What is a personality disorder?
an enduring pattern of inner experience and behavior that
- deviates markedly from the expectations of the individual'sculture
- is pervasive and inflexible
- has an onset in adolescence or early adulthood
- is stable over time
- leads to distress or impairment
What is the essential feature of borderline personality disorder?
a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity that begins by early adulthood and is present in a variety of contexts
What are criteria 1 and 2 for borderline personality disorder?
frantic efforts to avoid real or imagined abandonment (not including suicidal or self-mutilating behavior)
a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
What are criteria 3 and 4 for borderline personality disorder?
3. identity disturbance; markedly and persistently unstable self-image or sense of self
4. impulsivity in at least two areas that are potentially self-damaging (ex. spending, sex, substance abuse, reckless driving, binge eating) (do not include suicidal or self-mutilating behavior)
What are criteria 5 and 6 of borderline personality disorder?
5. recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
6. affective instability due to a marked reactivity of mood (ex. intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
What are criteria 7 and 8 of borderline personality disorder?
7. chronic feelings of emptiness
8. inappropriate, intense anger or difficulty controlling anger (ex. frequent displays of temper, constant anger, recurrent physical fights)
What is criterion 9 of borderline personality disorder and how many of the criteria must be present for diagnosis?
9. transient, stress-related paranoid ideation or severe dissociative symptoms
Five or more of the nine criteria must be present for diagnosis.
Do males or females get diagnosed with borderline personality disorder more frequently?
Women account for about 75% of the cases of borderline personality disorder.
What are associated features of borderline personality disorder?
undermining selves when goal is about to be realized (dropping out of school just before graduation, destroying good relationships, etc.)
psychotic-like symptoms (hallicinations, body-image distortions, ideas of reference, etc.)
recurrent job losses, interrupted education, and broken marriages common
childhood history of abuse, neglect, hostile conflict, early parental loss common
frequent comorbidity w/axis I disorders and other personality disorders
What axis I disorders are commonly co-occurring with borderline personality disorder?
eating disorders (notably bulimia)
How can borderline personality disorder be differentiated from histrionic personality disorder?
borderline is distinguished by self-destructiveness, angry disruptions in close relationships, and chronic feelings of deep emptiness and loneliness
How can borderline personality disorder be distinguished from schizotypal personality disorder?
paranoid ideas or illusions are more transient, interpersonally reactive, and responsive to external structuring in borderline personality disorder
How can borderline personality disorder be differentiated from paranoid or narcissistic personality disorders?
paranoid and narcissistic personality disorders have a relative stability of self-image and a relative lack of self-destructiveness, impulsivity, and abandonment concerns
How can borderline personality disorder be distinguished from antisocial personality disorder?
Individuals with antisocial personality disorder are manipulative to gain profit, power, or some other material gratification, instead of gaining gratification of the caretaker.
What distinguishes borderline personality disorder from dependent personality disorder?
reaction to abandonment
Borderline: reacts with emotional emptiness, rage, and demands
Dependent: reacts with increasing appeasement and submissiveness and seeks replacement relationship