User:Irfan Dotani

Irfan Dotani

Irfan Dotani, Student
Contact: 515-509-6250
Email: irfandotani123@gmail.com

Current Position

Student Research Fellow, PERFUSE Study Group

Professional Background

Irfan Dotani is a student research fellow of cardiovascular medicine at the PERFUSE Study Group at Beth Israel Deaconess Medical Center. He is a sophomore at Bowdoin College and is 18 years of age. He has a deep interest in the medical field and hopes to one day pursue his goals and dreams of contributing to the medical field. Irfan is a contributor to multiple chapters, including St. Louis encephalitis, Osteoarthritis, Borderline Personality Disorder, etc.

Education

2021'-Expected graduate date from Bowdoin College.

Causes

Researchers commonly believe that BPD results from a combination of a traumatic childhood, a vulnerable temperament, and stressful maturational events during adolescence or adulthood. Otto Kernberg formulated the theory of Borderline Personality based on a premise of failure to develop in childhood. There are, according to Kernberg, three developmental tasks an individual must accomplish; when one fails to accomplish a certain developmental task, this often corresponds with an increased risk of developing certain psychopathologies. Failing the first developmental task,psychic clarification of self and other, may result in an increased risk to develop varieties of psychosis. Not accomplishing the second task, overcoming splitting, may result in an increased risk to develop a borderline personality.

Causes of Borderline Personality Disorder

Etiology	Description
Childhood abuse, Trauma, or Negelct	Numerous studies have shown a strong correlation between childhood abuse and the development of BPD.[12][13][14][6] Majority of individuals with BPD report having had a history of abuse, neglect, or separation as young children.[15] Patients with BPD have been found to be significantly more likely to report having been verbally, emotionally, physically, and sexually abused by caretakers of either gender. Patients were also much more likely to report having caretakers (of both genders) deny the validity of their thoughts and feelings. They were also reported to have failed to been provided needed protection. Individuals with ignored child physical care during adolescence are more likely to have Borderline Personality Disorder. Parents (of both sexes) were typically reported to have withdrawn from the child emotionally and to have treated the child inconsistently. Additionally, women with BPD who reported a previous history of neglect by a female caretaker and abuse by a male caretaker were consequently at significantly higher risk for being sexually abused by a non-caretaker (not a parent).[16] It has been suggested that children who experience chronic early maltreatment and Reactive Attachment Disorder go on to develop a variety of personality disorders, including Borderline Personality Disorder.[17] Many of these children are violent[18] and aggressive[19]. As adults, these individuals are at risk of developing a variety of psychological problems[20] such as borderline personality disorder.[17] According to Joel Paris,[21] "Some researchers, like Judith Herman, believe that BPD is a name given to a particular manifestation of post-traumatic stress disorder (PTSD): In Trauma and Recovery, she theorizes that when PTSD takes a form that emphasizes heavily on its elements of identity and relationship disturbance, the disorder is named BPD; when the somatic (body) elements are emphasized, the disorder is named hysteria; when the dissociative/deformation of consciousness elements are the focus, the disorder is named DID/MPD" (dissociative identity disorder or multiple personality disorder).
Genetics	An overview of the existing literature suggested that traits related to BPD are influenced by genes, and since personality is generally quite heritable then BPD should also be, but studies have had methodological problems and the links are not yet clear.[27] A major twin study found that if one identical twin met criteria for BPD, the other also met criteria in around a third (35%) of cases.[28] Twin, sibling and other family studies indicate a partially heritable basis for impulsive aggression, but studies of serotonin-related genes to date have suggested only modest contributions to behavior.[22]
Neurofunction	Neurotransmitters implicated in BPD include serotonin, norepinephrine and acetylcholine (related to various emotions and moods); GABA, the brain's major inhibitory neurotransmitter (which can stabilize mood change); and glutamate, an excitatory neurotransmitter. Enhanced amygdala activation in BPD has been identified as reflecting the intense and slowly subsiding emotions commonly observed in BPD in response to even low-level stressors. The activation of both the amygdala and prefrontal cortical areas can reflect attempts to control intensive emotions during the recall of unresolved life events.[29] Impulsivity or aggression, as sometimes seen in BPD, has been linked to alterations in serotonin function and specific brain regions in the cingulate and the medial and orbital prefrontal cortex.[22]
Other Developmental Factors	Some studies suggest that BPD may not necessarily be a trauma-spectrum disorder and that it is biologically distinct from the post traumatic stress disorder that could be a precursor. The personality symptom clusters seem to be related to specific abuses, but they may be related to more persistent aspects of interpersonal and family environments in childhood.[22] There is evidence for the central role of the family in the development of BPD, including interactions that are negative and critical rather than supportive and empathic, with parental and family behaviors transacting with the child's own behaviors and emotional vulnerabilities.[23] Some findings suggest that BPD may lie on a bipolar spectrum, with a number of points of phenomenological and biological overlap between the affective lability criterion of borderline personality disorder and the extremely rapid cycling bipolar disorders.[24][25] Some findings suggest that the DSM-IV BPD diagnosis mixes up two sets of unrelated items—an affective instability dimension related to Bipolar-II, and an impulsivity dimension not related to Bipolar-II.[26]