high vs low functioning BPD?

[Before you can make things better, you have to stop making them worse...]

What is the difference between a high-functioning BPD and a low-functioning BPD?

[AustenJ]

What is the difference between a high-functioning BPD and a low-functioning BPD?

[once removed]

there was some discussion on the differences recently starting here: https://bpdfamily.com/message_board/index.php?topic=299307.msg12806105#msg12806105

a more extensive discussion on the differences can be found on the Psychology of Personality Disorders board here: https://bpdfamily.com/message_board/index.php?topic=56415.0

[infjEpic]

My current impression (this will evolve I'm sure):

Group A: Benign, More Impulsive:
The volatile, harmless*, depressed type
- mild level of pathology** & less co-morbid traits,
- more likely to self inflict,
- attachment disorder more likely to affect the broad spectrum of relationships not just romantic
- more receptive to & responsive to treatment

Group B: Malignant, More Predatory:
The volatile, dangerous, destructive type
- high level of pathology & more co-morbid traits,
- more likely to inflict on others and/or more likely to have substitute coping mechanisms such as Trichotillomania,
- attachment disorder less likely to affect the broad spectrum of relationships but very pronounced disordered behaviour in intimate relationships
- less receptive to & responsive to treatment (due to increased NPD trait co-morbidity)


* harmless meaning they are less likely to pose a threat to others
** mild meaning less traits, not mild pain or outcomes


I've seen other type distinctions such as:
Discouraged, Impulsive, Self Destructive, Petulant

These distinctions do not make a great deal of sense to me presently, since so many of these behaviours seem to be concurrent (including in non-disordered people).
They make much more sense as 'mode' distinctions, with the understanding that 'mode' can change rapidly where BPD is concerned.

[steelwork]

My two cents: I think putting people in "A" or "B" groups wrt personality disordered traits goes against the idea of a spectrum, which implies a distribution along the expanse from "no traits" to "severe impairment"... .and also I don't think the expressions of disorder can be sorted into high and low functioning, exactly. For instance, is it necessarily true that someone who is less impaired would be more impulsive, infjEpic? I don't think so... .but I am not an expert.

[steelwork]

Group B: Malignant, More Predatory:
The volatile, dangerous, destructive type
- high level of pathology & more co-morbid traits,
- more likely to inflict on others and/or more likely to have substitute coping mechanisms such as Trichotillomania,
- attachment disorder less likely to affect the broad spectrum of relationships but very pronounced disordered behaviour in intimate relationships
- less receptive to & responsive to treatment (due to increased NPD trait co-morbidity)

Some of this sounds like antisocial personality disorder to me.

[infjEpic]

My two cents: I think putting people in "A" or "B" groups wrt personality disordered traits goes against the idea of a spectrum, which implies a distribution along the expanse from "no traits" to "severe impairment"... .

The premise of the question requires categorisation under 2 groupings (High/Low or A/B)

Classification doesn't invalidate spectrum distribution, it merely indicates segmentation of the spectrum. (You actually provided a sample segmentation in your example [None/Severe])

and also I don't think the expressions of disorder can be sorted into high and low functioning, exactly.

Not sure if you misinterpreted, but I agree but the expressions of the disorder aren't being classified, the traits are (tho admittedly extremely bluntly).

I agree with you that a spectrum of BPD doesn't make much sense anyway.
A spectrum of disorder may, particularly due to comorbidity. I've been trying to research medical/clinical opinions recently, and there seem to be surprisingly few  professionals so far who do not believe BPD/NPD are always co-morbid to some extent.

For instance, is it necessarily true that someone who is less impaired would be more impulsive, infjEpic? I don't think so... .but I am not an expert.

Again, not sure if you wrote that incorrectly or misinterpreted.

In the example I outlined above, Group A are low functioning. So someone who is less impaired is more impulsive, not less. Personality disorders manifest in a social context, hence they struggle with the broad range of social contexts.

High functioning, by it's very name would indicate less impulsivity - (or more self control, in general, but not in entirety). As an example, they can be highly successful in their career or other social contexts, they have substitute coping mechanism and only family members or intimate partners may ever experience their disordered behaviour.

It's important to stress here - I'm not a professional, and there is no medical or scientific fact in the opinion I've provided.
This is merely the current impression I've acquired through reading

[infjEpic]

Some of this sounds like antisocial personality disorder to me.

Could be a multitude or could just be a non-disordered nasty person.

But it's distinct from low functioning - in that it's premeditated (as opposed to impulsive) and mens rea applies.

[steelwork]

infjEpic: I actually was not saying a spectrum didn't make sense. I don't have that kind of expertise... .I was taking that wisdom (that BPD is a spectrum disorder) at face value. So high would be at one end and low would be at the other end. That's not to put the disorder in two categories--that's just identifying the extremes of the spectrum.

Not sure if you misinterpreted, but I agree but the expressions of the disorder aren't being classified, the traits are (tho admittedly extremely bluntly).

I think I mean "expressions of the disorder" the way you mean "trait", maybe.

A spectrum of disorder may, particularly due to comorbidity. I've been trying to research medical/clinical opinions recently, and there seem to be surprisingly few  professionals so far who do not believe BPD/NPD are always co-morbid to some extent.

Interesting. Cluster B is a cluster for a reason, I guess!

In the example I outlined above, Group A are low functioning. So someone who is less impaired is more impulsive, not less.

I see--thanks for the clarification!

[lovenature]

The higher functioning the less visible their disorder is to anyone that isn't too close and the more life in general works for them. The lower functioning the more visible their disorder is to others who aren't that close to them and the less life in general works for them.
The lower functioning they are, the more likely they are to get the help they need.