Yale has received a $3 million grant from a Swiss family to study borderline personality disorder as well as other personality disorders.
The three-year grant was made by the Personality Disorder Research Foundation, which is based in New York City and Zurich, Switzerland.
"The family has had the personal, highly distressing and difficult experience of having a member of the family who had borderline personality disorder," said Thomas McGlashan, M.D., professor of psychiatry at the Yale School of Medicine.
There are about 12 personality disorders defined in the American Psychiatric Association Diagnostic and Statistical Manual. The disorders generally become manifest in adolescence and young adulthood and persist for years, if not a lifetime. The borderline personality disorder is the most common and the most severe, affecting one to two percent of the population, McGlashan said.
A person with a borderline personality disorder exhibits a variety of characteristics, among them frequent mood swings, including depression and despair that lead to suicidal ideas and behaviors. "Often there are multiple suicide attempts where at times it is hard to distinguish the actual intent, whether it is to kill themselves or to call for attention and help," McGlashan said.
The self-destructive behavior might manifest itself as "para- suicidal," he said, where the patients hurt themselves by burning their hands or arms with cigarettes or by cutting or scratching their wrists or body.
"This self-mutilation becomes almost an obsession," McGlashan said. "This is the most obvious and most difficult aspect of the disorder, as well as the behavior that most often brings the patients to the attention of psychiatrists and general practitioners."
Other aspects of the borderline personality disorder are impulsivity and difficulty controlling behavior, especially in the areas of substance abuse and sexual behavior.
McGlashan said another characteristic of patients with borderline personality disorder is that they try to be close to people, but they also fear abandonment.
"In many disorders people isolate themselves from intimacy, but the person with a borderline personality disorder seeks it out," he said. "However, they have very unstable relationships and have difficulty sustaining any kind of intimacy. They seek out the relationship, but they can¹t manage it."
He said a typical relationship cycle is one in which a person first idealizes another and is intensely attracted, but then his or her feelings turn suddenly to jealousy, hatred and disgust -- similar to the homicidal woman in the film, "Fatal Attraction."
There are a variety of theories about the cause of borderline personality disorder ranging from genetics and difficulty with development to traumatic events in childhood, especially sexual abuse, McGlashan said.
Most people with borderline personality disorder are women, although it is also seen in men. The women tend to be depressed and self-destructive. The men are more anti-social and often have criminal records.