Mood Swings: A Musical Comedy Revue By, For, And About The Emotionally Unstable

Family environment mediates the effect of child sexual abuse on the development of BPD. An unstable family environment predicts the development of the disorder, while a stable family environment predicts a lower risk. One possible explanation is that a stable environment buffers against its development. Self-complexity , or considering one's self to have many different characteristics, appears to moderate the relationship between Actual-Ideal self-discrepancy issues and the development of BPD symptoms.

That is, for individuals who believe that their actual characteristics do not match the characteristics that they hope to acquire, high self-complexity reduces the impact of their conflicted self-image on BPD symptoms. That is, for individuals who believe that their actual characteristics do not match the characteristics that they should already have, high self-complexity does not reduce the impact of their conflicted self-image on BPD symptoms. The protective role of self-complexity in Actual-Ideal self-discrepancy, but not in Actual-Ought self-discrepancy, suggests that the impact of conflicted or unstable self-image in BPD depends on whether the individual views himself or herself in terms of characteristics that they hope to acquire, or in terms of characteristics that they should already have acquired.

A study found that thought suppression , or conscious attempts to avoid thinking certain thoughts, mediates the relationship between emotional vulnerability and BPD symptoms. However, this study did find that thought suppression mediates the relationship between an invalidating environment and BPD symptoms. Diagnosis of borderline personality disorder is based on a clinical assessment by a mental health professional. The best method is to present the criteria of the disorder to a person and to ask them if they feel that these characteristics accurately describe them.

In general, the psychological evaluation includes asking the patient about the beginning and severity of symptoms, as well as other questions about how symptoms impact the patient's quality of life. Issues of particular note are suicidal ideations, experiences with self-harm, and thoughts about harming others. In the DSM-5 , the name of the disorder remains the same as in the previous editions.

Consequently, all disorders, including personality disorders, are listed in Section II of the manual. A person must meet 5 of 9 criteria to receive a diagnosis of borderline personality disorder. These alternative criteria are based on trait research and include specifying at least four of seven maladaptive traits. The World Health Organization 's ICD defines a disorder that is conceptually similar to borderline personality disorder, called F Its two subtypes are described below.

At least three of the symptoms mentioned in F The ICD also describes some general criteria that define what is considered a personality disorder. Theodore Millon has proposed four subtypes of BPD. He suggests that an individual diagnosed with BPD may exhibit none, one, or more of the following: People with BPD may be misdiagnosed for a variety of reasons. One reason for misdiagnosis is BPD has symptoms that coexist comorbidity with other disorders such as depression, posttraumatic stress disorder PTSD , and bipolar disorder.

People with BPD are prone to feeling angry at members of their family and alienated from them. On their part, family members often feel angry and helpless at how their BPD family members relate to them. However, these links may apply to personality disorders in general. Onset of symptoms typically occurs during adolescence or young adulthood, although symptoms suggestive of this disorder can sometimes be observed in children.

They are also more likely to develop other forms of long-term social disabilities. However, BPD can sometimes be diagnosed before age 18, in which case the features must have been present and consistent for at least one year. A BPD diagnosis in adolescence might predict that the disorder will continue into adulthood. Lifetime comorbid co-occurring conditions are common in BPD. Compared to those diagnosed with other personality disorders, people with BPD showed a higher rate of also meeting criteria for [94].

A study found that at some point in their lives, 75 percent of people with BPD meet criteria for mood disorders, especially major depression and Bipolar I, and nearly 75 percent meet criteria for an anxiety disorder. There are marked gender differences in the types of comorbid conditions a person with BPD is likely to have— [94] a higher percentage of males with BPD meet criteria for substance-use disorders, while a higher percentage of females with BPD meet criteria for PTSD and eating disorders. Regardless that it is an infradiagnosed disorder, a few studies have shown that the "lower expressions" of it might lead to wrong diagnoses.

The many and shifting Axis I disorders in people with BPD can sometimes cause clinicians to miss the presence of the underlying personality disorder. However, since a complex pattern of Axis I diagnoses has been found to strongly predict the presence of BPD, clinicians can use the feature of a complex pattern of comorbidity as a clue that BPD might be present. Many people with borderline personality disorder also have mood disorders , such as major depressive disorder or a bipolar disorder.

At face value, the affective lability of BPD and the rapid mood cycling of bipolar disorders can seem very similar. First, the mood swings of BPD and bipolar disorder tend to have different durations. In some people with bipolar disorder, episodes of depression or mania last for at least two weeks at a time, which is much longer than moods last in people with BPD. Second, the moods of bipolar disorder do not respond to changes in the environment, while the moods of BPD do respond to changes in the environment.

Similarly, an undesirable event would not dampen the euphoria caused by bipolar disorder, but an undesirable event would dampen the euphoria of someone with borderline personality disorder. Third, when people with BPD experience euphoria, it is usually without the racing thoughts and decreased need for sleep that are typical of hypomania , [] though a later study of data collected in found that borderline personality disorder diagnosis and symptoms were associated with chronic sleep disturbances, including difficulty initiating sleep, difficulty maintaining sleep, and waking earlier than desired, as well as with the consequences of poor sleep, and noted that "[f]ew studies have examined the experience of chronic sleep disturbances in those with borderline personality disorder".

Because the two conditions have a number of similar symptoms, BPD was once considered to be a mild form of bipolar disorder [] [] or to exist on the bipolar spectrum. However, this would require that the underlying mechanism causing these symptoms be the same for both conditions. Differences in phenomenology, family history, longitudinal course, and responses to treatment indicate that this is not the case.

Premenstrual dysphoric disorder PMDD occurs in 3—8 percent of women. Symptoms may include marked mood swings, irritability, depressed mood, feeling hopeless or suicidal, a subjective sense of being overwhelmed or out of control, anxiety, binge eating, difficulty concentrating, and substantial impairment of interpersonal relationships. They are distinguishable by the timing and duration of symptoms, which are markedly different: In addition, the symptoms of PMDD do not include impulsivity.

More than two-thirds of people diagnosed with BPD also meet the criteria for another Axis II personality disorder at some point in their lives. In a study, the rate was The second most common is another Cluster B disorder, which includes antisocial , histrionic , and narcissistic. These have an overall prevalence of Psychotherapy is the primary treatment for borderline personality disorder. Medications are useful for treating comorbid disorders, such as depression and anxiety.

