Borderline Personality Disorder: Pathogenesis and Clinical Findings

Behavioral Traits:

 • Unstable Relationships - Alternating extremes of idealization and devaluation

 • Impulsivity - Impulsivity in at least two areas that are potentially self-damaging such as sex, drugs, financial spending

 • Suicidal Behaviours - Recurrent suicidal behaviour gestures, or threats, or self-mutilating behavior

 • Avoid Abandonment - Frantic efforts to avoid both real and imagined abandonment



Cognitive-Emotional:

 • Dissociative / Paranoid - Transient, stress-related paranoid ideation or severe dissociative symptoms

 • Unstable Mood - Affective instability due to marked reactivity of mood (eg. dysphoria/ irritability/anxiety lasting hours to days)

 • Anger - Intense and inappropriate, or difficulty controlling

 • Unstable Self-image - Markedly and persistently unstable self-image or sense of self

 • Feelings of Emptiness - Chronically experienced



BPD Mnemonic: AM SUICIDE

 - Abandonment (fear of)

 - Mood instability

 - Suicide attempts/ideation

 - Unstable relationships

 - Impulsivity

 - Control of anger (poor)

 - Identity disturbances

 - Dissociate/paranoid when stressed

 - Empty feeling

Dx: >5 of the above with symptoms noted since adolescence, inflexible pattern across multiple environments causing marked social impairment



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