{"id":1694,"date":"2013-06-05T14:32:30","date_gmt":"2013-06-05T21:32:30","guid":{"rendered":"https:\/\/www.optimumperformanceinstitute.com\/?p=1694"},"modified":"2018-07-25T09:54:31","modified_gmt":"2018-07-25T15:54:31","slug":"dsm-5-and-how-it-affects-the-diagnosis-of-bpd","status":"publish","type":"post","link":"https:\/\/www.optimumperformanceinstitute.com\/bpd-treatment\/dsm-5-and-how-it-affects-the-diagnosis-of-bpd\/","title":{"rendered":"DSM-5 and How it Affects the Diagnosis of BPD"},"content":{"rendered":"
Changes to the DSM – Diagnostic and Statistical Manual<\/a>, often referred to as the \u201cbible\u201d for psychiatrists and other mental health professionals and the subject of much recent controversy, affect several diagnoses, including that of Borderline Personality Disorder (BPD)<\/a>.\u201d Changes to the BPD diagnosis<\/a> in the new DSM-5 involve radical changes that fundamentally amend a definition of BPD that has survived with minimal changes since it entered the DSM system 30 years ago. Because a BPD diagnosis is currently greatly underutilized, most clinicians lack the training that is needed to treat patients with BPD, and because of this lack of training, they are hesitant to work with this population.<\/p>\n Changes within the DSM-5 may encourage doctors to make a BPD diagnosis more frequently than before. The diagnosis will be more visible and accessible, possibly (and hopefully) leading to the creation of much-needed training programs for clinicians. In the DSM-III and IV, placing BPD under the parent class of Personality Disorders may have encouraged excessive use of the residual category, PDNOS (Personality Disorders Not Otherwise Specified).<\/p>\n Hopefully, the changes in the DSM-5, which make the criteria more specific will diminish both BPD\u2019s overlaps and its heterogeneity.\u00a0 Below are the changes we will see, starting with the current DSM-IV-TR and moving into the DSM-5:<\/p>\n Borderline Personality Disorder<\/strong><\/p>\n 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:<\/p>\n Borderline Personality Disorder<\/strong><\/p>\n 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:<\/p>\n A)<\/strong> Significant impairments in personality functioning manifest by:<\/p>\n a) Identity: <\/em>Markedly impoverished, poorly developed, or unstable self-image, often associated with excessive self-criticism; chronic feelings of emptiness; dissociative states under stress.<\/p>\n b) Self-direction: <\/em>Instability in goals, aspirations, values, or career plans.AND<\/li>\n a) Empathy: <\/em>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.<\/p>\n b) Intimacy:<\/em> 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.<\/li>\n<\/ol>\nThe DSM-IV-TR (2000) criteria for Borderline Personality Disorder is as follows:<\/h3>\n
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The DSM-5 (2013) diagnostic criteria for Borderline Personality Disorder:<\/h3>\n
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Impairments in self-functioning (a or b)<\/h4>\n
Impairments in interpersonal functioning (a or b)<\/h4>\n