Revising the Borderline Diagnosis for DSM-V: An Alternative Proposal

The changes in the borderline personality disorder (BPD) diagnosis proposed by the DSM-V personality disorder work group involve radical changes in format (prototype and dimensions) and descriptive characteristics (traits). Changes of this magnitude will create an unwelcome and potentially harmful d...

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Bibliographic Details
Published inJournal of personality disorders Vol. 24; no. 6; pp. 694 - 708
Main Author Gunderson, John G.
Format Journal Article
LanguageEnglish
Published New York, NY Guilford 01.12.2010
Guilford Press
Subjects
Adult and adolescent clinical studies
Algorithms
Biological and medical sciences
Borderline Personality Disorder - diagnosis
Borderline Personality Disorder - psychology
Cooperative Behavior
Depression (Psychology)
Diagnostic and Statistical Manual of Mental Disorders
Humans
Interpersonal Relationship
Mathematics
Medical diagnosis
Medical sciences
Nosology. Terminology. Diagnostic criteria
Patients
Personality
Personality disorders
Personality Problems
Phenomenology
Psychiatric Status Rating Scales
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Resistance (Psychology)
Schizophrenia
Social Psychology
Techniques and methods
Human
Borderline
Criterion
Diagnostic and Statistical Manual V
Classification
Nosology
Diagnosis
Revised drafting
Personality disorder
Recommendation
Online AccessGet full text
ISSN0885-579X
1943-2763
1943-2763
DOI10.1521/pedi.2010.24.6.694

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Summary:The changes in the borderline personality disorder (BPD) diagnosis proposed by the DSM-V personality disorder work group involve radical changes in format (prototype and dimensions) and descriptive characteristics (traits). Changes of this magnitude will create an unwelcome and potentially harmful discontinuity with the definition that has guided BPD research and the development of disorder-specific therapies. This paper offers an alternative proposal that was developed in collaboration with clinical and research leaders. It includes modification of existing criteria, use of a diagnostic algorithm based on phenotypes, and giving BPD a hierarchical relationship vis-à-vis other personality disorders. These changes are incremental, diminish overlap and heterogeneity, sustain clinical and research development, and will improve utilization.
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The author was assisted by Igor Weinberg, PhD, and is deeply indebted to the many colleagues who offered encouragement, identified relevant research, and helped shape this proposal (see Appendix).
ISSN:0885-579X
1943-2763
1943-2763
DOI:10.1521/pedi.2010.24.6.694