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Table 1 Staging model for BPD (adapted from [29])

From: Designing a range of mentalizing interventions for young people using a clinical staging approach to borderline pathology

StageBorderline featuresCo-morbiditySocial and occupational functioning
Stage 0No classic symptoms of BPD, but latent impairments in self and interpersonal functioning, expressed in problems in mood regulation, attention deficits, frustration and distress toleranceEither no formal disorders or some areas of mental problems, including ADHD, conduct problemsNo extensive problems, but areas of problems, including school functioning or peer contacts
Stage IEmerging symptoms of BPD, usually in the areas of affect dysregulation and impulse controlUsually ‘co-morbid’ disorders, including mood, anxiety and conduct disordersEmerging significant problems in school, peer contacts or relationship between parents and child
Stage IIFirst episode of full BPDUsually co-morbid disorders, often in associated areas of emotion dysregulation (mood disorders, PTSD, substance abuse)Significant and lasting problems in school, peer contacts and family
Stage IIIRelapse in full BPD or chronic patterns of full BPDUsually chronic and multiple co-morbid disordersUsually recurring significant problems in social and occupational functioning
Stage IVFull BPD without remission of main problem areasUsually severe and chronic associated psychopathologyNo social or occupational recovery