Borderline Personality Disorder dsm 5

Personality is a mental disorder in that abnormal thoughts and behavior affect the person’s relationship of work and day-to-day functioning and affect throughout most adult life. 

schizoid personality disorder vs schizophrenia
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Table of Contents


Cluster A: paranoid, schizoid, schizotypal personality disorder 

Cluster B: antisocial, histrionic, narcissistic personality disorders, Borderline personality disorder

Cluster C: avoidant(anxious), dependent, and obsessive-compulsive personality disorders


  • Genetic factors can be responsible for a psychopathic personality. 
  • Separation from the parents
  • Identity and independence may trigger a personality disorder.
  • Maternal deprivation, especially in antisocial Personality.
  • Broken home
  • Low self-esteem 
  • Lake of constructive criticism.
  • Borderline personality patients are more likely to physical and sexual abuse in child­hood.

I have already covered What is Sexual Assault? in depth:

  • Histrionic personality disorder is excessive use of repression as a mecha­nism of defence.
  • Paranoid Personality is due to lack of trusting relationship trust, lack of parental affection in childhood, and parents’ rejection leading to low self-esteem.

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Clinical features of abnormal perssonalities

Paranoid Personality Disorder:

  • Lake of trust in other people, suspicious nature, keeping the things hidden.
  • The signs and symptoms are: –
  • Suspicious
  • Mistrustful
  • Sensitive
  • Argumentative
  • Stubborn
  • Self-important
  • Hypersensitive
  • Jealous and irritable

Schizoid Personality Disorder 

  • In Schizoid personality disorder, detachment, social withdrawal, lonely People with this disorder described as loners, with solitary interests and occupations and no close friends; maintain a social distance from family members and seem unconcerned about other’s praise or criticism. 

The signs and symptoms are:  

  • Inappropriate effect
  • Odd beliefs or magical thinking
  • Social withdrawal
  • Odd, eccentric 
  • Lack of close relationships
  • Social isolation
  • Not fitting easily with others

Antisocial (Dissocial) Personality Disorder (Sociopath, Psychopath)

  • An antisocial personality disorder violates others’ rights or social norms, which predisposes the affected person to criminal behavior. The person cannot maintain consistent, responsible functioning at work, school, or as a parent. 

The signs and symptoms are: 

  • Failure to sustain relationships 
  • Disregard for the feelings of others
  • Impulsive actions 
  • Low tolerance for frustration 
  • Tendency to cause violence 
  • Lack of guilt
  • Failure to learn from experience 
  • Reckless disregard for own or others safety 
  • Impulsivity and failure to plan ahead 
  • Manipulative behavior for self-gratification

Histrionic Personality Disorder

Patients with this disorder have an attention-seeking problem and excessively emotional. This disorder is more common in females. People with the disease need to be the center of attention at all times.

The signs and symptoms are:

  • Dramatic emotionality (Emotional blackmail, angry scenes, demonstrative, Suicide attempts, etc.)
  • Craving for novelty and excitement
  • Shallow and labile affectivity
  • Attention-seeking behavior
  • Over concern with physical attractiveness
  • Exaggerated, vague speech
  • Self-dramatization
  • Impulsivity
  • Ego-centricity, self-indulgence, and lack of consideration for others

Narcissistic Personality Disorder

  • People with a narcissistic personality are self-absorbed, self-centered, the lack kindness towards other people.
  • He typically takes advantage of people to achieve his ends and uses them without regard to their feelings.

The signs and symptoms are:

  • Inflated sense of self-importance
  • Attention-seeking, dramatic behavior
  • Unable to face criticism
  • Lack of empathy
  • Exploitative behavior
  • Arrogance
  • Fixed ideas

Borderline personality disorder

  • A borderline personality disorder is a pattern of instability in interpersonal relationships, mood, behavior, and self-image.
  • The four main categories of signs and symptoms are:
  • Unstable relationships
  • Unstable self-image
  • Unstable emotions
  • Impulsivity

Other symptoms include:

  • Lack of control of anger
  • Recurrent suicidal threats or behavior
  • Uncertainty about personal identity
  • Chronic feelings of emptiness
  • Efforts to avoid abandonment
  • Transient stress-related paranoid or dissocia­tive symptoms

Anxious (Avoidant) Personality Disorder: 

  • A nervous personality disorder is a feeling of inadequacy, extreme social anxiety, social withdrawal, and hypersensitivity to other opinions.

