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In the DSM 5, 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:

Self (impairment in at least 1):

Identity: Experience of oneself as unique, with clear boundaries between self and others; stability of self-esteem and accuracy of self-appraisal; capacity for, and ability to regulate, a range of emotional experience.  To be rated from healthy functioning (Level = 0) to extreme impairment (Level = 4).

Self-direction: Pursuit of coherent and meaningful short-term and life goals; utilization of constructive and prosocial internal standards of behavior; ability to self-reflect productively.   To be rated from healthy functioning (Level = 0) to extreme impairment (Level = 4).

Interpersonal (impairment in at least 1):

Empathy*: Comprehension and appreciation of others’ experiences and motivations; tolerance of differing perspectives; understanding of the effects of own behavior on others.    To be rated from healthy functioning (Level = 0) to extreme impairment (Level = 4).

Intimacy*: Depth and duration of positive connections with others; desire and capacity for closeness; mutuality of regard reflected in interpersonal behavior.   To be rated from healthy functioning (Level = 0) to extreme impairment (Level = 4).

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Below is the scale for "empathy".  There are four scales in total (identity, self direction, empathy, intimacy).  To me, it is facinating to see "empathy" defined in such clear terms.

Healthy (0) Capable of accurately understanding others’ experiences and motivations in most situations. Comprehends and appreciates others’ perspectives, even if disagreeing.  Is aware of the effect of own actions on others.

Mild impairment (1) Somewhat compromised in ability to appreciate and understand others’ experiences; may tend to see others as having unreasonable expectations or a wish for control. Although capable of considering and understanding different perspectives, resists doing so. Inconsistent is awareness of effect of own behavior on others.

Impaired (2) Hyper-attuned to the experience of others, but only with respect to perceived relevance to self. Excessively self-referential; significantly compromised ability to appreciate and understand others’ experiences and to consider alternative perspectives. Generally unaware of or unconcerned about effect of own behavior on others, or unrealistic appraisal of own effect.

Very Impaired (3) Ability to consider and understand the thoughts, feelings and behavior of other people is significantly limited; may discern very specific aspects of others’ experience, particularly vulnerabilities and suffering.  Generally unable to consider alternative perspectives; highly threatened by differences of opinion or alternative viewpoints. Confusion or unawareness of impact of own actions on others; often bewildered about peoples’ thoughts and actions, with destructive motivations frequently misattributed to others.

Extreme Impairment (4)  Pronounced inability to consider and understand others’ experience and motivation. Attention to others' perspectives virtually absent (attention is hypervigilant, focused on need-fulfillment and harm avoidance).  Social interactions can be confusing and disorienting.

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Here is the scale for intimacy.  There are four scales in total

Healthy (0) -Maintains multiple satisfying and enduring relationships in personal and community life. Desires and engages in a number of caring, close and reciprocal relationships. Strives for cooperation and mutual benefit and flexibly responds to a range of others’ ideas, emotions and behaviors.

Mild impairment (1) -Able to establish enduring relationships in personal and community life, with some limitations on degree of depth and satisfaction.Capacity and desire to form intimate and reciprocal relationships, but may be inhibited in meaningful expression and sometimes constrained if intense emotions or conflicts arise. Cooperation may be inhibited by unrealistic standards; somewhat limited in ability to respect or respond to others’ ideas, emotions and behaviors.

Impaired (2) Capacity and desire to form relationships in personal and community life, but connections may be largely superficial. Intimate relationships are largely based on meeting self-regulatory and self-esteem needs, with an unrealistic expectation of being perfectly understood by others. Tends not to view relationships in reciprocal terms, and cooperates predominantly for personal gain.

Very Impaired (3) Some desire to form relationships in community and personal life is present, but capacity for positive and enduring connection is significantly impaired. Relationships are based on a strong belief in the absolute need for the intimate other(s), and/or expectations of abandonment or abuse.  Feelings about intimate involvement with others alternate between fear/rejection and desperate desire for connection. Little mutuality: others are conceptualized primarily in terms of how they affect the self (negatively or positively); cooperative efforts are often disrupted due to the perception of slights from others.

Extreme Impairment (4)  :)esire for affiliation is limited because of profound disinterest or expectation of harm.  Engagement with others is detached, disorganized or consistently negative. Relationships are conceptualized almost exclusively in terms of their ability to provide comfort or inflict pain and suffering. Social/interpersonal behavior is not reciprocal; rather, it seeks fulfillment of basic needs or escape from pain.

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The remaining scales are listed here:  dsm5.org/ProposedRevisions.aspx?rid=468 (http://www.dsm5.org/ProposedRevisions/pages/proposedrevision.aspx?rid=468)

The DSM-5, due out in 2013, is anticipated to bring a number of changes to the definition of the personality disorders.  As I understand it, the working group is trying to do away with the complex multiaxial diagnostic approach and to make the personality disorders more discrete (less overlap) - basically the Axes I, II, III will be consolidated to one -- the 10 personality disorders will be reduced to 6 -- and PD will be "scored" on a rating system based on severity.

The basic DSM 5 description is actually simpler than the DSM-IV - it will look something like this (note: no 5/9 criteria)

1 Impairments  The must be impairments in self functioning AND impairments in interpersonal functioning (more on this later)

2 Negative Affectivity, characterized by:

• Emotional lability: Unstable emotional experiences and frequent mood changes; emotions that are easily aroused, intense, and/or out of proportion to events and circumstances.

• 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.

• Separation insecurity: Fears of rejection by – and/or separation from – significant others, associated with fears of excessive dependency and complete loss of autonomy.

• 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.

3 Disinhibition, characterized by:

• 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 behavior under emotional distress.

• 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.

4 Hostility:  Persistent or frequent angry feelings; anger or irritability in response to minor slights and insults.