Fast Five Quiz: Personality Disorders

Stephen Soreff, MD

Disclosures

January 09, 2019

According to the DSM-5, BPD is diagnosed on the basis of (1) a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and (2) marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by at least five of the following:

  • Frantic efforts to avoid real or imagined abandonment; this does not include suicidal or self-mutilating behavior covered in criterion 5

  • A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

  • Identity disturbance—a markedly and persistently unstable self-image or sense of self

  • Impulsivity in at least two areas that are potentially self-damaging (eg, spending, sex, substance abuse, reckless driving, or binge eating); this does not include suicidal or self-mutilating behavior covered in criterion 5

  • Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

  • Affective instability due to a marked reactivity of mood (eg, intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

  • Chronic feelings of emptiness

  • Inappropriate, intense anger or difficulty controlling anger (eg, frequent displays of temper, constant anger, or recurrent physical fights)

  • Transient, stress-related paranoid ideation or severe dissociative symptoms

These characteristics of BPD result in a great deal of distress, struggles, and unstable relationships for individuals and also represent a psychotherapeutic challenge for therapists.

For more information on borderline personality, read here.

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