Borderline personality disorder (BPD) is still seen in many settings as a chronic disorder. This book details the ways that it is symptomatically a “good prognosis” diagnosis. This is particularly seen in the high rate of remissions of BPD and its constituent symptoms. The rate of suicide is also good news, as it is half the expected rate from four follow-back studies conducted in the 1980s. Areas with a more guarded prognosis, particularly for those who have not recovered, are poor physical health and poor vocational adjustment. In addition, rates of other deaths are increasing and have surpassed the rate of deaths by suicide. This book covers the following topics: History of the borderline diagnosis, models of the core features of BPD, earlier studies of the longitudinal course of BPD, the McLean Study of Adult Development (MSAD), the symptoms of BPD assessed in MSAD, the long-term course of the symptoms of BPD, symptomatic remissions and recurrences of the borderline diagnosis, prevalence and predictors of physically self-destructive acts over time, additional symptom areas over time, psychosocial functioning over time, recovery from BPD, predictors of time-to-remission and recovery, co-occurring disorders over time, mental health treatment over time, physical health and medical treatment, adult victimization over time, sexual issues over time, defense mechanisms over time, and new directions.