Long-term psychotherapy is currently the treatment of choice for BPD. More rigorous treatments are not substantially better than less rigorous treatments. Transference focused therapy aims to break away from absolute thinking. In this, it gets the people to articulate their social interpretations and their emotions in order to turn their views into less rigid categories. The therapist addresses the individual's feelings and goes over situations, real or realistic, that could happen as well as how to approach them.

Dialectical behavior therapy has similar components to CBT, adding in practices such as meditation. In doing this, it helps the individual with BPD gain skills to manage symptoms. These skills include emotion regulation, mindfulness, and stress hardiness. This type of therapy relies on changing people's behaviors and beliefs by identifying problems from the disorder. CBT is known to reduce some anxiety and mood symptoms as well as reduce suicidal thoughts and self-harming behaviors.

Mentalization-based therapy and transference-focused psychotherapy are based on psychodynamic principles, and dialectical behavior therapy is based on cognitive-behavioral principles and mindfulness. Some research indicates that mindfulness meditation may bring about favorable structural changes in the brain, including changes in brain structures that are associated with BPD.

A review by the Cochrane collaboration found that no medications show promise for "the core BPD symptoms of chronic feelings of emptiness, identity disturbance and abandonment". However, the authors found that some medications may impact isolated symptoms associated with BPD or the symptoms of comorbid conditions. Of the typical antipsychotics studied in relation to BPD, haloperidol may reduce anger and flupenthixol may reduce the likelihood of suicidal behavior. Among the atypical antipsychotics , one trial found that aripiprazole may reduce interpersonal problems and impulsivity.

The effect of ziprasidone was not significant. Of the mood stabilizers studied, valproate semisodium may ameliorate depression, interpersonal problems, and anger. Lamotrigine may reduce impulsivity and anger; topiramate may ameliorate interpersonal problems, impulsivity, anxiety, anger, and general psychiatric pathology. The effect of carbamazepine was not significant. Of the antidepressants , amitriptyline may reduce depression, but mianserin , fluoxetine , fluvoxamine , and phenelzine sulfate showed no effect.

Omega-3 fatty acid may ameliorate suicidality and improve depression. As of , trials with these medications had not been replicated and the effect of long-term use had not been assessed. Because of weak evidence and the potential for serious side effects from some of these medications, the UK National Institute for Health and Clinical Excellence NICE clinical guideline for the treatment and management of BPD recommends, "Drug treatment should not be used specifically for borderline personality disorder or for the individual symptoms or behavior associated with the disorder.

They suggest a "review of the treatment of people with borderline personality disorder who do not have a diagnosed comorbid mental or physical illness and who are currently being prescribed drugs, with the aim of reducing and stopping unnecessary drug treatment". There is a significant difference between the number of those who would benefit from treatment and the number of those who are treated.

The so-called "treatment gap" is a function of the disinclination of the afflicted to submit for treatment, an underdiagnosing of the disorder by healthcare providers, and the limited availability and access to state-of-the-art treatments. Experience of services varies. People with BPD typically have a chronically elevated risk of suicide much above that of the general population and a history of multiple attempts when in crisis.

Borderline personality disorder remains the most commonly associated personality disorder with suicide. At the time, there were 60 specialized inpatient beds in England, all of them located in London or the northeast region. With treatment, the majority of people with BPD can find relief from distressing symptoms and achieve remission, defined as a consistent relief from symptoms for at least two years.

Within four years, By the end of the study, Patient personality can play an important role during the therapeutic process, leading to better clinical outcomes. Recent research has shown that BPD patients undergoing dialectical behavior therapy DBT exhibit better clinical outcomes correlated with higher levels of the trait of agreeableness in the patient, compared to patients either low in agreeableness or not being treated with DBT.

This association was mediated through the strength of a working alliance between patient and therapist; that is, more agreeable patients developed stronger working alliances with their therapists, which in turn, led to better clinical outcomes. In addition to recovering from distressing symptoms, people with BPD also achieve high levels of psychosocial functioning. Vocational achievement was generally more limited, even compared to those with other personality disorders.

However, those whose symptoms had remitted were significantly more likely to have good relationships with a romantic partner and at least one parent, good performance at work and school, a sustained work and school history, and good psychosocial functioning overall. The prevalence of BPD was initially estimated to be 1 to 2 percent of the general population [] [] and to occur three times more often in women than in men. Borderline personality disorder is estimated to contribute to 20 percent of psychiatric hospitalizations and to occur among 10 percent of outpatients. The coexistence of intense, divergent moods within an individual was recognized by Homer , Hippocrates , and Aretaeus , the latter describing the vacillating presence of impulsive anger, melancholia, and mania within a single person.

Other writers noted the same pattern, including the American psychiatrist Charles H. Hughes in and J. Rosse in , who called the disorder "borderline insanity". The first significant psychoanalytic work to use the term "borderline" was written by Adolf Stern in The s and s saw a shift from thinking of the condition as borderline schizophrenia to thinking of it as a borderline affective disorder mood disorder , on the fringes of bipolar disorder, cyclothymia , and dysthymia.

In the DSM-II , stressing the intensity and variability of moods, it was called cyclothymic personality affective personality. After standardized criteria were developed [] to distinguish it from mood disorders and other Axis I disorders, BPD became a personality disorder diagnosis in with the publication of the DSM-III. Earlier versions of the DSM, prior to the multiaxial diagnosis system, classified most people with mental health problems into two categories, the psychotics and the neurotics. Clinicians noted a certain class of neurotics who, when in crisis, appeared to straddle the borderline into psychosis.

The term stuck and evolved into the personality disorder diagnosis of today. The credibility of individuals with personality disorders has been questioned at least since the s. Researchers disagree about whether dissociation , or a sense of detachment from emotions and physical experiences, impacts the ability of people with BPD to recall the specifics of past events. A study reported that the specificity of autobiographical memory was decreased in BPD patients.

Some theorists argue that patients with BPD often lie. The belief that lying is a distinguishing characteristic of BPD can impact the quality of care that people with this diagnosis receive in the legal and healthcare systems. For instance, Jean Goodwin relates an anecdote of a patient with multiple personality disorder, now called dissociative identity disorder , who suffered from pelvic pain due to traumatic events in her childhood.

