Sunday, May 28, 2006

Diagnosis of Borderline Personality Disorder

According to the DSM-IV (The Psychologists Bible) Borderline Personlity Disorder is diagnosed with the following criteria:

Diagnostic criteria for 301.83 Borderline Personality Disorder
(cautionary statement)

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

(1) frantic efforts to avoid real or imagined abandonment.
Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

(2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

(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 (e.g., spending, sex, Substance Abuse, reckless driving, binge eating).
Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

(5) recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

(6) affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

(7) chronic feelings of emptiness

(8) inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

(9) transient, stress-related paranoid ideation or severe dissociative symptoms

Now this one is the most frequent diagnosis of anyone that self injures. In a study 48% either met the criteria or were diagnosed with BPD (I can't remember which) but if you removed self injury then only 28% met the criteria. Some people will diagnose it just for self injury, they don't have to meet 4 more of the symptoms. It also seems to be the catch all of psychological disorders. Borderline personality disorder is typically a label given to women while Antisocial Personality Disorder is typically label given to men. So if someone tells you that you might have Borderline Personality Disorder then it's not such a good thing. Doctors are also reluctant to treat patients with this diagnosis chalking them up to a lost cause and difficult to treat. Maybe they should either do away with this diagnosis or change it so it is more useful. After all at some points in our life almost all of us could probably get the diagnosis.

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