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Relationship Partner with BPD (Straight and LGBT+) => Romantic Relationship | Detaching and Learning after a Failed Relationship => Topic started by: hopealways on October 14, 2013, 12:23:16 AM



Title: DSM-5 New 2013 Diagnostic Criteria for BPD
Post by: hopealways on October 14, 2013, 12:23:16 AM
Since entering the DSM system 30 years ago the psychiatric definition of BPD has remained largely unchanged until NOW! I myself believed that the DSM-IV criteria reflected a lack of clinical understanding of the borderline patient and am happy to see the new criteria which seems to open the door to better and even more diagnoses.  I believe more of the population suffers from BPD than previously thought.  You can search online for the new DSM-5 criteria but here it is:

To diagnose borderline personality disorder, the following criteria must be met:

A) Significant impairments in personality functioning manifest by:

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

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 feeling 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:

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.

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 behavior 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.

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. substances of abuse or medication) or a general medical condition (e.g. severe brain injury).



Title: Re: DSM-5 New 2013 Diagnostic Criteria for BPD
Post by: Octoberfest on October 14, 2013, 12:31:38 AM
This is not entirely accurate-

"During the development process of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders(DSM-5), several proposed revisions were drafted that would have significantly changed the method by which individuals with these disorders are diagnosed. Based on feedback from a multilevel review of proposed revisions, the American Psychiatric Association Board of Trustees ultimately decided to retain the DSM-IV categorical approach with the same 10 personality disorders.

The proposed revisions that were not accepted for the main body of the manual were approved as an alternative hybrid dimensional-categorical model that will be included in a separate chapter in Section III of DSM-5. This alternative model is included to encourage further study on how this new methodology could be used to assess personality and diagnose personality disorders in clinical practice
"

Source: www.dsm5.org/Documents/Personality%20Disorders%20Fact%20Sheet.pdf

More information found here: https://bpdfamily.com/message_board/index.php?topic=114843.60

What you have posted is the "alternative dimensional-categorical model".  The old criteria is still what is used for diagnosis.


Title: Re: DSM-5 New 2013 Diagnostic Criteria for BPD
Post by: fromheeltoheal on October 14, 2013, 06:35:12 AM
Well, whatever it's called and whether it fits in the shrink bible or not, it describes my ex to a T, and reading it felt really good, further validation that that package of traits is indeed an observeable, replicated 'thing', distinct enough to get defined so precisely.  It wasn't me!  OK, I had my part.  Working on that... .


Title: Re: DSM-5 New 2013 Diagnostic Criteria for BPD
Post by: paul16 on October 14, 2013, 03:15:25 PM
I've always taken the DSM's with a pound of salt. Seems like a set of codes that allow for the diagnosis of a litany of disorders. Show me a human, and I'll show you an applicable diagnosis from the DSM. There is always the coverall, disorder not otherwise specified.

This manual was written by psych doctors who need these codes in order to bill insurance companies for their services.

Don't get me wrong. There are many similarities in the behavior of people considered borderline personalities. But I believe that each one is an individual and needs to be treated as such. When they suggest that behaviors are co-morbid with one another I feel that it over simplifying the situation. When an alcoholic exhibits borderline or histrionic behavior, and acts anti-socially, that unique situation has to be addressed.

I haven't checked but is "math disorder" and "spelling disorder" still listed?