopment- and stress-related genes are suggested to underlie the relationship between early life adversary and borderline personality disorder. Only limited studies have investigated the role of gene-environment interactions and epigenetic changes in the genesis of antisocial, schizotypal, and avoidant personality disorders. Considering the lack of pharmacological treatment for most personality disorders, the emerging evidence on the critical role of G×E and epigenetic changes in the genesis of personality disorders could help develop more biologically oriented therapeutic approaches. Future studies should explore the potential of this new therapeutic dimension.

Pacientes, problemas e fronteiras: psicanálise e quadros borderline / Patients, problèmes et frontières: psychanalyse et cadres borderline / Pacientes, problemas y fronteras: psicoanálisis y cuadros borderline / Patients, problems and borders: psychoanalysis and borderline cases

Resumo O artigo trata do quadro clínico conhecido como borderline e é derivado de um exame da literatura psicanalítica sobre o quadro. Nosso objetivo é oferecer informações de maneira sistematizada para que os leitores possam se aprofundar no tema, ou mesmo para que possam confrontar suas posições com as de diversos autores. Trataremos das diversas definições e nomenclaturas, da psicodinâmica, dos sintomas, da etiologia, da diversidade das técnicas terapêuticas, dos problemas comuns durante o tratamento e dos aspectos gerais da transferência e da contratransferência. Ao final, ofereceremos uma contribuição acerca da psicodinâmica, a qual se refere à identificação na literatura da ideia de um objeto borderline que é parte da essência psicodinâmica do quadro. Ademais, desenvolveremos análises das informações examinadas nos utilizando da ideia de objeto borderline como baliza.

Résumé L´article traite cadre clinique connu sous le nom borderline et est dérivé d´un examen de la littérature psychanalytique sur le tableau clinique. Notre objectif est de fournir des informations de manière systématique afin que les lecteurs puissent s'approfondir le sujet, ou même pour qu'ils puissent faire face à leurs positions avec celles de plusieurs auteurs. Nous aborderons les différentes définitions et classifications, les psychodynamique, les symptômes, l'étiologie, la diversité des techniques thérapeutiques et des problèmes communs au cours du traitement, et les aspects généraux du transfert et contre-transfert. A la fin, nous offrons notre contribution sur les psychodynamique, qui fait référence à l'identification dans la littérature de l'idée d'un objet borderline qui fait partie de l'essence du cadre psychodynamique. De plus, nous allons développer des analyses des donnés examinées en utilisant l'idée de l'objet borderline comme objectif.

Resumen El artículo trata del cuadro clínico conocido como borderline y se deriva de un examen de la literatura psicoanalítica sobre el cuadro. Nuestro objetivo es ofrecer informaciones de manera sistematizada para que los lectores puedan profundizarse en el tema, o incluso para que puedan confrontar sus posiciones con las de diversos autores. Trataremos de las diversas definiciones y nomenclaturas, de la psicodinámica, de síntomas, de la etiología, de la diversidad de las técnicas terapéuticas y de los problemas comunes durante el tratamiento, y de los aspectos generales de la transferencia y de la contratransferencia. Al final, ofrecemos una contribución nuestra acerca de la psicodinámica, la cual se refiere a la identificación en la literatura de la idea de un objeto borderline que es parte de la esencia psicodinámica del cuadro. Además, desarrollaremos análisis de las informaciones examinadas utilizando la idea de objeto borderline como baliza.

Abstract The article deals with the clinical condition known as borderline disorder and is derived from an examination of psychoanalytic literature on the case. Our goal is to provide systematic information so that readers can delve into the subject, or even so that they can confront their positions with those of various authors. We'll discuss the several definitions and nomenclatures, psychodynamics, symptoms, etiology, therapeutic techniques, common problems during treatment and the general aspects of the transference and countertransference. In the end, we'll offer a contribution in the psychodynamics, which refers to the identification in the literature of the idea of a borderline object that is part of the psychodynamics essence of the case. In addition, we will analyze the information examined using the idea of borderline object as guideline.