Title page
Course: PYC4802
Assignment 3 (2025)
Title: Diagnosing Borderline Personality Disorder: Challenges and Contextual
Considerations in South Africa
Student name:
Student number:
Due: August 2025
Abstract (≈220 words)
Borderline Personality Disorder (BPD) presents diagnostic complexity worldwide and in
South Africa owing to symptom overlap with mood, trauma- and substance-related
disorders, and high comorbidity. In resource-constrained and culturally diverse settings
such as South Africa, contextual factors including high trauma exposure, limited mental-
health workforce, stigma, and variable awareness among primary care providers further
complicate accurate identification and timely intervention. This study will synthesise
South African and international literature, and undertake a mixed-methods investigation
combining (1) a quantitative chart review of psychiatric and emergency admissions to
estimate clinical prevalence and common presenting profiles, and (2) qualitative
interviews with clinicians and family members to explore diagnostic challenges, cultural
conceptualisations of emotional dysregulation, and systemic barriers to accurate
diagnosis. Quantitative data will use standardised diagnostic checklists (structured
clinical interview notes or validated screening tools) to quantify rates of documented
borderline or borderline-phenotype presentations; qualitative data will be analysed
thematically to capture lived and professional experiences. Ethical issues
(confidentiality, risk management for self-harm) and cultural sensitivity in interviewing
will be central. Findings will inform locally-appropriate diagnostic recommendations and
, training priorities for clinicians in South Africa. The study aims to increase diagnostic
clarity, reduce misdiagnosis, and improve early access to evidence-based interventions
adapted to the South African context.
1. Introduction (short)
Why this topic? BPD causes substantial distress, functional impairment and
high service use (outpatient and inpatient). International community prevalence
estimates commonly range ~0.7–3% while clinical settings show much higher
rates; South African data are limited but indicate BPD and borderline pathology
are commonly encountered in psychiatric settings and among adolescents in
clinical samples. ScienceDirectSciELO
South African context: high rates of trauma/violence, constrained psychiatric
workforce, variability in access to specialised psychotherapy, and stigma shape
diagnostic pathways and management. bpdvideo.comSciELO
2. Aims & Research Questions
Overall aim: To examine diagnostic challenges and contextual considerations
surrounding BPD in South Africa and produce recommendations for more accurate,
culturally-sensitive identification.
Research questions
1. What is the documented prevalence and clinical profile of BPD presentations in
selected South African psychiatric/ED settings? SciELO
2. What challenges do clinicians report in diagnosing BPD (e.g., comorbidity, time
constraints, stigma, training gaps)? ResearchGate
3. How do family members and patients conceptualise the difficulties associated
with BPD (cultural attributions, help-seeking)? University of Johannesburg
Course: PYC4802
Assignment 3 (2025)
Title: Diagnosing Borderline Personality Disorder: Challenges and Contextual
Considerations in South Africa
Student name:
Student number:
Due: August 2025
Abstract (≈220 words)
Borderline Personality Disorder (BPD) presents diagnostic complexity worldwide and in
South Africa owing to symptom overlap with mood, trauma- and substance-related
disorders, and high comorbidity. In resource-constrained and culturally diverse settings
such as South Africa, contextual factors including high trauma exposure, limited mental-
health workforce, stigma, and variable awareness among primary care providers further
complicate accurate identification and timely intervention. This study will synthesise
South African and international literature, and undertake a mixed-methods investigation
combining (1) a quantitative chart review of psychiatric and emergency admissions to
estimate clinical prevalence and common presenting profiles, and (2) qualitative
interviews with clinicians and family members to explore diagnostic challenges, cultural
conceptualisations of emotional dysregulation, and systemic barriers to accurate
diagnosis. Quantitative data will use standardised diagnostic checklists (structured
clinical interview notes or validated screening tools) to quantify rates of documented
borderline or borderline-phenotype presentations; qualitative data will be analysed
thematically to capture lived and professional experiences. Ethical issues
(confidentiality, risk management for self-harm) and cultural sensitivity in interviewing
will be central. Findings will inform locally-appropriate diagnostic recommendations and
, training priorities for clinicians in South Africa. The study aims to increase diagnostic
clarity, reduce misdiagnosis, and improve early access to evidence-based interventions
adapted to the South African context.
1. Introduction (short)
Why this topic? BPD causes substantial distress, functional impairment and
high service use (outpatient and inpatient). International community prevalence
estimates commonly range ~0.7–3% while clinical settings show much higher
rates; South African data are limited but indicate BPD and borderline pathology
are commonly encountered in psychiatric settings and among adolescents in
clinical samples. ScienceDirectSciELO
South African context: high rates of trauma/violence, constrained psychiatric
workforce, variability in access to specialised psychotherapy, and stigma shape
diagnostic pathways and management. bpdvideo.comSciELO
2. Aims & Research Questions
Overall aim: To examine diagnostic challenges and contextual considerations
surrounding BPD in South Africa and produce recommendations for more accurate,
culturally-sensitive identification.
Research questions
1. What is the documented prevalence and clinical profile of BPD presentations in
selected South African psychiatric/ED settings? SciELO
2. What challenges do clinicians report in diagnosing BPD (e.g., comorbidity, time
constraints, stigma, training gaps)? ResearchGate
3. How do family members and patients conceptualise the difficulties associated
with BPD (cultural attributions, help-seeking)? University of Johannesburg