The signs and symptoms are:

  • Persistent feeling of tension and appre­hension
  • Inferiority complex
  • Fear of criticism, disapproval, or rejection
  • Unwillingness to become involved with people
  • Poor self-confidence
  • Low self-esteem
  • Fear of rejection from society 
  • Many people with avoidant personality disorder have other psychiatric disorders like social phobia, anxiety disorder, obsessive-compulsive disorder, depressive disorders, and schizophrenia.

Dependent Personality:

  • It leads to passive and clinging behavior and fear of separation or rejection. People with this disorder let others make critical decisions and have a strong need for constant reassurance and support.

The signs and symptoms are:

  • Feeling discomfort with others.
  • inability to take a decision
  • low self-esteem
  • lack of self-confidence
  • Hypersensitivity to criticism. 

Obsessive-compulsive (Anankastic ) Personality Disorder:

  • This disorder is marked by a pervasive desire for perfection and order at the expense of openness, flexibility, and efficiency. 
  • Person feels that whatever he is doing, that is a perfect way.
  • OBLEM: He may force himself and others to follow the right moral principles, conform to too high-performance standards, and insist on literal compliance with authority and rules. 

The signs and symptoms are: 

  • Feeling of excessive doubt and caution.
  • Preoccupation with details, rules, lists, order or schedule 
  • Perfectionism 
  • Rigidity and stubbornness 
  • High standards

Treatment modalities

  • A personality disorder is often challenging to treat. Drug treatment has a minimal role and used if associated mental illness like depres­sion or psychosis is present. Individual and group psychotherapy, therapeutic community, and behavioral therapy may be beneficial. Manipulation of the social environment can try.
  • Group therapy helps patients improve their interaction skills and gain an understanding of how others perceive them. Patients can learn how to ventilate anxiety and trust others in a safe environment. They can practice problem-solving methods within the group to resolve community issues. Individual therapy helps patients gain insight into their thinking and behavior. Ways can explore for them to modify their behavior to a more functional level.
  • Recreation therapy helps the patient to express the feelings and divert the mind of the patient.
  • Occupational treatment allows patients to increase their level of functioning so that they become more independent. Task completion skills can also be evaluated and enhanced by these activities.
  • The therapist’s interaction and guidance can provide patients with constructive ways to deal with anger and other self-destructive behaviors.
  • Provide a safe environment, especially important for patients who exhibit self-mutilating behavior.
  • Do not make exceptions or show favoritism.
  • Identify triggers of acting-out behaviors.
  • Maintain alertness to the manipulative behaviors of patients.
  • Communicate problems with manipulative patients to other team members.
  • Provide positive feedback to patients who are making efforts to change behavior.
  • Medications if needed.

Follow up, homecare, and rehabilitation for personality disorders

  • Because of the long-term, deeply ingrained patterns of maladaptive perceptions, feelings, cognitions, and behaviors that accompany personality disorders, the prognosis for these patients is generally low. At best, it is guarded-It is challenging to change a person’s lifelong patterns of living.

I also wrote a article on Disruptive Behavior Disorder: Causes, Symptoms, and Treatment also you can read.

Patient and family teaching

  • Inform the family that the patient may self mutilate or attempt to injure themself or others, requiring safety precautions and professional interventions.
  • Teach the family how to control malicious behavior.
  • Instruct the patient/family to verbalize their anger rather than use aggressive or passive-aggressive behaviors.
  • Advise the family to reinforce the patient’s realistic self-perceptions and realistic app­raisal of others.
  • Inform the patient/family that the patient needs opportunities to practice simple decision-making skills.
  • Teach the patient/family to identify stressors and recognize, manage, and prevent symptoms.


The critical aspect of treating a personality disorder people recognizes that the problem exists in the first place.

In personality disorder also essential to avoid drinking alcohol and using illicit drugs. These substances can harm emotions and treatment.

If you are close to any family member you suspect might have a personality disorder, you should encourage them to seek help. They may get angry and defensive, but it’s vital to avoid arguing with them.

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I tried to cover as much as I could for personality disorder, but if you still have a question in your mind, feel free to give us comment.

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