DSM V Criteria For BPD

DSM V Criteria for Borderline Personality Disorder

The essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits. To diagnose borderline personality disorder, the following criteria must be met:
A. Significant impairments in personality functioning manifest by:
1. Impairments in self functioning (a or b):
a. Identity: Markedly impoverished, poorly developed, or unstable self-image, often associated with excessive self-criticism; chronic feelings of emptiness; dissociative states under stress.
b. Self-direction: Instability in goals, aspirations, values, or career plans.
AND
2. Impairments in interpersonal functioning (a or b):
a. Empathy: Compromised ability to recognize the feelings and needs of others associated with interpersonal hypersensitivity (i.e., prone to feel slighted or insulted); perceptions of others selectively biased toward negative attributes or vulnerabilities.
b. Intimacy: Intense, unstable, and conflicted close relationships, marked by mistrust, neediness, and anxious preoccupation with real or imagined abandonment; close relationships often viewed in extremes of idealization and devaluation and alternating between over involvement and withdrawal.
B. Pathological personality traits in the following domains:
1. Negative Affectivity, characterized by:
a. Emotional lability: Unstable emotional experiences and frequent mood changes; emotions that are easily aroused, intense, and/or out of proportion to events and circumstances.
b. Anxiousness: Intense feelings of nervousness, tenseness, or panic, often in reaction to interpersonal stresses; worry about the negative effects of past unpleasant experiences and future negative possibilities; feeling fearful, apprehensive, or threatened by uncertainty; fears of falling apart or losing control.
c. Separation insecurity: Fears of rejection by – and/or separation from – significant others, associated with fears of excessive dependency and complete loss of autonomy.
d. Depressivity: Frequent feelings of being down, miserable, and/or hopeless; difficulty recovering from such moods; pessimism about the future; pervasive shame; feeling of inferior self-worth; thoughts of suicide and suicidal behavior.
2. Disinhibition, characterized by:
a. Impulsivity: Acting on the spur of the moment in response to immediate stimuli; acting on a momentary basis without a plan or consideration of outcomes; difficulty establishing or following plans; a sense of urgency and self-harming behaviour under emotional distress.
b. Risk taking: Engagement in dangerous, risky, and potentially self-damaging activities, unnecessarily and without regard to consequences; lack of concern for one’s limitations and denial of the reality of personal danger.
3. Antagonism, characterized by:
a. Hostility: Persistent or frequent angry feelings; anger or irritability in response to minor slights and insults.
C. The impairments in personality functioning and the individual‟s personality trait expression are relatively stable across time and consistent across situations.
D. The impairments in personality functioning and the individual‟s personality trait expression are not better understood as normative for the individual’s developmental stage or socio-cultural environment.
E. The impairments in personality functioning and the individual’s personality trait expression are not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma).

2012

I think this is a much better approach to PD's. I know it is still far off from being reliable... splitting up the ego disturbance from the pathological traits makes it so much easier to ID BPD, imo. Which is likely the goal... since APA feels that the current clinical setting is underdiagnosing because of how varied the disorder can be.

Ouch. It's hurts to admit that the list describes me fairly well... although, I do have periods of time where they affect me to a much lesser degree.

It's problems with goal-setting and following through that bother me most these days.

Dang...that list makes it more apparent that I have those traits and dx.... yuck.

do you know what that could be any person with or without a personality disorder makes it large but also retarded, because it doesn't go into great detail of why the person acts the way they do. its to largely generalized which I personally feel to be me and not me because its faulty.

This is my diagnosis along with depression. I really see myself reflected throughout. I was very fortunate that the hospital where I was an inpatient has a fantastic outpatient program. In addition to individual therapy I also participated in a DBT Group. Dialectical Behavior Therapy (DBT) was created by Dr. Marsha Linehan. It combines behavioral science, Buddhism, acceptance and MINDFULNESS...LoL

It is my hope to eventually get into another DBT Group. It still helps me to this day. It taught me when I have thoughts of harming myself that it's the pain and not my life that I want to end. I learned to sit with and still the pain. It is what I learned through that program that is helping me through this rough patch in my life right now.

I gave up trying to find the model for ICD-11, besides the generalized information about putting PDs on a spectrum... not enthusiastic about that. The alternate model in DSM-5 shows clear distinictions between the PD's - not to mention there are defining empirical statistics regarding their risk of suicide and comorbid behaviors - like impulse control and depression.

But, we'll see. Both DSM-4RV and ICD-10 critria for BPD makes me nauseated.

