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Cluster B: Borderline PD Flashcards

(9 cards)

1
Q

Cluster B

A

Dramatic, emotional, erratic - Wild

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2
Q

Criteria

A

5 or more of the following
* Frantic efforts to avoid real or imagined abandonment
* a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
* identity disturbance markedly and persistently unstable self-image or sense of self
* impulsivity and at least two areas that are potentially self-damaging
* E.g. spending, sex, substance abuse, reckless driving, binge eating
* recurrent suicidal Behavior gestures or threats or self-mutilating behavior
* affective instability due to a marked reactivity of mood
* E.g. intense episodic dysphoria irritability or anxiety usually lasting a few hours or only rarely more than a few days
* chronic feelings of emptiness
* inappropriate intense anger or difficulty controlling anger
* transient stress-related paranoid ideation or severe dissociative symptoms

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3
Q

Main characteristics

A
  • Instability in interpersonal relationships, self-image, and affects
  • Marked impulsivity
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4
Q

Associated features

A
  • Instability in multiple aspects of life
  • Reports of ACEs (adverse childhood experiences)
  • Several common co-ocurring disoders
  • High prevalence of co-ocurring disorders: depressive and bipolar disorders, PTSD, ADHD, eating disorders, substance use
  • behavior may result in job loss, academic disruptions, or relationship instability
  • Emotionally intense, sensitive to rejection, and reactive to interpersonal slights
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5
Q

Diagnostic features

A
  • Core symptoms include emotional dysregulation, impulsivity, relationship instability, and unstable self-concept.
  • Commonly reported behaviors include self-sabotage (e.g., quitting just before success), splitting (idealizing/devaluing others), and suicidal/self-injurious behaviors.
  • Often report Adverse Childhood Experiences (ACEs), including abuse, neglect, or parental loss.
  • May develop brief psychotic symptoms during stress (e.g., hallucinations, body distortions, or ideas of reference).
  • Prefer inanimate transitional objects over actual relationships for emotional comfort.
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6
Q

Differential diagnoses

A
  • Depressive/Bipolar Disorders: Co-occurring is common. Avoid diagnosing BPD based only on mood episodes; look for enduring patterns.
  • Histrionic PD: Both are attention-seeking and manipulative, but BPD includes self-destructiveness, emptiness, and unstable identity.
  • Schizotypal PD: Shares paranoid ideas, but BPD symptoms are more interpersonally reactive and transient.
  • Paranoid/Narcissistic PD: Both may have anger issues, but BPD is more unstable, impulsive, and emotionally reactive.
  • Antisocial PD: Both may manipulate, but BPD manipulates for emotional response (caretaking), while ASPD manipulates for material gain.
  • Dependent PD: Both fear abandonment; BPD reacts with rage and clinging, while dependent PD reacts with submissiveness and appeasement.
  • Identity Problems: Adolescents may show temporary identity crises that do not indicate BPD.
  • Personality Change Due to Another Medical Condition: Exclude conditions that could mimic BPD symptoms.
  • Substance Use Disorders: Exclude symptoms caused by substance intoxication or withdrawal.
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7
Q

Gender and prevalence

A
  • Prevalence: 1.6-5.9%
    • 6% in primary care, 10% in outpatient, and 20% in inpatient settings
  • About 75% of diagnosed cases are female
  • May be underdiagnosed in males and misattributed to other disorders
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8
Q

Cultural considerations

A
  • Present globally in various cultures.
  • Adolescents and young adults may show transient symptoms due to identity crises, cultural expectations, or life stressors—not necessarily indicative of BPD.
  • Clinicians should consider developmental and cultural context before diagnosing.
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9
Q

Early signs

A
  • Family history of BPD, substance use disorders, antisocial PD, bipolar, or depression increases risk.
  • Early emotional sensitivity, intense mood swings, and difficulty managing emotions.
  • Childhood experiences of physical or sexual abuse, parental loss, neglect, or hostile/conflicted family dynamics are common precursors.
  • Early signs of impulsivity, identity confusion, and interpersonal turmoil may emerge in adolescence.
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