Due to their disbelief in her accounts of these events, physicians diagnosed her with borderline personality disorder, reflecting a belief that lying is a key feature of BPD. Based upon her BPD diagnosis, the physicians then disregarded the patient's assertion that she was allergic to adhesive tape. The patient was in fact allergic to adhesive tape, which later caused complications in the surgery to relieve her pelvic pain.

Since BPD can be a stigmatizing diagnosis even within the mental health community, some survivors of childhood abuse who are diagnosed with BPD are re-traumatized by the negative responses they receive from healthcare providers.

Borderline Personality Disorder

Critics of the PTSD diagnosis argue that it medicalizes abuse rather than addressing the root causes in society. Joel Paris states that "In the clinic That may not be true in the community. The most probable explanation for gender differences in clinical samples is that women are more likely to develop the kind of symptoms that bring patients in for treatment. Men and women with similar psychological problems may express distress differently. Men tend to drink more and carry out more crimes. Women tend to turn their anger on themselves, leading to depression as well as the cutting and overdosing that characterize BPD.

We have even more specific evidence that men with BPD may not seek help. In a study of completed suicides among people aged 18 to 35 years Lesage et al. Most of the suicide completers were men, and very few were in treatment. In short, men are less likely to seek or accept appropriate treatment, more likely to be treated for symptoms of BPD such as substance abuse rather than BPD itself the symptoms of BPD and ASPD possibly deriving from a similar underlying aetiology , possibly more likely to wind up in the correctional system due to criminal behavior, and possibly more likely to commit suicide prior to diagnosis.

Among men diagnosed with BPD there is also evidence of a higher suicide rate: There are also sex differences in borderline personality disorders. Manipulative behavior to obtain nurturance is considered by the DSM-IV-TR and many mental health professionals to be a defining characteristic of borderline personality disorder.

However, since people with BPD lack the ability to successfully manage painful emotions and interpersonal challenges, their frequent expressions of intense pain, self-harming, or suicidal behavior may instead represent a method of mood regulation or an escape mechanism from situations that feel unbearable. The features of BPD include emotional instability; intense, unstable interpersonal relationships; a need for intimacy; and a fear of rejection. As a result, people with BPD often evoke intense emotions in those around them. Pejorative terms to describe people with BPD, such as "difficult", "treatment resistant", "manipulative", "demanding", and " attention seeking ", are often used and may become a self-fulfilling prophecy, as the negative treatment of these individuals triggers further self-destructive behavior.

The stigma surrounding borderline personality disorder includes the belief that people with BPD are prone to violence toward others. In addition, adults with BPD have often experienced abuse in childhood, so many people with BPD adopt a "no-tolerance" policy toward expressions of anger of any kind. People with BPD are considered to be among the most challenging groups of patients to work with in therapy, requiring a high level of skill and training in the psychiatrists, therapists and nurses involved in their treatment. In psychoanalytic theory, the stigmatization among mental healthcare providers may be thought to reflect countertransference when a therapist projects his or her own feelings on to a client.

Thus, a diagnosis of BPD "often says more about the clinician's negative reaction to the patient than it does about the patient" and "explains away the breakdown in empathy between the therapist and the patient and becomes an institutional epithet in the guise of pseudoscientific jargon". Some clients feel the diagnosis is helpful, allowing them to understand that they are not alone and to connect with others with BPD who have developed helpful coping mechanisms.

However, others experience the term borderline personality disorder as a pejorative label rather than an informative diagnosis. They report concerns that their self-destructive behavior is incorrectly perceived as manipulative and that the stigma surrounding this disorder limits their access to healthcare. Because of the above concerns, and because of a move away from the original theoretical basis for the term see history , there is ongoing debate about renaming borderline personality disorder.

While some clinicians agree with the current name, others argue that it should be changed, [] since many who are labelled with borderline personality disorder find the name unhelpful, stigmatizing, or inaccurate. Alternative suggestions for names include emotional regulation disorder or emotional dysregulation disorder. Impulse disorder and interpersonal regulatory disorder are other valid alternatives, according to John G.

Films and television shows have portrayed characters either explicitly diagnosed or with traits suggestive of BPD. These may be misleading if they are thought to depict this disorder accurately. The films Play Misty for Me [] and Girl, Interrupted based on the memoir of the same name both suggest the emotional instability of the disorder. Nobody , Moksha , Cracks , [] and Welcome to Me. In particular, Bui points to the character's abandonment issues, uncertainty over his identity, and dissociative episodes.

Borderline personality disorder BPD , also known as emotionally unstable personality disorder EUPD ,[8] is a long-term pattern of abnormal behavior characterized by unstable relationships with other people, unstable sense of self and unstable emotions. The mainstay of management of borderline personality disorder is various forms of psychotherapy with medications being found to be of little use. Psychotherapy There has traditionally been skepticism about the psychological treatment of personality disorders, but several specific types of psychotherapy for BPD have developed in recent years.

There is growing evidence for the role of psychotherapy in the treatment of people with BPD, with indications that both comprehensive and non-comprehensive psychotherapeutic interventions may have a beneficial effect. Psychotherapy can often be conducted either with individuals or with groups. Group therapy can aid the learning and practice of interpersonal skills and self-awareness by individuals with BPD,[3] though dro Dissociative identity disorder DID , formerly known as multiple personality disorder,[5] is a mental disorder characterized by at least two distinct and relatively enduring personality states.

They include antisocial personality disorder, borderline personality disorder, histrionic personality disorder and narcissistic personality disorder. As a result, they show patterns of behaviour most would regard as dramatic, erratic and threatening or disturbing. They generally avoid becoming involved with others unless they are certain they will be liked. As the name suggests, the main coping mechanism of those with avoidant personality disorder is avoidance of feared stimuli. Paranoid personality disorder PPD is a mental disorder characterized by paranoia and a pervasive, long-standing suspiciousness and generalized mistrust of others.

