High impact global research

Much of what we know about personality disorder — from its early beginnings to diagnosis, treatment and personal recovery — is based on rigorous research conducted around the world. Learn more about seminal research that has been published on personality disorder and related topics. 

Advances in the treatment of personality disorder have led to a variety of evidence-based psychotherapies, including Dialectical Behaviour Therapy, Mentalization Based Treatment and Transference Focused Psychotherapy. Find out more about evidence-based treatments for personality disorder.

• Choi-Kain, L. W., Finch, E. F., Masland, S. R., Jenkins, J. A., & Unruh, B. T. (2017). What works in the treatment of borderline personality disorder. Current Behavioral Neuroscience Reports, 4, 21-30. https://doi.org/10.1007/s40473-017-0103-z

• Bateman, A. W., Gunderson, J., & Mulder, R. (2015). Treatment of personality disorder. The Lancet, 385(9969), 735-743. https://doi.org/10.1016/S0140-6736(14)61394-5

• Cristea, I. A., Gentili, C., Cotet, C. D., Palomba, D., Barbui, C., & Cuijpers, P. (2017). Efficacy of psychotherapies for borderline personality disorder: A systematic review and meta-analysis. Jama Psychiatry, 74(4), 319-328. https://doi.org/10.1001/jamapsychiatry.2016.4287

• Bateman, A., Constantinou, M. P., Fonagy, P., & Holzer, S. (2021). Eight-year prospective follow-up of mentalization-based treatment versus structured clinical management for people with borderline personality disorder. Personality Disorders: Theory, Research, and Treatment, 12(4), 291–299. https://doi.org/10.1037/per0000422

• Giesen-Bloo, J., Van Dyck, R., Spinhoven, P., Van Tilburg, W., Dirksen, C., Van Asselt, T., ... & Arntz, A. (2006). Outpatient psychotherapy for borderline personality disorder: randomized trial of schema-focused therapy vs transference-focused psychotherapy. Archives of General Psychiatry, 63(6), 649-658. https://doi.org/ 10.1001/archpsyc.63.6.649

• Zanarini, M. C. (2009). Psychotherapy of borderline personality disorder. Acta Psychiatrica Scandinavica, 120(5), 373-377. https://doi.org/10.1111/j.1600-0447.2009.01448.x

BPD was once regarded as untreatable. However, longitudinal research has demonstrated that the prognosis for BPD is far more positive than previously thought. Find out more about the longitudinal course and recovery outcomes for people with BPD.

• Choi-Kain, L. W., Reich, D. B., Masland, S. R., Iliakis, E. A., & Ilagan, G. S. (2020). Longitudinal course of borderline personality disorder: What every clinician needs to know. Current Treatment Options in Psychiatry, 7(3), 429-445. https://doi.org/10.1007/s40501-020-00223-x

• Gunderson, J. G., Stout, R. L., McGlashan, T. H., Shea, M. T., Morey, L. C., Grilo, C. M., Zanarini, M. C., Yen, S., Markowitz, J. C., Sanislow, C., Ansell, E., Pinto, A., & Skodol, A. E. (2011). Ten-year course of borderline personality disorder: Psychopathology and function from the collaborative longitudinal personality disorders study. Archives of General Psychiatry, 68(8), 827–837. https://doi.org/10.1001/archgenpsychiatry.2011.37

• Ng, F. Y., Bourke, M. E., & Grenyer, B. F. (2016). Recovery from Borderline Personality Disorder: A Systematic Review of the Perspectives of Consumers, Clinicians, Family and Carers. PLoS One, 11(8), e0160515. https://doi.org/10.1371/journal.pone.0160515

• Temes, C. M., & Zanarini, M. C. (2018). The longitudinal course of borderline personality disorder. Psychiatric Clinics, 41(4), 685-694. https://doi.org/10.1016/j.psc.2018.07.002

• Stone, M. H. (2016). Long-term course of borderline personality disorder. Psychodynamic Psychiatry, 44(3), 449-474. https://doi.org/10.1521/pdps.2016.44.3.449

• Zanarini, M. C., Temes, C. M., Frankenburg, F. R., Reich, D. B., & Fitzmaurice, G. M. (2018). Description and prediction of time-to-attainment of excellent recovery for borderline patients followed prospectively for 20 years. Psychiatry Research, 262, 40-45. https://doi.org/10.1016/j.psychres.2018.01.034

• Chakhssi, F., Zoet, J. M., Oostendorp, J. M., Noordzij, M. L., & Sommers-Spijkerman, M. (2021). Effect of psychotherapy for borderline personality disorder on quality of life: a systematic review and meta-analysis. Journal of Personality Disorders, 35(2), 255-269. https://doi.org/10.1521/pedi_2019_33_439

BPD is a highly stigmatised condition, particularly among mental health professionals. Stigmatising behaviour towards people with BPD can exacerbate mental health difficulties and reduce the likelihood of engaging in future treatment episodes. Find out more about the impact of stigma on people with BPD.

