uicide attempts among BPD patients in order to improve our methods of intervention. Hence, rather than just looking at external causal factors such as comorbidity, it is critical to also evaluate the individual characteristics of BPD that is associated with suicidal behaviour, such as impulsivity. Dialectical Behaviour Therapy (DBT) emerged as a one of the only structured psychotherapeutic programme that prioritises decreasing suicidality in BPD patients, by applying behavioural techniques that are targeted at controlling impulsive tendencies. Since its inception, DBT has been established as the primary treatment for suicidal BPD patients due to the large number of randomized controlled trials (RCTs) conducted on it compared to other treatments. In this essay, I will examine the strength of the evidence highlighting the efficacy of DBT in treating impulsive suicidal behaviours in BPD patients, as well as explore the limitations of this intervention.

DEFINITION OF BPD

DSM-IV-TR characterises patients with BPD as having a “pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity”, the diagnosis is determined when at least five of the nine diagnostic criteria are present in an individual (Oldham, 2006, p.20). The cause of BPD symptoms are thought to stem from an interaction between genetic factors and adverse childhood experiences. Social factors such as physical and sexual abuse during childhood as well as intrafamilial trauma (e.g. violence, neglect and losses) have been specifically associated with the diagnosis of BPD and may build the foundation for dysfunctional behaviours and psychological deficits present in patients (Gado, 2016). BPD patients come across as impulsive risk-takers, and being temperamental, which may result in angry outburst and overreactions. Consequently, these characteristics frequently lead to volatile interpersonal relationships being formed with people in their lives (Sack, 2015). Clinical signs of the disorder commonly include emotional dysregulation and impulsive aggressions; however, the most useful indication for a correct diagnosis is repeated self-injury or chronic suicidal tendencies (Lieb, et al., 2004). Patients with thi