People with this personality disorder may be hypersensitive, easily insulted, and habitually relate to the world by vigilant scanning of the environment for clues or suggestions that may validate their fears or biases. They are eager observers. They think they are in danger and look for signs and threats of that danger, potentially not appreciating other evidence. Their reduced capacity for meaningful emotional involvement and the general pattern of isolated withdrawal often lend a quality of schizoid isolation to their life experience.

Personality disorders PD are a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating from those accepted by the individual's culture. These patterns develop early, are inflexible, and are associated with significant distress or disability. The definitions may vary somewhat, according to source. Personality, defined psychologically, is the set of enduring behavioral and mental traits that distinguish individual humans.

Hence, personality disorders are defined by experiences and behaviors that differ from social norms and expectations. Those diagnosed with a personality disorder may experience difficulties in cognition, emotiveness, interpersonal functioning, or impulse control. Dependent personality disorder DPD , formerly known as asthenic personality disorder, is a personality disorder that is characterized by a pervasive psychological dependence on other people.

This personality disorder is a long-term condition[1] in which people depend on others to meet their emotional and physical needs, with only a minority achieving normal levels of independence. Dependent personality disorder is a Cluster C personality disorder [2], characterized by excessive fear and anxiety. It begins by early adulthood, and it is present in a variety of contexts and is associated with inadequate functioning. Symptoms can include anything from extreme passivity, devastation or helplessness when relationships end, avoidance of responsibility and severe submission.

History Psychoanalytic theory The conceptualization of dependency, within classical psychoanalytic theory, is directly related to Freud's oral psychosexual stage of development. Frustration or over-gratification was said to result in an oral f Dissocial personality disorder DPD , a similar or equivalent concept, is defined in the International Statistical Classification of Diseases and Related Health Problems ICD , which includes antisocial personality disorder in the diagnosis. Both manuals provide similar criteria for diagnosing the disorder. Schizotypal personality disorder STPD or schizotypal disorder is a mental disorder characterized by severe social anxiety, thought disorder, paranoid ideation, derealization, transient psychosis, and often unconventional beliefs.

People with this disorder feel extreme discomfort with maintaining close relationships with people, mainly because they think that their peers harbor negative thoughts towards them, so they avoid forming them. Peculiar speech mannerisms and odd modes of dress are also symptoms of this disorder.

Those with STPD may react oddly in conversations, not respond or talk to themselves. Such people frequently seek medical attention for anxiety or depression instead of their personality disorder. Cyclothymia, also known as cyclothymic disorder, is a mental disorder that involves periods of symptoms of depression and periods of symptoms of hypomania. The depressive and manic symptoms in cyclothymia last for variable amounts of time due to the unstable An identity disturbance can be conceptualized as a deficit or inability to maintain one or more major components of identity.

These components include a sense of continuity over time, emotional commitment to representations of self, role relationships, core values and self-standards, development of a meaningful world view, and recognition of one's place in the world. Narcissistic personality disorder NPD is a personality disorder with a long-term pattern of abnormal behavior characterized by exaggerated feelings of self-importance, excessive need for admiration, and a lack of empathy.

The scale was created in by and uses items from the Multidimensional Personality Questionnaire, an instrument commonly included in large longitudinal data sets, so that such past studies can be reanalyzed to study borderline personality disorder. Graduate School Theses and Dissertations. Transference focused psychotherapy TFP is a highly structured, twice-weekly modified psychodynamic treatment based on Otto F. Kernberg's object relations model of borderline personality disorder. The defense against these contradictory internalized object relations leads to disturbed relationships with others and with self.

The distorted perceptions of self, others, and associated affects are the focus of treatment as they emerge in the relationship with the therapist transference.

A Dangerous Cult

The treatment focuses on the integration of split off parts of self and object representations, and the consistent interpretation of these distorted perceptions is considered the mechanism of change. TFP has been validated as an efficacious treatment for borderline personality disorder BPD ,[2][3] though too few studies hav Emotional abandonment is a subjective emotional state in which people feel undesired, left behind, insecure, or discarded.

People experiencing emotional abandonment may feel at a loss, cut off from a crucial source of sustenance that has been withdrawn, either suddenly, or through a process of erosion. In a classic abandonment scenario, the severance of the emotional bond is unilateral, that is, the object of one's attachment is the one who chose to break the connection.

Feeling rejected, which is a significant component of emotional abandonment, has a biological impact in that it activates the physical pain centers of the brain and can leave an emotional imprint in the brain's warning system. Self-destructive behavior is any behavior that is harmful or potentially harmful towards the person who engages in the behavior.

Self-destructive behaviors exist on a continuum, with suicide at one extreme end of the scale. The term however tends to be applied toward self-destruction that either is fatal, or is potentially habit-forming or addictive and thus potentially fatal. Self-destructive behavior is often associated with mental illnesses such as borderline personality disorder[2] or schizophrenia. Types of self-destructive behavior Suicide Self-harm Eating disorders Substance abuse Forms Self-destructive behavior may be used as a coping mechanism when one is overwhelmed.

For example, faced with a pressing scholastic assessment, someone may choose to sabotage their work rather than cope with the stress. Look up codependency in Wiktionary, the free dictionary. Codependency is a controversial concept[1] for a dysfunctional helping relationship where one person supports or enables another person's addiction, poor mental health, immaturity, irresponsibility, or under-achievement.

Splitting also called black-and-white thinking or all-or-nothing thinking is the failure in a person's thinking to bring together the dichotomy of both positive and negative qualities of the self and others into a cohesive, realistic whole. It is a common defense mechanism. Splitting was first described by Ronald Fairbairn in his formulation of object relations theory;[2] it begins as the inability of the infant to combine the fulfilling aspects of the parents the good object and their unresponsive aspects the unsatisfying object into the same individuals, instead seeing the good and bad as separate.

In psychoanalytic theory this functions as a defense mechanism. Maniac is an American psychological dark comedy-drama web television miniseries that premiered on September 21, , on Netflix. The series was officially announced in March , with Netflix ordering the production straight-to-series that same month. Upon release, the series received positive reviews from critics, with many praising its visuals, direction and acting, particularly the performances of Stone and Hill.

Cast and characters Main Emma Stone as Annie Landsberg, a woman with borderline personality disorder who dwells unhealthily on her relationships. Dynamic deconstructive psychotherapy DDP is a manual-based treatment for borderline personality disorder. Goals The goals of DDP are: Focus of treatment The primary focus of treatment is on recent social interactions. Three sets of techniques are employed: Association, Attribution, and Alterity.

