Tests and diagnosis
By Mayo Clinic staffPersonality disorders are diagnosed based on signs and symptoms and a thorough psychological evaluation. To be diagnosed with borderline personality disorder, you must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published and updated by the American Psychiatric Association and is used by mental health professionals to diagnose mental conditions and by insurance companies to reimburse for treatment.
For borderline personality disorder to be diagnosed, at least five of the following signs and symptoms must be present:
- Intense fear of abandonment
- A pattern of unstable relationships
- Unstable self-image or sense of identity
- Impulsive and self-destructive behaviors
- Suicidal behavior or self-injury
- Wide mood swings
- Chronic feelings of emptiness
- Anger-related problems, such as frequently losing your temper or having physical fights
- Periods of paranoia and loss of contact with reality
A diagnosis of borderline personality disorder is usually made in adults, not in children or adolescents. That's because what appear to be signs and symptoms of borderline personality disorder may go away with maturity.
- Borderline personality disorder. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/borderline-personality-disorder-fact-sheet/index.shtml. Accessed March 4, 2010.
- Cluster B personality disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed March 4, 2010.
- Skodol AE, et al. Personality disorders. In: Hales RE, et al., eds. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Association; 2008. http://www.psychiatryonline.com. Accessed March 4, 2010.
- Kernberg OF, et al. Borderline personality disorder. American Journal of Psychiatry. 2009;166:5.
- Oldham JM. Guideline Watch: Practice Guideline for the Treatment of Patients With Borderline Personality Disorder. Arlington, Va.: American Psychiatric Association, 2005. Accessed March 4, 2010.
- Silk KR. Personality disorders. http://www.uptodate.com/home/index.html. Accessed March 4, 2010.
- Hall-Flavin D (expert opinion). Mayo Clinic, Rochester, Minn. March 4, 2010.

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