Transcript Differential Diagnosis: Borderline Personality Disorder

Differential Diagnosis: Borderline
Personality Disorder
• DSM IV Diagnostic Criteria
– 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 5 (or more) of
the following:
• Frantic efforts to avoid real or imagined abandonment
• A pattern of unstable and intense interpersonal relationships
characterized by alternating between extremes of idealization
and devaluation
• Identity disturbance: markedly and persistently unstable selfimage or sense of self
• Impulsivity in at least two areas that are potentially selfdamaging (e.g., spending, sex, substance abuse, reckless
driving, binge eating).
• Recurrent suicidal behavior, gestures, or threats, or selfmutilating behavior.
• 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).
• Chronic feelings of emptiness.
• Inappropriate, intense anger or difficulty controlling
anger (e.g., frequent displays of temper, constant anger,
recurrent physical fights).
• Transient, stress-related paranoid ideation or severe
dissociative symptoms.
Why Consider Borderline
Personality Disorder?
• Impulsivity in at least two areas that are
potentially self-damaging
– Shops for clothes and jewelries, maxing out her 2
credit cards
– Went to SM mall of asia and spent at least 14,000 for
shopping
– Tendency to shoplift things
• Chronic feelings of emptiness
– She was approached by a man who told her she
looks miserable and sick (2002)
Why Consider Borderline
Personality Disorder?
• Transient, stress-related paranoid ideation
– When they got stuck on traffic, she got out of
the car and ran away because she thought
there was a coup d’etat going on
Why It Is Not Borderline Personality
Disorder?
• Only 3 out of the required 5 or more
criteria