With Attribution techniques, the therapist helps the client to examine alternative ways to interpret the interaction, thereby deconstructing rigid, polarized attributions towards self and other, and opening up new and more complex perspectives. Emotional dysregulation ED is a term used in the mental health community to refer to an emotional response that is poorly modulated, and does not fall within the conventionally accepted range of emotive response.

Possible manifestations of emotional dysregulation include angry outbursts or behavior outbursts such as destroying or throwing objects, aggression towards self or others, and threats to kill oneself. These variations usually occur in seconds to minutes or hours. Emotional dysregulation can lead to behavioral problems and can interfere with a person's social interactions and relationships at home, in school, or at place of employment.

Psychological pain, mental pain, or emotional pain is an unpleasant feeling a suffering of a psychological, non-physical origin. A pioneer in the field of suicidology, Edwin S. Shneidman, described it as "how much you hurt as a human being. It is mental suffering; mental torment. Technical terms include algopsychalia and psychalgia,[2] but it may also be called mental pain,[3][4] emotional pain,[5] psychic pain,[6][7] social pain,[8] spiritual or soul pain,[9] or suffering.

Factitious disorder imposed on self, also known as Munchausen syndrome, is a factitious disorder wherein those affected feign disease, illness, or psychological trauma to draw attention, sympathy, or reassurance to themselves. Munchausen syndrome fits within the subclass of factitious disorder with predominantly physical signs and symptoms, but patients also have a history of recurrent hospitalization, travelling, and dramatic, extremely improbable tales of their past experiences.

Factitious disorder imposed on self is related to factitious disorder imposed on another, which refers to the abuse of another person, typically a child, in order to seek attention or sympathy for the abuser. This drive to create symptoms for the victim can result in unnecessary and costly diagnostic or corrective procedures. Nightmare disorder, also known as 'dream anxiety disorder', is a sleep disorder characterized by frequent nightmares.

The nightmares, which often portray the individual in a situation that jeopardizes their life or personal safety, usually occur during the REM stages of sleep. Though such nightmares occur within many people, those with nightmare disorder experience them with a greater frequency. The treatment depends on if it is due to PTSD or not.

The victim is often awakened by these threatening, frightening dreams and can often vividly remember their experience. Upon awakening, the sleeper is unusually alert and oriented within their surroundings, but may have an increased heart rate and symptoms of anxiety, like sweating. They may have trouble falling back to sleep for fear they will experience another nightmare. A person experiencing night In personality pathology, dimensional models of personality disorders also known as the dimensional approach to personality disorders, dimensional classification, and dimensional assessments conceptualize personality disorders as quantitatively rather than qualitatively different from normal personality.

They consist of extreme, maladaptive levels of certain personality characteristics these characteristics are commonly described as facets within broader personality factors or traits. Within the context of personality psychology, a "dimension" refers to a continuum on which an individual can have various levels of a characteristic, in contrast to the dichotomous categorical approach in which an individual does or does not possess a characteristic. According to dimensional models personality disorders are classified according to which characteristics are expressed at which levels.

This stands in contrast to the traditional categorical models of classification, which are based on the boolean presence or abs Peter Michael Davidson born November 16, [2] is an American comedian and actor. He is a cast member on Saturday Night Live. Davidson, who was seven years old at the time, was profoundly affected by the loss. He told The New York Times that it was "overwhelming This time-limited therapy was developed in the context of the UK's National Health Service with the aim of providing effective and affordable psychological treatment which could be realistically provided in a resource constrained public health system.

It is distinctive due to its intensive use of reformulation, its integration of cognitive and analytic practice and its collaborative nature, involving the patient very actively in their treatment. The CAT practitioner aims to work with the patient to identify procedural sequences; chains of events, thoughts, emotions and motivations that explain how a target problem for example self-harm is established and maintained. In addition to the procedural sequence model, a second distinguishing feature of CAT is the use of reciprocal roles RRs. These identify problems as occurring between people and not within the patient.

RRs may be set u Sexual addiction, also known as sex addiction, is characterized as a state of compulsive participation or engagement in sexual activity, particularly sexual intercourse, despite negative consequences. Related or synonymous models of pathological sexual behavior include hypersexuality nymphomania and satyriasis , erotomania, Don Juanism or Don Juanitaism , and paraphilia-related disorders.

Animal research has been establish Psychopathy is traditionally a personality disorder characterised by persistent antisocial behaviour, impaired empathy and remorse, and bold, disinhibited, and egotistical traits. Different conceptions of psychopathy have been used throughout history that are only partly overlapping and may sometimes be contradictory.

In version IV , it was replaced by "Identity problem", which was not defined as a mental disorder per se, but was listed in a chapter containing problems that might be a focus of clinical attention. Identity disorder was 'downgraded' to Identity problem as research indicated that distress over one's identity is so common that it might very well be considered part of the normality. In practice, if a person's distress persisted or worsened, an Identity problem would often be succeeded by a diagnosis of an actual disorder, such as a mood disorder or borderline personality disorder.

In DSM-5 , "Identity problem" was removed. Danny Harold Rolling May 26, — October 25, , also known as the Gainesville Ripper, was an American serial killer who murdered five students in Gainesville, Florida over four days in late August Rolling later confessed to raping several of his victims, committing an additional November 4, , triple homicide in Shreveport, Louisiana, and attempting to murder his father in May In total, Rolling confessed to killing eight people.

He was executed by lethal injection in Early years Danny Rolling was born in Shreveport, Louisiana. His father was a Shreveport police officer named James Rolling, who told Danny that he was unwanted from birth and abused his mother, Claudia, and his brother, Kevin. In one incident, Danny's mother went to the hospital after claiming her husband tried to make her cut herself with a razor blade.

She made repeated attempts to leave her husband, but always returned. In one example of the senior Rolli Depersonalization can consist of a detachment within the self, regarding one's mind or body, or being a detached observer of oneself. It can be a disturbing experience. Chronic depersonalization refers to depersonalization-derealization disorder, which is classified by the DSM-5 as a dissociative disorder. Depersonalization-derealization is the single most important symptom in the spectrum of dissociative disorders, including dissociative identity disorder and "dissociative disorder not otherwise specified" DD-NOS.

