Monday, 21 June 2010


Proposed title changes for Borderline Personality Disorder:

"One possible alternative proposed by Marsha Linehan, Ph.D (an expert in BPD) is Emotional Regulation Disorder. This term integrates a key component of BPD - Emotion dysreguation. Another term proposed is Emotional Processing Disorder.This last term better integrates emotional dysreguation and the cognitive dysreguation which is now thought to be a key factor in BPD."

-Extracted from: Target:David J. Kupfer Chair of the DSM-V Task Force .Sponsored by: The Borderline Personality Disorder Awareness Campaign

One of the best ones I've read....

"Individuals who match this personality disorder type have an extremely fragile self-concept that is easily disrupted and fragmented under stress and results in the experience of a lack of identity or chronic feelings of emptiness. As a result, they have an impoverished and/or unstable self structure and difficulty maintaining enduring intimate relationships. Self-appraisal is often associated with self-loathing, rage, and despondency. Individuals with this disorder experience rapidly changing, intense, unpredictable, and reactive emotions and can become extremely anxious or depressed. They may also become angry or hostile, and feel misunderstood, mistreated, or victimized. They may engage in verbal or physical acts of aggression when angry. Emotional reactions are typically in response to negative interpersonal events involving loss or disappointment.

Relationships are based on the fantasy of the need for others for survival, excessive dependency, and a fear of rejection and/or abandonment. Dependency involves both insecure attachment, expressed as difficulty tolerating aloneness; intense fear of loss, abandonment, or rejection by significant others; and urgent need for contact with significant others when stressed or distressed, accompanied sometimes by highly submissive, subservient behavior. At the same time, intense, intimate involvement with another person often leads to a fear of loss of an identity as an individual. Thus, interpersonal relationships are highly unstable and alternate between excessive dependency and flight from involvement. Empathy for others is severely impaired.
Core emotional traits and interpersonal behaviors may be associated with cognitive dysregulation, i.e., cognitive functions may become impaired at times of interpersonal stress leading to information processing in a concrete, black-and white, all-or-nothing manner. Quasi-psychotic reactions, including paranoia and dissociation, may progress to transient psychosis. Individuals with this type are characteristically impulsive, acting on the spur of the moment, and frequently engage in activities with potentially negative consequences. Deliberate acts of self-harm (e.g., cutting, burning), suicidal ideation, and suicide attempts typically occur in the context of intense distress and dysphoria, particularly in the context of feelings of abandonment when an important relationship is disrupted. Intense distress may also lead to other risky behaviors, including substance misuse, reckless driving etc.


A. Type rating. Rate the patient%u2019s personality using the 5-point rating scale shown below. Circle the number that best describes the patient%u2019s personality.

5 = Very Good Match: patient exemplifies this type
4 = Good Match: patient significantly resembles this type
3 = Moderate Match: patient has prominent features of this type
2 = Slight Match: patient has minor features of this type
1 = No Match: description does not apply

B. Trait ratings. Rate extent to which the following traits associated with the Borderline Type are descriptive of the patient using this four-point scale:

0 = Very little or not at all descriptive
1 = Mildly descriptive
2 = Moderately descriptive
3 = Extremely descriptive
1. Negative Emotionality: Emotional Lability
Having unstable emotional experiences and mood changes; having emotions that are easily aroused, intense, and/or out of proportion to events and circumstances

2. Negative Emotionality: Self-harm
Engaging in thoughts and behaviors related to self-harm (e.g., intentional cutting or burning) and suicide, including suicidal ideation, threats, gestures, and attempts

3. Negative Emotionality: Separation insecurity
Fears of rejection by, and/or separation from, significant others; distress when significant others are not present or readily available

4. Negative Emotionality: Anxiousness
Feelings of nervousness, tenseness, and/or being on edge; worry about past unpleasant experiences and future negative possibilities; feeling fearful and threatened by uncertainty

5. Negative Emotionality: Low self-esteem
Having a poor opinion of one%u2019s self and abilities; believing that one is worthless or useless; disliking or being dissatisfied with one%u2019s self; believing that one cannot do things or do them well

6. Negative Emotionality: Depressivity
Having frequent feelings of being down/ miserable/ depressed/ hopeless; difficulty %u201Cbounding back%u201D from such moods; belief that one is simply a sad/ depressed person

7. Antagonism: Hostility
Irritability, hot temperedness; being unfriendly, rude, surly, or nasty; responding angrily to minor slights and insults

8. Antagonism: Aggression
Being mean, cruel, or cold-hearted; verbally, relationally, or physically abusive; humiliating and demeaning of others; willingly and willfully engaging in acts of violence against persons and objects; active and open belligerence or vengefulness; using dominance and intimidation to control others

9. Disinhibition: 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 and following plans; failure to learn from experience

10. Schizotypy: Dissociation Proneness
Tendency to experience disruptions in the flow of conscious experience; %u201Closing time,%u201D (e.g., being unaware of how one got to one%u2019s location); experiencing one%u2019s surroundings as strange or unreal"