Very strong efforts to avoid real or imagined abandonment.
DSM-5-TR · Cluster B · personality disorder
Could I have borderline personality disorder?
Borderline personality disorder is characterised by a persistent pattern of instability in relationships, self-image and emotions together with marked impulsivity. Having some of these traits does not mean that someone has a personality disorder: DSM-5-TR requires an enduring, pervasive and clinically significant pattern.
Cluster BDramatic, emotional or erratic patterns
5/9
DSM-5-TR
What are the DSM-5-TR features?
DSM-5-TR requires at least 5 of the 9 specific features, together with the general requirements for a personality disorder.
Specific criteria — paraphrased
Intense, unstable relationships that rapidly alternate between idealisation and devaluation.
A markedly unstable self-image or sense of identity.
Impulsivity in at least two potentially self-damaging areas, such as spending, sex, substances, driving or eating.
Repeated suicidal behaviours, gestures or threats, or self-injury.
Marked mood reactivity with changes that are generally brief.
Persistent feelings of emptiness.
Intense anger or major difficulty controlling anger.
Transient stress-related persecutory ideas or marked dissociative symptoms.
Diagnostic reference: DSM-5-TR (American Psychiatric Association, 2022). The wording above is intentionally concise and paraphrased.
The specific criteria are not sufficient on their own
- The pattern is enduring, inflexible and present across different contexts — not only during a crisis or in one particular relationship.
- It causes significant distress or impairment in social, occupational or other important areas of functioning.
- The pattern is stable over time and can be traced back at least to adolescence or early adulthood.
- It is not better explained by another mental disorder, a substance/medication effect or a medical condition.
Differential diagnosis
Borderline personality disorder, bipolar disorder or High Potential?
Emotional dysregulation in borderline personality disorder is often reactive to interpersonal events and may shift rapidly. Bipolar disorder involves distinct mood episodes meeting specific criteria. Emotional intensity in a person with HIP or HEP is also not enough to indicate borderline personality disorder: High Potential and personality disorder are different dimensions that should be assessed separately.
Clinical assessment
How is the diagnosis made?
Diagnosis is not based on a checklist or a single questionnaire. It requires clinical interviewing, review of the person’s long-term pattern and functional impact across settings, and differential diagnosis. Personality questionnaires and tests can support that assessment.
The 10 specific DSM-5-TR personality disorders
Explore the other personality disorders
Personality disorders can share features and sometimes overlap, making differential diagnosis essential.
Are you wondering about your personality functioning?
An emotional and personality assessment can compare several hypotheses, clarify the overall pattern and avoid drawing conclusions from a few isolated traits.
