Borderline personality disorder across the lifespan

Area of Science:

• Geriatric Psychiatry
• Clinical Psychology
• Developmental Psychology

Background:

• Borderline personality disorder (BPD) presents with affective dysregulation, unstable relationships, impulsivity, and identity disturbance.
• BPD shares diagnostic overlaps with Post-Traumatic Stress Disorder (PTSD) and bipolar spectrum disorders.
• Limited research exists on late-life BPD, necessitating a nuanced understanding of its presentation in older adults.

Purpose of the Study:

• To explore the characteristics and diagnostic considerations of Borderline Personality Disorder in older adults.
• To understand the etiological factors and treatment approaches for late-life BPD.
• To provide guidance for care environments regarding the management of BPD in the elderly.

Main Methods:

• Review of existing literature on late-life Borderline Personality Disorder.
• Analysis of core BPD features and their manifestation in older individuals.
• Examination of diagnostic challenges and therapeutic strategies for BPD in geriatric populations.

Main Results:

• Core BPD features like interpersonal difficulties, unstable affect, and anger may persist in late life.
• Impulsivity and identity disturbance may decline or present differently in older adults with BPD.
• Diagnosis requires flexible application of criteria and longitudinal history.

Conclusions:

• Late-life BPD requires adapted diagnostic approaches and therapeutic interventions.
• Treatment combines pharmacotherapy (mood stabilizers, SSRIs, antipsychotics) and psychotherapy (DBT, Schema Focused Therapy).
• Caregivers in residential facilities need training to manage BPD behaviors with empathy and limit-setting.