From the Guidelines
Borderline personality disorder is characterized by a pervasive pattern of instability in interpersonal relationships, self-image, emotions, and impulsivity, with diagnostic features including intense fear of abandonment, unstable relationships, identity disturbance, impulsivity, recurrent suicidal behavior, emotional instability, and chronic feelings of emptiness, as outlined in the DSM-IV criteria 1. The diagnostic features of borderline personality disorder (BPD) include:
- Intense fear of abandonment
- Unstable and intense relationships that alternate between idealization and devaluation
- Identity disturbance with an unstable self-image
- Impulsivity in at least two potentially self-damaging areas, such as spending, sex, substance abuse, reckless driving, or binge eating
- Recurrent suicidal behavior or self-harm
- Emotional instability with intense mood shifts lasting hours to days
- Chronic feelings of emptiness
- Inappropriate intense anger or difficulty controlling anger
- Transient stress-related paranoid ideation or severe dissociative symptoms These symptoms cause significant distress and impairment in various areas of functioning, and for a diagnosis, at least five of these criteria must be present, as noted in the study by 1. The instability associated with BPD often disrupts work, relationships, and one's sense of self, and the disorder typically emerges in adolescence or early adulthood, believed to result from a combination of genetic vulnerability and environmental factors, particularly childhood trauma or invalidating environments, as suggested by the American Academy of Child and Adolescent Psychiatry 1. Early identification and appropriate treatment, including dialectical behavior therapy, can significantly improve outcomes for individuals with this disorder, highlighting the importance of prompt and effective intervention to address the complex needs of individuals with BPD, as implied by the assessment and treatment guidelines outlined in 1.
From the Research
Diagnostic Features of Borderline Personality Disorder
The diagnostic features of borderline personality disorder (BPD) include:
- Pervasive patterns of instability in emotions, interpersonal relationships, and self-image 2
- Emotional dysregulation, impulsive aggression, repeated self-injury, and chronic suicidal tendencies 3
- Unstable sense of self, chaotic relationships, fear of abandonment, emotional lability, and impulsivity such as self-injurious behaviors 4
- Impulsivity, mood instability, and reduction in hospitalization rate 5
Common Symptoms
Common symptoms of BPD include:
- Emotional dysregulation
- Impulsive aggression
- Repeated self-injury
- Chronic suicidal tendencies
- Unstable sense of self
- Chaotic relationships
- Fear of abandonment
- Emotional lability
- Impulsivity
Causal Factors
Causal factors that contribute to the development of BPD include:
- Genetic factors
- Adverse events during childhood, such as physical and sexual abuse 3