• Klein, P., Fairweather, A. K., & Lawn, S. (2022). Structural stigma and its impact on healthcare for borderline personality disorder: A scoping review. International Journal of Mental Health Systems, 16(1), 48. https://doi.org/10.1186/s13033-022-00558-3

• Grambal, A., Prasko, J., Kamaradova, D., Latalova, K., Holubova, M., Marackova, M., ... & Slepecky, M. (2016). Self-stigma in borderline personality disorder–cross-sectional comparison with schizophrenia spectrum disorder, major depressive disorder, and anxiety disorders. Neuropsychiatric Disease and Treatment, 2439-2448. https://doi.org/10.2147/NDT.S114671

• Lam, D. C., Poplavskaya, E. V., Salkovskis, P. M., Hogg, L. I., & Panting, H. (2016). An experimental investigation of the impact of personality disorder diagnosis on clinicians: Can we see past the borderline? Behavioural and Cognitive Psychotherapy, 44(3), 361-373. https://doi.org/10.1017/S1352465815000351

Personality disorder is associated with an elevated risk of engaging in self-harm and suicidal thoughts and behaviour. Find out more about the prevalence, functions, risk factors, and ways of managing self-harm and suicidal behaviour in people with personality disorder.

• Reichl, C., & Kaess, M. (2021). Self-harm in the context of borderline personality disorder. Current Opinion in Psychology, 37, 139-144. https://doi.org/10.1016/j.copsyc.2020.12.007

• Wolff, J. C., Thompson, E., Thomas, S. A., Nesi, J., Bettis, A. H., Ransford, B., ... & Liu, R. T. (2019). Emotion dysregulation and non-suicidal self-injury: A systematic review and meta-analysis. European Psychiatry, 59, 25-36. https://doi.org/10.1016/j.eurpsy.2019.03.004

• 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. https://doi.org/10.1001/jamapsychiatry.2020.3598

• Mummé, T. A., Mildred, H., & Knight, T. (2017). How do people stop non-suicidal self-injury? A systematic review. Archives of Suicide Research, 21(3), 470-489. https://doi.org/10.1080/13811118.2016.1222319

Complex trauma disorders can result from cumulative exposures to adverse interpersonal experiences during childhood and adolescence, including abuse or neglect from caregivers. Experiencing traumatic events can have profound and enduring effects on a person’s development, relationships, and well-being.

• Ford, J. D., & Courtois, C. A. (2021). Complex PTSD and borderline personality disorder. Borderline Personality Disorder and Emotion Dysregulation, 8(1), 16. https://doi.org/10.1186/s40479-021-00155-9

• De Jongh, A. D., Resick, P. A., Zoellner, L. A., Van Minnen, A., Lee, C. W., Monson, C. M., ... & Bicanic, I. A. (2016). Critical analysis of the current treatment guidelines for complex PTSD in adults. Depression and Anxiety, 33(5), 359-369. https://doi.org/10.1002/da.22469

• Cloitre, M., Garvert, D. W., Weiss, B., Carlson, E. B., & Bryant, R. A. (2014). Distinguishing PTSD, complex PTSD, and borderline personality disorder: A latent class analysis. European Journal of Psychotraumatology, 5(1), 25097. https://doi.org/10.3402/ejpt.v5.25097

• Kezelman, C., & Stavropoulos, P. (2012). ‘The last frontier’ - practice Guidelines for Treatment of Complex Trauma and Trauma Informed Care and Service Delivery. Sydney: Adults Surviving Child Abuse. https://blueknot.org.au/product/practice-guidelines-for-treatment-of-complex-trauma-and-trauma-informed-care-and-service-delivery-digital-download/

Personality disorders have traditionally been conceptualised in terms of distinct categorical diagnoses, however classification systems are rapidly shifting toward the use of a dimensional approach to personality disorder.

• Tyrer, P., Mulder, R., Kim, Y. R., & Crawford, M. J. (2019). The development of the ICD-11 classification of personality disorders: An amalgam of science, pragmatism, and politics. Annual Review of Clinical Psychology, 15, 481-502. https://doi.org/10.1146/annurev-clinpsy-050718-095736

• Sharp, C., & Wall, K. (2021). DSM-5 level of personality functioning: Refocusing personality disorder on what it means to be human. Annual Review of Clinical Psychology, 17, 313-337. https://doi.org/10.1146/annurev-clinpsy-081219-105402

In psychotherapy, ‘common treatment factors’ refer to therapeutic elements that are present across all evidence-based treatments for borderline personality disorder. These common treatment factors promote therapeutic outcomes. Learn more about common factors that underpin the treatment of personality disorder.

• Fonagy, P., Luyten, P., & Bateman, A. (2017). Treating borderline personality disorder with psychotherapy: where do we go from here? JAMA Psychiatry, 74(4), 316-317. https://doi.org/10.1001/jamapsychiatry.2016.4302

• Merced, M. (2015). The beginning psychotherapist and borderline personality disorder: Basic treatment principles and clinical foci. American Journal of Psychotherapy, 69(3), 241-268. https://doi.org/10.1176/appi.psychotherapy.2015.69.3.241

• Sledge, W., Plakun, E. M., Bauer, S., Brodsky, B., Caligor, E., Clemens, N. A., ... & Yeomans, F. (2014). Psychotherapy for suicidal patients with borderline personality disorder: An expert consensus review of common factors across five therapies. Borderline personality Disorder and Emotion Dysregulation, 1(1), 1-8. https://doi.org/10.1186/2051-6673-1-16