What is the basis for diagnosis for borderline personality disorder (BPD)?

Updated: Nov 05, 2018
  • Author: Roy H Lubit, MD, PhD; Chief Editor: Caroly Pataki, MD  more...
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Answer

In the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), [4] the diagnosis of BPD is based on the following (see Overview):

  • A pervasive pattern of instability of interpersonal relationships, self-image, and affects

  • Marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by the presence of at least 5 of 9 diagnostic criteria

In a small study, 18 patients with BPD underwent a modified version of the Iowa Gambling Task while an electroencephalogram (EEG) was recorded. The results indicated that patients with BPD are impaired with respect to decision-making. This impairment which might be related to a dysfunctional use of feedback information, in that the patients did not learn to avoid harmful choices even though they were aware of the negative consequences. [25]


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