It is also a prominent symptom in some other non-dissociative disorders, such as anxiety di Misery is a psychological horror thriller novel by Stephen King. The novel was nominated for the World Fantasy Award for Best Novel in ,[1] and was later made into a Hollywood film and an off-Broadway play of the same name.

When King was writing Misery in he planned the book to be released under the pseudonym Richard Bachman but the identity of the pseudonym was discovered before the release of the book. One day he is rescued from a car crash by crazed fan Annie Wikes, who transports him to her house and, once finding out what he has done to Misery in his latest book, forces him to write a new book modifying the story — no matter what it takes. Plot Paul Sheldon, the author of the best-selling series of Victorian-era romance novels surrounding the character Misery Chastain, had just finished the manuscript of his new crime novel, Fast Cars.

He has an alcohol-induc Masterson March 25, —April 12, was a prominent American psychiatrist. He was an internationally recognized psychiatrist who helped inaugurate the study and treatment of personality disorder including borderline personality disorder and narcissistic personality disorder. He died April 12, of pneumonia at the age of eighty-four. After the war, he earned a medical degree from Jefferson Medical College in Philadelphia.

He was long associated with the Payne Whitney Psychiatric Clinic in New York, serving as the head of its adolescent program in the s and s, where he developed his theory of borderline personality disorder. A psychiatrist and psychoanalyst, Masterson was a founding authority on the theory and treatment of borderline and narcissistic personality disorders, as well as the understanding of p The plot follows a star college baseball player McGaw who has a fling with a disturbed medical student Ringwald who begins to stalk him.

The film's main character has been discussed by psychiatrists and film experts, and has been used as a film illustration for the psychiatric entity known as borderline personality disorder. The Field Guide to Personality Disorders. External links Malicious on IMDb A mood stabilizer is a psychiatric pharmaceutical drug used to treat mood disorders characterized by intense and sustained mood shifts, typically bipolar disorder type I or type II, borderline personality disorder BPD and schizoaffective disorder. Uses Used to treat bipolar disorder,[1] mood stabilizers suppress swings between mania and depression.

Mood-stabilizing drugs are also used in borderline personality disorder[2] and schizoaffective disorder. Examples The term "mood stabilizer" does not describe a mechanism, but rather an effect. More precise terminology is used to classify these agents. Drugs commonly classed as mood stabilizers include: Therapeutic drug monitoring is required to ensure lithium levels remain in the therapeutic range: Signs and symptoms of toxicity include nausea, vomiting, diarrhea, and ataxia.

Look up panphobia in Wiktionary, the free dictionary. Panphobia, omniphobia, pantophobia, or panophobia is a vague and persistent dread of some unknown evil. The film stars Kristen Wiig as Alice Klieg, a multi-millionaire with borderline personality disorder who uses her newfound wealth to write and star in an autobiographical talk show. The film was released on May 1, in a limited release. She appears on the local TV news celebrating her win, but is upset when the speech she had prepared is abruptly cut off after she mentions using masturbation as a sedative.

She discontinues her medication, against the advice of her psychiatrist, Daryl Moffat Tim Robbins , and moves into a casino hotel with her best friend Gina Selway Linda Cardellini. During a vitamin supplement infomercial presented by Gabe R His death in is generally accepted to have been a suicide. Many competing hypotheses have been advanced as to possible medical conditions from which he may have suffered.

Van Gogh suffered from some sort of seizures or crises, and in one of these attacks, on December 23, , he cut off a part, or pos Many films have portrayed mental disorders or used them as backdrops for other themes. This is a list of some of those films, sorted by disorder, regardless of whether or not the disorder is portrayed accurately.

For instance, though 50 First Dates presents a case of anterograde amnesia, the type depicted does not actually exist. Also, of the "mental disorders" listed below, "sadistic personality disorder", "self-injury", and "suicide"—while referring to undesirable behaviors—are not mental disorders recognized in the American Psychiatric Association's Diagnostic and Statistical Manual.

Similarly, dissociative identity disorder, formerly called "multiple identity disorder", is one of the most controversial psychiatric disorders, with no clear consensus on diagnostic criteria or treatment. Owing to the nature of drama, extreme and florid manifestations of any given disorder tend to prevail over the more subt Histrionic personality disorder HPD is defined by the American Psychiatric Association as a personality disorder characterized by a pattern of excessive attention-seeking emotions, usually beginning in early adulthood, including inappropriately seductive behavior and an excessive need for approval.

Histrionic people are lively, dramatic, vivacious, enthusiastic, and flirtatious. HPD is diagnosed four times as frequently in women as men. Associated features include egocentrism, self-indulgence, continuous longing for appreciation, and persi It is used, or relied upon, by clinicians, researchers, psychiatric drug regulation agencies, health insurance companies, pharmaceutical companies, the legal system, and policy makers together with alternatives such as the ICD Classification of Mental and Behavioural Disorders, produced by the WHO.

The DSM evolved from systems for collecting census and psychiatric hospital statistics, and from a United States Army manual. Revisions since its first publication in have incrementally added to the total number of mental disorders, and removed those no longer considered to be mental disorders. It has broader scope than the D He was signed by the New Orleans Saints as a free agent on Nov. Marshall is known for his ability to break and dodge tackles. Regarding Marshall's breakaway ability, cornerback Brandon Flowers said, "Brandon Marshall is a defensive lineman playing wide receiver.

He wants to inflict punishment on you.

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He wants you to try to tackle him so he can shove you off of him and get more yards. When off leash, dog comes immediately when called. Dog willingly shares toys with other dogs. Dog leaves food or objects alone when told to do so. Dog is dominant over other dogs. Dog is assertive with other dogs e. Dog behaves aggressively towards unfamiliar people.

Dog shows aggression when nervous or fearful. Dog aggressively guards coveted items e. Dog is quick to sneak out through open doors, gates. Dog works at tasks e. Dog works hard all day herding or pulling a sleigh if a "working dog" on the farm or in the snow. Dog seeks constant activity. Dog is very excitable around other dogs. Open To Experience "Open-Minded". Dog is able to focus on a task in a distracting situation e. Closed To Experience "Closed-Minded". Dog is slow to respond to corrections. Dog is slow to learn new tricks or tasks. Dog is attention seeking e. Dog gets bored in play quickly.

