The DSM-IV Axis II Work Group of the American Psychiatric Association finally decided on the name "borderline personality disorder", which is still in use by the DSM-5 today. However, the term "borderline" has been described as uniquely inadequate for describing the symptoms characteristic of this disorder. Etymology
Earlier versions of the DSM—before the multiaxial diagnosis system—classified most people with mental health problems into two categories: the psychotics and the neurotics. Clinicians noted a certain class of neurotics who, when in crisis, appeared to straddle the borderline into psychosis. The term "borderline personality disorder" was coined in American psychiatry in the 1960s. It became the preferred term over a number of competing names, such as "emotionally unstable character disorder" and "borderline schizophrenia" during the 1970s. Borderline personality disorder was included in DSM-III (1980) despite not being universally recognized as a valid diagnosis. Controversies
Credibility and validity of testimony
The credibility of individuals with personality disorders has been questioned at least since the 1960s. : 2  Two concerns are the incidence of dissociation episodes among people with BPD and the belief that lying is a key component of this condition. Dissociation
Researchers disagree about whether dissociation, or a sense of emotional detachment and physical experiences, impacts the ability of people with BPD to recall the specifics of past events. A 1999 study reported that the specificity of autobiographical memory was decreased in BPD patients. The researchers found that decreased ability to recall specifics was correlated with patients levels of dissociation. Lying as a feature
Some theorists argue that patients with BPD often lie.
There is typically a low numbers of macrophages and inflammatory cells (although this is variable). Treatment
The standard treatment for PAP is whole-lung lavage and supportive care. Whole lung lavage is a procedure performed under general anesthesia, in which one lung is pumped with oxygen (ventilated lung), and the other lung (non-ventilated lung) is filled with a warm saline solution (up to 20 L) and drained, removing any proteinaceous effluent along with it. This is generally effective at improving PAP symptoms, often for a prolonged period of time. Other treatments still being studied include subcutaneous and inhaled GM-CSF, and rituximab, an intravenous infusion that works to stop the production of the autoantibodies responsible for autoimmune PAP. Lung transplantation has been performed in individuals with the various forms of PAP; however, this is often only used when all other treatment options have failed and significant lung damage has developed due to the risks, complications, or recurrence of PAP following transplantation. Epidemiology
The disease is more common in males and in tobacco smokers.In a recent epidemiologic study from Japan,  Autoimmune PAP has an incidence and prevalence higher than previously reported and is not strongly linked to smoking, occupational exposure, or other illnesses. Endogenous lipoid pneumonia and non-specific interstitial pneumonitis has been seen prior to the development of PAP in a child. History
PAP was first described in 1958 by the physicians Samuel Rosen, Benjamin Castleman, and Averill Liebow.