Abstract
Borderline personality disorder (BPD) is characterized by a long-term pattern of instability of interpersonal relationships, unstable self-image, marked impulsivity, and/or affective instability. In addition, these features can be evidenced by efforts to avoid real or feared abandonment, chronic feelings of emptiness, mood reactivity, recurrent self-injurious or suicidal behavior, other impulsive behaviors with potential for self-damaging effects, intense anger or difficulty with anger control, and transient paranoid ideation or stress-related dissociative symptoms. BPD is associated with substantial lifetime burdens and psychosocial impairments, including high rates of co-occurring psychiatric disorders; disruptions in interpersonal relationships, school, work, and housing; and suicide attempts and nonsuicidal self-injury. Consequently, early identification and treatment of BPD are crucial. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Borderline Personality Disorder aims to enhance knowledge and increase the appropriate use of interventions for BPD, thereby improving the quality of care and treatment outcomes. To this end, this evidence-based Performance in Practice tool can facilitate the implementation of a systematic approach to practice improvement for the care of individuals with BPD. This practice assessment activity can also be used in partial fulfillment of Continuing Medical Education and ABPN Continuing Certification, Improvement in Medical Practice.