Dog tends to be calm. Dog is relaxed when greeting people. Dog adapts easily to new situations and environments. Dog behaves fearfully towards unfamiliar people. Dog exhibits fearful behaviors when restrained. Dog avoids other dogs.

Psychiatric diagnosis

Dog behaves fearfully towards other dogs. Dog behaves submissively e. Modified from Jones, A. Development and validation of a dog personality questionnaire. University of Texas, Austin. However, dogs and humans are quite different on the "Conscientiousness" factor - because the canine brain is designed for hunting, not building. That's why dogs don't build dog houses. For example, when a male approaches a female, the female must: Nevertheless, cats also show the "Big 5 Factors" of personality. Enlarge Image Enlarge Image. The general requirements for the diagnosis of a personality disorder are: Mild personality disorder is typically not associated with substantial harm to self or others.

There are marked problems in most interpersonal relationships and in the performance of expected occupational and social roles across a wide range of situations that are sufficiently extensive that most are compromised to some degree. Moderate personality disorder often is associated with a past history and future expectation of harm to self or others, but not to a degree that causes long-term damage or has endangered life.

There are severe problems in interpersonal functioning affecting all areas of life. Severe personality disorder usually is associated with a past history and future expectation of severe harm to self or others that has caused long-term damage or has endangered life. Borderline Personality Disorder occurs in between 1. This disorder is characterized by pathological personality traits in the following domains: Antagonism , characterized by: Inappropriate, intense anger or difficulty controlling anger; bullying or intimidating others; mean, nasty, or vengeful behavior.

Disinhibition , characterized by: Acting on the spur of the moment in response to immediate stimuli; acting on a momentary basis without a plan or consideration of outcomes; difficulty establishing and following plans. Engagement in dangerous, risky, and potentially self-damaging activities, unnecessarily and without regard for consequences; boredom proneness and thoughtless initiation of activities to counter boredom; lack of concern for one's limitations and denial of the reality of personal danger.

Emotional Distress , characterized by: Markedly impoverished, poorly developed, or unstable self-image, often associated with excessive self-criticism; chronic feelings of emptiness; dissociative states under stress. Intense, unstable, and conflicted close relationships, marked by mistrust, neediness, and anxious preoccupation with real or imagined abandonment; close relationships often viewed in extremes of idealization and devaluation and alternating between over involvement and withdrawal. Intense feelings of nervousness, tenseness, or panic, often in reaction to interpersonal stresses; worry about the negative effects of past unpleasant experiences and future negative possibilities; feeling fearful, apprehensive, or threatened by uncertainty; fears of falling apart or losing control.

Easily angered, provoked, or annoyed. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation Identity disturbance: Are impulsive in at least two areas that are potentially self-damaging e. Are irritable and aggressive, as indicated by repeated physical fights or assaults. Show reckless disregard for safety of themselves or others.

Are interpersonally exploitative, i. Are often envious of others or believe that others are envious of them. Show frantic efforts to avoid real or imagined abandonment. Are preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love. For this diagnosis to be given, the individual must be at least in early adulthood. This disorder is only diagnosed when these behaviors become persistent and very disabling or harmful to others.

If the criteria are met for each disorder, both Borderline Personality Disorder and Cyclothymic Disorder may be diagnosed. Those who are diagnosed are almost always assigned the categories of borderline, antisocial, or not otherwise specified. Those who repeatedly self-harm are automatically given a diagnosis of borderline personality disorder and those who are aggressive and have a history of offending behaviour are given a diagnosis of antisocial personality disorder, irrespective of the complexity of their issues.

There is insufficient randomized controlled trial evidence to prove the effectiveness of any medication for adults with this disorder. However, research shows that Dialectical Behaviour Therapy is helpful for people with Borderline Personality Disorder. Effects included a decrease in inappropriate anger, a reduction in self-harm and an improvement in general functioning.

Overall, none of the psychotherapies for this disorder have a very robust evidence base. Dialectical behavior therapy and general psychiatric management have been shown to be equally effective. There are too few studies to allow firm conclusions to be drawn about other psychological therapies for Borderline Personality Disorder. Borderline Personality Disorder can persist for a lifetime. At 7 to 10 years follow-up, half of patients with BPD had achieved a symptomatic remission i.

Unfortunately, full recovery having stable relationships and full-time employment - as well as having no symptoms takes much longer. Fifteen- and year follow-up studies of patients with Borderline Personality Disorder show that "most of them no longer meet full criteria for the disorder by age Life expectancy at birth is shorter by 19 years for women and 18 years for men than it is in the general UK population. Increased mortality can be explained partly by increased incidence of suicide and homicide in people with personality disorder.

However, increased mortality from cardiovascular and respiratory diseases suggest that other factors are also important. Difficulties in interpersonal relationships, which lie at the heart of personality disorder, might have an effect on relationships with health-care professionals, resulting in misunderstandings, miscommunication, and poor quality care.

Lifestyle factors are probably also important, with high prevalence of smoking, alcohol, and drug misuse in people with personality disorders. Causes significant impairment in academic or occupational functioning interrupted education; sudden shifts in vocational aspirations; recurrent job losses. Hostility Callousness Transient, stress-related paranoid ideation Disinhibition: Impulsive irresponsibility at least two areas that are potentially self-damaging e.

Inappropriate, intense anger or difficulty controlling anger Emotional instability due to a marked reactivity of mood Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior Chronic feelings of emptiness Transient, stress-related severe dissociative symptoms Social Instability: Unstable, intense, chaotic interpersonal relationships characterized by alternating between extremes of idealization and devaluation Unstable self-image or sense of self Frantic efforts to avoid real or imagined abandonment Physical Illness: Significantly associated with arteriosclerosis or hypertension, hepatic disease, cardiovascular disease, gastrointestinal disease, arthritis, venereal disease, and "any assessed medical condition" SAPAS Personality Screening Test Individuals with this disorder would answer "Yes" to the red questions: In general, do you have difficulty making and keeping friends?

