Borderline personality disorder, a diagnosis that cannot be challenged: If rejecting the diagnosis is a symptom, can the diagnosis ever be wrong? A response to Chazhoor and Younger (2026)
Abstract
Objective: Chazhoor and Younger describe borderline personality disorder (BPD) as a diagnostic and management challenge in regional inpatient psychiatry, including patients' reluctance to accept the diagnosis and preference for autism, attention-deficit/hyperactivity disorder (ADHD) or complex post-traumatic stress disorder (CPTSD). This Perspective examines the epistemic assumptions embedded in that framing and their implications for trauma, neurodivergence, gender diversity, sensory distress and iatrogenic harm. Conclusions: Diagnostic disagreement is not evidence for the diagnosis being disputed. BPD is itself historically and culturally situated, and its application can relocate traumatic, neurodevelopmental, sensory and minority-stress-related distress into a purportedly disordered personality. When dissent, self advocacy or reports of harm are reinterpreted through the same construct, diagnostic reasoning risks becoming recursive and unfalsifiable. I argue for moving beyond BPD towards trauma-informed, neurodiversity-affirming, sensory-informed and epistemically just formulations that remain open to revision.
Related
- Machine Learning in the Differential Diagnosis of Bipolar and Borderline Personality Disorders: A Scoping Review
- From Gendered Diagnosis to Community Care: How Borderline Personality Disorder Organizes Community Mental Health Nursing Practice.
- Canine-Assisted Interventions and Symptoms Associated with Borderline Personality Disorder: A Scoping Review
- Piloting New Medications for Borderline Personality Disorder: The Use of Artificial Intelligence in Psychopharmacological Research
- Attachment, Emerging Borderline Personality Features and Mentalizing Capacity: A Comparative Analysis in Maltreated and Community Children
BibTeX
@misc{cobbaert2026borderline,
title = {{Borderline personality disorder, a diagnosis that cannot be challenged: If rejecting the diagnosis is a symptom, can the diagnosis ever be wrong? A response to Chazhoor and Younger (2026)}},
author = {Laurence Cobbaert},
howpublished = {PsyArXiv},
year = {2026},
month = nov,
doi = {10.31234/osf.io/nw3g7_v1},
url = {https://osf.io/preprints/psyarxiv/nw3g7_v1/},
note = {CC BY 4.0},
}
RIS
TY - UNPB
TI - Borderline personality disorder, a diagnosis that cannot be challenged: If rejecting the diagnosis is a symptom, can the diagnosis ever be wrong? A response to Chazhoor and Younger (2026)
AU - Laurence Cobbaert
PY - 2026
DA - 2026/11/02
PB - PsyArXiv
DO - 10.31234/osf.io/nw3g7_v1
UR - https://osf.io/preprints/psyarxiv/nw3g7_v1/
AB - Objective: Chazhoor and Younger describe borderline personality disorder (BPD) as a diagnostic and management challenge in regional inpatient psychiatry, including patients' reluctance to accept the diagnosis and preference for autism, attention-deficit/hyperactivity disorder (ADHD) or complex post-traumatic stress disorder (CPTSD). This Perspective examines the epistemic assumptions embedded in that framing and their implications for trauma, neurodivergence, gender diversity, sensory distress and iatrogenic harm. Conclusions: Diagnostic disagreement is not evidence for the diagnosis being disputed. BPD is itself historically and culturally situated, and its application can relocate traumatic, neurodevelopmental, sensory and minority-stress-related distress into a purportedly disordered personality. When dissent, self advocacy or reports of harm are reinterpreted through the same construct, diagnostic reasoning risks becoming recursive and unfalsifiable. I argue for moving beyond BPD towards trauma-informed, neurodiversity-affirming, sensory-informed and epistemically just formulations that remain open to revision.
ER -