Actually the ICD-10 is pretty more accurate as a matter of fact; what people don't ount are the comorbidities and how they affect the whole picture, I'm very much comfortable with my F-60.3 and the five other codes (AS COMORBIDITIES) than this imbecilc drivel that is the DSM. It all simply boils down that if you don't treat the other traits, some of them might worsen or the PD itself worsens due to misleading therapy and diagnoses brought forth from this thing. One has to take also consideration of the psychanalitic side of things too. That's why until now I've only met quacks and opportunists shoving me drugs and wrong therapeautical approaches as if I was a lab rat. Thank Nogod for my new psychiatrist, therapist and mother.

I think all the classification does is make a clearer classification for BPD so that those who have some traits but not BPD are not misdiagnosed. I don't honestly know the ICD 10 to compare, but I think there has been a problem with over diagnosis of BPD, and this criteria helps eliminate that a bit. I think some Ts are lazy and don't look deep enough, and it was easier to give this diagnosis. now maybe it will be a little harder.

OP is DSM-5 Alternate Method... the others (ICD-10 and DSM-4) look pretty similar really. Except ICD-10 has them split up with impulsive type and borderline type /smack forehead.

My problem is with including pathology in primary criteria for both DSM-4 and ICD-10. I believe ICD 11 will clear this up by doing a top-down method, but I also think it is the wrong direction to classify all PDs in one category together. But again, as we can't see this new method yet we'll have to wait and see.

As for comorbids, nothing stops DSM-4 or DSM-5 from properly diagnosing them.
--

ICD 10
ICD-10 Criteria for Borderline Personality Disorder

F60.30 Impulsive type
At least three of the following must be present, one of which must be (2):

• marked tendency to act unexpectedly and without consideration of the consequences;

• marked tendency to engage in quarrelsome behavior and to have conflicts with others, especially when impulsive acts are thwarted or criticized;

• liability to outbursts of anger or violence, with inability to control the resulting behavioral explosions;

• difficulty in maintaining any course of action that offers no immediate reward;
  unstable and capricious (impulsive, whimsical) mood.

F60.31 Borderline type
At least three of the symptoms mentioned in F60.30 Impulsive type must be present [see above], with at least two of the following in addition:

• disturbances in and uncertainty about self-image, aims, and internal preferences;

• liability to become involved in intense and unstable relationships, often leading to emotional crisis;

• excessive efforts to avoid abandonment;recurrent threats or acts of self-harm;

• chronic feelings of emptiness.

• demonstrates impulsive behavior, e.g., speeding, substance abuse

DSM-4 Revised
http://behavenet.com/node/21651

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

Moronic drivel to me. I'd rather consider the other pathologies and disregard overgeneralizing ''all encompassing'' diagnoses. There are so many things that this DSM V crap lets slide that I can't even count on every single limb I have, including my two balls.

Edit: alas, I'd said already I wouldn't enter the merits of such a pointless debate. That's not even my opinion it's FACT, so it's a moot point that I should argue with this. If you guys feel comfortable with the DSM, feel free to live on with it and the quacks that develop it.

BTW, that's the 1992 edition of the DSM, I've got the 2008 book here. Things have changed...do youm homework right fellas. Eductae yerselves with something with a cover and pages inside for a change.

Hey guys, sorry if my post is causing some distress, I don't really mean to debate, just give my opinion and clarify any of my posts which are called into question - it is important to me that there is clarity and easy to find information about what I post, which is why I post links to where I get my info.

Anyway, someone mentioned they had no way to compare the two and so I found links online for anyone else who was interested in comparing. I definitely encourage your own research, if you feel like it, they are easy to research by publication.

Anyone who doesn't want to talk anymore about this should definitely take a break, and take care of themselves! Thats most important.

After a little hunting, I was able to find a PDF that has the alternate model in detail from the DSM-5, which is back on topic! It gives a little more insight into how the major criteria are judged at a level of functioning, and then goes on to show the pathologies of each PD.

The alternate method included at the end (which is what the OP posted) is not in clinical use as it is being worked on still, this and the changes in DSM-5 has caused a major controversy in APA and within the profession as well.

Its pretty interesting reading, I refer back to it still when talking about BPD.

Here is the page with the PDF link:
http://focus.psychiatryonline.org/So...d_JournalID=21

And a link right to the download:
http://focus.psychiatryonline.org/da...?resultClick=1

I always think the criteria questions don't help. What matters is the way in which you think, and the problems that it causes you. Treat the symptoms - because you can't actually treat the cause.

BPD is varied - 5 of 9 of the symptoms needed, which leads us to work out that there are 151 different clinical presentations of the condition! Who cares? What matters is the bits that bother you. Get those treated, and ignore the labels.