Mediating And Moderating Factors
Executive function
While high rejection sensitivity is associated with stronger symptoms of borderline personality disorder, executive function appears to mediate the relationship between rejection sensitivity and BPD symptoms. That is, a group of cognitive processes that include planning, working memory, attention, and problem-solving might be the mechanism through which rejection sensitivity impacts BPD symptoms. A 2008 study found that the relationship between a person’s rejection sensitivity and BPD symptoms was stronger when executive function was lower and that the relationship was weaker when executive function was higher. This suggests that high executive function might help protect people with high rejection sensitivity against symptoms of BPD. A 2012 study found that problems in working memory might contribute to greater impulsivity in people with BPD.
Family environment
Family environment mediates the effect of child sexual abuse on the development of BPD. An unstable family environment predicts the development of the disorder, while a stable family environment predicts a lower risk. One possible explanation is that a stable environment buffers against its development.
Self-complexity
Thought suppression
Types Of Personality Disorders
DSM-5 groups the 10 types of personality disorders into 3 clusters , based on similar characteristics. However, the clinical usefulness of these clusters has not been established.
Cluster A is characterized by appearing odd or eccentric. It includes the following personality disorders with their distinguishing features:
What Is The Diagnostic Criteria For Bpd
Are you wondering if you or someone you know has Borderline Personality Disorder ? While a true diagnosis requires the expertise of a mental health professional, you can start by familiarizing yourself with the diagnostic criteria for BPD.
Below are the nine diagnostic criteria for Borderline Personality Disorder, as set out in the Diagnostic and Statistical Manual of Mental Disorders-IV , as well as a brief explanation of what each one means. For there to be a diagnosis of BPD, at least five of the criteria must be met.
1. Frantic efforts to avoid real or imagined abandonment.
People with Borderline Personality Disorder often experience intense fears of abandonment, which can have a serious effect on their self-image and behavior, as well as their ability to maintain relationships.
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
One of the most marked traits of people suffering from BPD is unstable relationships. They will jump from one relationship to another, never really settling down. Sometimes they will put their partner on a pedestal, almost to the point of worshipping them. If something goes wrong, they will demonize the other person. They lack perspective on situations people are either very good or very bad. These same behaviors apply to all relationships, not just romantic relationships.
6. Affective instability due to a marked reactivity of mood .
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Within the DSM-5personality workgroup, there was debate about its redefinition . That debate concerned whether BPD should be redefined as a trait disorder representing a variant of normal personality. … 151 Gunderson JG, Links P: BorderlinePersonalityDisorder: A Clinical Guide, 2nd ed. Washington, DC, American Psychiatric Press, Inc., 2008.
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Table 2 lists the diagnostic criteria for borderlinepersonalitydisorder as outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th ed. . 14 The clinical diagnosis is.
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5. DSM-5BorderlinePersonalityDisorder 301.83 Diagnostic criteria require at least 5 of the following features: Frantic efforts to avoid real or imagined abandonment. (Note: Do not include suicidal or self-mutilating behavior from.
What Should I Do If I Think I Have Bpd

If you think you may have BPD, the first step is to find a mental health professional. While they can be hard to find, there are clinicians who are specially trained to treat BPD and answer your questions. Start by asking your primary care doctor for a referral, or check with family and friends to see if they have any recommendations of a local professional with expertise in your condition.
Borderline Personality Disorder Discussion Guide
Get our printable guide to help you ask the right questions at your next doctor’s appointment.
If you have health insurance, you may want to talk to the insurance company about whether the clinician takes your insurance and how many sessions would be covered and how much the co-pay would be.
If you do not have insurance, you may qualify for public assistance programs or services through your state or region’s department of mental health or social services. You can also ask your primary care physician for a referral, or look into whether medical centers or universities in your area offer psychiatric or psychological services.
In addition to working with a clinician, it may help to educate yourself about the variety of effective treatments available, including medication, psychotherapy, and self-help treatments. Finally, it is important to know that you are not alone and that with help, people with BPD lead normal and fulfilling lives.
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Tip : Improve Your Interpersonal Skills
If you have borderline personality disorder, youve probably struggled with maintaining stable, satisfying relationships with lovers, co-workers, and friends. This is because you have trouble stepping back and seeing things from other peoples perspective. You tend to misread the thoughts and feelings of others, misunderstand how others see you, and overlook how theyre affected by your behavior. Its not that you dont care, but when it comes to other people, you have a big blind spot. Recognizing your interpersonal blind spot is the first step. When you stop blaming others, you can start taking steps to improve your relationships and your social skills.
