DSM-IV-TR Definition of Borderline Personality Disorder

In the most recent edition of the American Psychiatric Associations’ Diagnostic and Statistical Manual (DSM-IV-TR), the following explanation and diagnostic criteria are provided for borderline personality disorder:

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 (5).

2.A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. This is called "splitting."

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 (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.


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