who presents the Borderline Personality Disorder tends to act compulsively, without taking into account the consequences and, together with this, manifests great affective instability.
There are other fundamental elements that are analyzed for the diagnosis of this condition, including: chronic anxiety; obsessions; hypochondria; paranoid tendencies; perverse sexual tendencies; impulsivity; tendency to different types of drug addiction; exhibitionist and dependency needs; and feelings of emptiness.
The 10 most obvious symptoms in Borderline Personality Disorder they are:
The characteristics of affective instability, impulsivity and aggressiveness are even more pronounced when borderline individuals present suicide ideation or attempts. In addition, the bearers of this painting cross borders such as time.
They live the present intensely, although they cannot integrate their past and future plans. This intensity with which the individual needs to experience his relationships is associated with his feelings of inferiority, which are invasive and cover almost his entire personality.
Although anxiety is usually present in borderline individuals, it is not a constant and disturbing feature in these individuals. On the contrary, apparently, many appear to be physically and mentally calm, even impressing others by not getting so upset in difficult situations.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), on average, the prevalence of individuals with Borderline Personality Disorder is estimated at 1.6%, and may reach 5.9%.
The diagnosis is predominant in women. However, the prevalence tends to decrease in older age groups.
Due to the diverse symptoms and types of manifestations, it is important to differentiate Borderline Personality Disorder from other psychopathologies. When the symptoms focus on the presence of behaviors closer to psychosis, the diagnosis is usually no longer borderline disorder, but rather schizotypal personality disorder. Thus, it is important to adequately investigate the traits of the borderline disorder, in order to make the correct diagnosis. So, when there is a suspicion that an individual has Borderline Personality Disorder, he must undergo a psychological evaluation process.
Psychological assessment provides a clearer and more specific understanding of an individual’s psychic functioning, seeking to identify and evaluate various aspects to classify the case and predict its direction, in addition to communicating the results through feedback and proposing solutions. However, the psychological evaluation of people who have Borderline Personality Disorder is difficult due to the different defense mechanisms that are common in these individuals.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM – 5), there are some criteria, five of which must be present for the diagnosis of Borderline Personality Disorder to be made. These criteria are:
- A pervasive pattern of instability in interpersonal relationships, self-image, and affect, and marked impulsivity that begins in early adulthood and is present in a variety of contexts, as indicated by 5 (or more) of the following:
- Intense efforts to avoid real or imagined abandonment.
- Instability and intensity in interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
- Identity disorders related to persistently unstable self-image or sense of self.
- Impulsivity in at least 2 areas that are potentially self-defeating, for example, substance abuse, binge eating, spending, sex, and irresponsible driving.
- Frequent suicidal behavior, in the form of gestures or threats, or self-mutilating behavior.
- Affective instability associated with mood, such as severe episodic dysphoria or irritability that may last for a few hours and rarely more than a few days.
- Chronic feelings of emptiness.
- Intense, inappropriate anger or difficulty controlling anger.
- Transient paranoid ideation associated with stress.
How is Borderline Personality Disorder diagnosed?
Diagnosis is based on symptoms that have been present since adolescence or early adulthood and appear in a variety of contexts. There are no laboratory or imaging tests that can help with this diagnosis.
Structured and semi-structured interviews can help with diagnosis, although they often require specialized training to apply. The Diagnostic Interview for Borderlines (Revised) is currently a validated and widely used tool, considered the “gold standard”, and can take 30 to 60 minutes to complete.
The diagnosis also requires that at least 5 of the 9 specific criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) be met.
In interviewing patients, different symptom domains should be explored, including interpersonal relationships, affectivity, cognition, and impulse control.
How should patients be informed about their diagnosis?
Once the diagnosis of borderline has been established, it is important to inform the patient of the diagnosis and discuss the implications for treatment options and outcomes. There is no evidence to suggest that informing patients of the diagnosis causes problems. On the contrary, it is advisable not to omit.
When informing the patient about the diagnostic suspicion, it is important to show the list of diagnostic criteria and explain the reasons why the diagnosis is being considered.
Making patients aware of the increasing number of specific treatments and the good prognosis with gradual resolution of symptoms can also help them reduce their anxiety about a highly stigmatized diagnosis in the medical system and the general population.
After the diagnosis is closed and the patient is informed, the most appropriate treatment can be defined, usually including psychotherapy and medication. In the past, treatment was considered challenging, but some interventions have been developed in the last few decades that have drastically changed the lives of patients with this disorder.
Source: blogdasaude.com.br