Recognizing Borderline Personality Disorder Symptoms
Given the epidemiology of BPD, experts consider the diagnostic criteria to be polythetic meaning that instead of requiring a single identifying symptom, a mix of BPD symptoms can qualify for diagnosis. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition provides nine symptomatic criteria, with at least five needed for a diagnosis. These include:
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Diagnostic Criteria For 30183 Borderline Personality Disorder
frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
identity disturbance: markedly and persistently unstable self-image or sense of self
impulsivity in at least two areas that are potentially self-damaging . Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
affective instability due to a marked reactivity of mood
chronic feelings of emptiness
inappropriate, intense anger or difficulty controlling anger
transient, stress-related paranoid ideation or severe dissociative symptoms
About the Author
David Oliver is the founder of BorderlineCentral.coma one stop source of information on how to cope and deal with borderline personality disorder.
What Are The Challenges In Making The Diagnosis
The current diagnostic criteria for borderline personality disorder allow for 256 different combinations of symptoms that could lead to a diagnosis. Clinicians thus may find it challenging to make a diagnosis of borderline personality disorder. Because of their limited time to spend with patients, clinicians can look for several key factors to help them decide whether further assessment for the disorder is necessary.
The most important factor is whether the difficulties have been long standing or, for adolescents, present for at least 1 year.11 If there is a sudden change in functioning or new symptoms, a diagnosis of borderline personality disorder is less likely according to the DSM-IV-TR definition.11
Having difficulties in multiple areas is another important factor.11,21 For example, suicidality or self-harm without problems with mood or relationships is less likely to be borderline personality disorder, whereas a history of suicide attempts along with impulsive substance use and problems with chronic feelings of emptiness and anger is more suggestive of a diagnosis.
If the diagnosis of borderline personality disorder is not made, an affected person may end up with several diagnoses of comorbid disorders, none of which responds to common treatments. For example, patients who have major depressive disorder and comorbid borderline personality disorder generally do not respond as well to antidepressant medications as patients do who have major depressive disorder alone.55
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Moving From Being Out Of Control Of Your Behavior To Being In Control
Its important to recognize that these impulsive behaviors serve a purpose. Theyre coping mechanisms for dealing with distress. They make you feel better, even if just for a brief moment. But the long-term costs are extremely high.
Regaining control of your behavior starts with learning to tolerate distress. Its the key to changing the destructive patterns of BPD. The ability to tolerate distress will help you press pause when you have the urge to act out. Instead of reacting to difficult emotions with self-destructive behaviors, you will learn to ride them out while remaining in control of the experience.
For a step-by-step, self-guided program that will teach you how to ride the wild horse of overwhelming feelings, check out our free Emotional Intelligence Toolkit. The toolkit teaches you how to:
- get in touch with your emotions
- live with emotional intensity
- manage unpleasant or threatening feelings
- stay calm and focused even in upsetting situations
The toolkit will teach you how to tolerate distress, but it doesnt stop there. It will also teach you how to move from being emotionally shut down to experiencing your emotions fully. This allows you to experience the full range of positive emotions such as joy, peace, and fulfillment that are also cut off when you attempt to avoid negative feelings.
A grounding exercise to help you pause and regain control
Find a quiet spot and sit in a comfortable position.
Borderline Personality Disorder Dsm
Reviewed by Whitney White, MS CMHC, NCC., LPC
Borderline personality disorder is a severe mental health issue that involves difficulties regulating mood and emotions. BPD’s signs and symptoms can be difficult to manage but it is possible, and effective treatments are available. This article will explain what borderline personality disorder is, how its described in the DSM-5, and what treatments may be helpful to those with the disorder.
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Personality Disorders And Stigma
When psychologists talk about personality, theyre referring to the patterns of thinking, feeling, and behaving that make each of us unique. No one acts exactly the same all the time, but we do tend to interact and engage with the world in fairly consistent ways. This is why people are often described as shy,outgoing,meticulous,fun-loving, and so on. These are elements of personality.
Because personality is so intrinsically connected to identity, the term personality disorder might leave you feeling like theres something fundamentally wrong with who you are. But a personality disorder is not a character judgment. In clinical terms, personality disorder means that your pattern of relating to the world is significantly different from the norm. . This causes consistent problems for you in many areas of your life, such as your relationships, career, and your feelings about yourself and others. But most importantly, these patterns can be changed!
