ABSTRACT
In this chapter, we provide an overview of borderline personality disorder (BPD) and discuss the relationship between BPD, self-harm behavior, and eating disorders. BPD is a disorder characterized by ongoing self-regulation difficulties (e.g., eating disorders) and chronic self-destructive behavior (e.g., self-harm). Epidemiological studies indicate that up to one-third of patients who engage in binging/purging have comorbid BPD. The etiology of BPD appears to be associated with early developmental trauma, although this does not exclude other possible contributory variables. With regard to diagnosis, reasonably clear DSM criteria exist, but we recommend using the Gunderson criteria, which can be organized around an acronym for easy recall. From a dynamic perspective, in those with BPD, the eating disorder symptoms appear to have dual meaning-complex relationships with food, body, and weight issues, as well as overt self-harm behavior (i.e., self-injury equivalents). Treatment for these issues is an integrated and long-term process.
