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This debate also involves the close linkage of BPD with post-traumatic stress. Recently the debate about the definition of BPD has been extended. Due to the fact that the majority of those diagnosed with BPD are female, this has resulted in the suggestion that "... The increase in such BPD diagnoses in women has its genesis in the revisions of the diagnostic code. Specifically, in the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) category, the definition of the term borderline has been resculpted to resemble that of the affective disorders, which has resulted in a diffusion of the "border" between psychosis and neurosis from which the disorder is named (Kroll, 1993)." (Hodges, 2003 p 409)
This will be treated in more depth in the second section.
It should be note that the effort to avoid abandonment is the initial item in the DSM -- IV-TR diagnostic criterion.
However, as has been suggested, there is an opposing point-of-view which views psychopharmacological agents as a viable first line of treatment. This is a perspective that has to be kept in mind in the assessment of the various dimensions of BPD.
In this respect it might be interesting to compare and contrast various Eastern therapeutic philosophies with the ideas of thought and thinking in BPD. Zen Buddhism is very accessible on this aspect through the work of T.D. Suzuki.
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