Self-help tips: 3 keys to coping with BPD
What Is Paranoid Ideation

Paranoid ideation is a symptom that can occur in borderline personality disorder, post-traumatic stress disorder , and psychotic disorders such as schizophrenia. It involves transient, stress-related paranoia. Paranoia is characterized by the experience of feeling threatened, persecuted, or conspired against. It can also loosely refer to beliefs of general suspicion regarding the motives or intentions of others.
If you have borderline personality disorder , it’s likely that you have experienced transient paranoid ideation under stress. It is one of the possible criteria for diagnosis, according to the current Diagnostic and Statistical Manual of Mental Disorders .
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How Can I Help Someone With Borderline Personality Disorder
If you know someone who lives with borderline personality disorder, here are some ways you can help them:
- Take time to learn about the BPD to understand what your loved one is experiencing.
- Encourage your loved one to seek treatment for BPD and ask about family therapy if theyre a relative of yours.
- Offer emotional support, understanding and patience. Change can be difficult and frightening to people with BPD, but their symptoms can improve over time with treatment.
- Seek therapy for yourself if youre experiencing significant stress or symptoms of mental health conditions, such as anxiety or depression. Choose a different therapist from the person your loved one is seeing.
People with BPD have a significantly higher rate of self-harming and suicidal behavior than the general population.
People with BPD who are thinking of harming themselves or attempting suicide need help right away.
If you or someone you know is in immediate distress or thinking about hurting themselves, call the National Suicide Prevention Lifeline toll-free at 1.800.273.TALK .
A note from Cleveland Clinic
Its important to remember that borderline personality disorder is a mental health condition. As with all mental health conditions, seeking help as soon as symptoms appear can help decrease the disruptions to life. Mental health professionals can offer treatment plans that can help people with BPD manage their thoughts and behaviors.
Dsm Definition: Borderline Personality Disorder
The Diagnostic and Statistical Manual of Mental Disorders , published by the American Psychiatric Association , offers a common language and standard criteria for the classification of mental disorders. It is used by clinicians, researchers, psychiatric drug regulation agencies, health insurance companies, pharmaceutical companies, the legal system, and policy makers together with alternatives such as the International Statistical Classification of Diseases and Related Health Problems , produced by the World Health Organization . The DSM is now in its fifth edition, DSM-5, published on May 18, 2013.
The first section of the definition is widely quoted as the “DSM definition of Borderline Personality Disorder” and this has contributed to the confusion of what the disorder is about. Below is the full excerpt from the May 18, 2013 edition.
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Examples Of Mild Dissociation
- Getting caught up in a book or movie to the extent that you are unaware of what’s going on around you
After years of study, researchers are now able to describe the experiences that go along with dissociation, including depersonalization, derealization, amnesia, identity confusion, and identity alteration.
These Criteria Are Obsolete
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 of the following:
frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
identity disturbance: markedly and persistently unstable self-image or sense of self
impulsivity in at least two areas that are potentially self-damaging . Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
affective instability due to a marked reactivity of mood
chronic feelings of emptiness
inappropriate, intense anger or difficulty controlling anger
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 of the following:
frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
chronic feelings of emptiness
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Improving Clinicians Familiarity With Bpd
Borderline personality disorder can be dangerous but remains underdiagnosed. Clinicians can help overcome the stigmas by evaluating more patients for DSM-5 criteria. While every case is different, patients may benefit from a mix of approaches across psychology and pharmacotherapy as long as theyre willing to try them.
Do You Have Borderline Personality Disorder
Knowing if you truly have borderline personality disorder will require a diagnosis from a mental health professional. If you or a loved one may be struggling with BPD, seeking support from a licensed mental health professional is an important step toward recovery.
In addition to going over the DSM-5 BPD criteria listed above, you can also take this BPD test and find out if your present symptoms may be related to BPD.
The test is brief and free. It is important to remember that online tools are helpful, but are not a substitute for clinical assessment or treatment.
A borderline personality disorder isnt always easy to diagnose since many of its symptoms may overlap with other issues. The information above may help you better understand BPD.
References
Frequently Asked Questions
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International Classification Of Disease
The World Health Organization‘s ICD-10 defines a disorder that is conceptually similar to BPD, called Emotionally unstable personality disorder. Its two subtypes are described below.
F60.30 Impulsive type
At least three of the following must be present, one of which must be :
F60.31 Borderline type
At least three of the symptoms mentioned in F60.30 Impulsive type must be present , with at least two of the following in addition:
The ICD-10 also describes some general criteria that define what is considered a personality disorder.