The Difficulty of Treating Personality Disorders in the Present Day: A Look at Borderline, Online Gaming and Gambling

Abstract
This article evaluates the challenges faced in treating personality disorders, with an emphasis on Borderline Personality Disorder (BPD) and the emerging influences of online gaming and gambling in the modern context. An analysis is conducted on therapeutic barriers and social dynamics that complicate clinical management, considering biopsychosocial and technological aspects. Using a qualitative approach based on a literature review, the study proposes alternatives to improve therapeutic interventions and concludes that effective treatment requires multidisciplinary integration, adaptation to sociocultural changes and greater institutional support.

Keywords: Personality disorders; Borderline; Online gaming; Gambling

Objectives
This study aims to explore the difficulties in managing personality disorders in the present day, with a particular focus on borderline personality disorder.

Materials and Methods
This study is based on a qualitative literature review, covering scientific articles, reports and case studies published between 2013 and 2024. The consulted databases include PubMed, Scielo and Google Scholar.

Discussion
The treatment of borderline personality disorder presents significant challenges due to the multifaceted nature of the disorder. Symptoms such as emotional instability^8,9, impulsivity and fear of abandonment often hinder treatment adherence and the establishment of effective therapeutic relationships. In the current context, these challenges are exacerbated by the widespread use of digital technologies, which can amplify dysfunctional behaviors^10-12. Online gaming and gambling platforms have been associated with high levels of immediate emotional reinforcement, a factor that can be particularly detrimental to individuals with BPD. These environments often trigger compulsive behavior patterns, exacerbating symptoms such as impulsivity^13,14. Recent studies suggest that the combination of BPD and problematic digital technology use is associated with a higher frequency of self-harm episodes, interpersonal conflicts and occupational difficulties¹⁵.

Furthermore, engagement in gambling platforms can lead to significant financial losses, further aggravating individuals’ emotional and social distress. The symbolic relationship between immediate rewards and financial losses in gambling reflects patterns of emotional and behavioral instability typical of BPD^16,17. From a therapeutic perspective, approaches based on cognitive-behavioral therapies (CBT) and skill-focused therapies, such as dialectical behavior therapy (DBT), have shown efficacy in treating BPD¹⁸. However, it is necessary to adapt these approaches to address the influence of digital technologies. The integration of digital tools, such as self-help apps, can also complement treatment by providing real-time support and encouraging the development of emotional regulation skills¹⁹.

Conclusion
The management of personality disorders, particularly BPD, faces substantial challenges in the contemporary context. Online gaming and gambling represent emerging factors that complicate clinical management, exacerbate symptoms and hinder treatment adherence. To address these difficulties, it is essential to adopt an integrated approach that considers biopsychosocial and technological aspects. The continuous training of mental health professionals, combined with technological innovation, is fundamental to advancing the treatment of these disorders. Public education campaigns and public policies also play a crucial role in creating a more favorable environment for mental health. Only through close collaboration between different sectors of society will it be possible to overcome the challenges posed by modern times.

Additionally, it is crucial for mental health professionals to stay updated on the digital dynamics influencing human behavior, ensuring that therapeutic interventions remain relevant and effective. Investments in future research and the training of qualified professionals are essential to facing the challenges imposed by this new reality.

References