Would you normally describe yourself as a loner? In general, do you trust other people? Do you normally lose your temper easily?

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Are you normally an impulsive sort of person? Are you normally a worrier? In general, do you depend on others a lot? In general, are you a perfectionist? Frantic efforts to avoid real or imagined abandonment still present Unstable and intense 'love-hate' relationships still present Identity disturbance: If this problem persists: She will continue to show frantic efforts to avoid real or imagined abandonment. Her frantic efforts to avoid abandonment might include impulsive actions such as self-mutilating or suicidal behaviors. She will continue to show a pattern of unstable and intense relationships.

She will switch quickly from idealizing other people to devaluing them. She will see things in terms of extremes, either all good or all bad. There will be sudden and dramatic shifts in her self-image, characterized by shifting goals, values, and vocational aspirations. She will see herself as a "victim" taking little responsibility for any problem. She will continue to show impulsivity in at least two areas that are potentially self-damaging i. She will continue to have recurrent suicidal gestures such as wrist cutting, overdosing, or self-mutilation.

Her self-destructive acts will be precipitated by threats of separation or rejection. She will continue to have rapidly shifting moods due to extreme reactivity to interpersonal stress e. She will continue to have chronic feelings of emptiness. She will be easily bored and constantly seeking something to do. She will continue to be inappropriately angry. Her anger will be triggered when a caregiver or lover is seen as neglectful, withholding, uncaring, or abandoning. During periods of extreme stress, she will continue to have transient paranoid ideation or dissociative symptoms e.

This will occur most frequently in response to a real or imagined abandonment. Back to top Diagnostic Features Individuals with Borderline Personality Disorder have a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by 5 or more of the following: Frantic efforts to avoid real or imagined abandonment.

Do not include suicidal or self-mutilating behavior here. Impulsivity in at least two areas that are potentially self-damaging e. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. Inappropriate, intense anger or difficulty controlling anger e. Transient, stress-related paranoid ideation or severe dissociative symptoms.

Like all personality disorders, Borderline Emotionally Unstable Personality Disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.

This disorder appears to consist of acute symptoms superimposed on chronic symptoms. The acute symptoms resolve the most quickly. These acute symptoms are impulsivity e. The chronic symptoms can persist for a decade or more. These chronic symptoms are affective symptoms reflecting areas of chronic dysphoria e. In the general population, rapid mood shifts, impulsivity, and hostility are normal in childhood and early adolescence, but disappear with maturity.

However, in Borderline Personality Disorder, rapid mood shifts, impulsivity, and hostility intensifies in adolescence and persists into adulthood. Fortunately, in their 30's and 40's, the majority develop emotional stability and adequate coping skills. The mood swings seen in Borderline Personality Disorder seldom last more than one day; whereas mood swings in Bipolar I Disorder last much longer. Borderline Personality Disorder doesn't exhibit the prolonged episodes of decreased need for sleep, hyperactivity, pressured speech, reckless over-involvement, and grandiosity that are characteristic of Bipolar I Disorder.

They may make frantic efforts to avoid real or imagined abandonment. Frequently they feel that their life is empty and lacking in meaning and purpose. Many don't have a clear sense of "who they are" and "where they are going in life" i. Emotions spiral out of control, leading to extremes of anxiety, sadness, rage, etc. Often angry or hostile. Has extreme reactions to perceived slights or criticism e.

Expresses emotion in exaggerated and theatrical ways. Emotions change rapidly and unpredictably. Feels unhappy, depressed, or despondent. These symptoms suggest that Borderline Personality Disorder is characterized by self-hatred and emotional instability. Emotional instability emotions change rapidly and unpredictably. Unstable, intense, chaotic relationships. Avoidance of casual sex "one night stands" AND absence of intense desire for illicit sex. Harmful impulsiveness acting without forethought or concern for consequences. Absence of anger or irritability in response to minor slights; absence of mean or vengeful behavior.

Emotional Stability instead has emotional instability. Stable Self-Image instead has unstable self-image. Stable Relationships instead has intense, chaotic relationships. Self-Confidence instead has feeling inferior or shy. Optimism instead has pessimism or expecting the worst. Belonging instead has fearing rejection by others. Independence instead has dependence on others. Assertiveness instead has submissiveness.

Peacemaking skills instead has inability to handle conflict Parental Behaviors Which Increase The Risk Of Developing A Personality Disorder Research has shown that genetic, environmental, and prenatal factors all play important roles in the development of personality disorder. Research has also shown that low parental affection and harsh parenting increase the risk of a child later developing a personality disorder.

There is a liability to outbursts of emotion and an incapacity control the behavioural explosions. There is a tendency to quarrelsome behavior and to conflicts with others, especially when impulsive acts are thwarted or censored. Two types may be distinguished: Borderline Subtype I can't decide what kind of person I want to be. I go to extremes to try to keep people from leaving me.

I get into very intense relationships that don't last. I've never threatened suicide or injured myself on purpose False. I often feel "empty" inside. Emotionally Unstable Personality Disorder: Impulsive Subtype I argue or fight when people try to stop me from doing what I want. I don't stick with a plan if I don't get results right away. Sometimes I get so angry I break or smash things. I take chances and do reckless things. The general criteria of personality disorder must be met: Evidence that the individual's characteristic and enduring patterns of inner experience and behavior deviate markedly as a whole from the culturally expected and accepted range or 'norm'.

The deviation must manifest itself pervasively as behavior that is inflexible, maladaptive, or otherwise dysfunctional across a broad range of personal and social situations i. There is personal distress, or adverse impact on the social environment, or both, clearly attributable to the behavior. There must be evidence that the deviation is stable and of long duration, having its onset in late childhood or adolescence.

The deviation cannot be explained as a manifestation or consequence of other adult mental disorders. Organic brain disease, injury, or dysfunction must be excluded as possible cause of the deviation. The general criteria of personality disorder above must be met: A marked tendency to quarrelsome behavior and to conflicts with others, especially when impulsive acts are thwarted or criticized.

At least two of the following must be present: A marked tendency to act unexpectedly and without consideration of the consequences. At least three of the following must be present: Disturbances in and uncertainty about self-image, aims and internal preferences including sexual. This enduring pattern of inner experience and behavior must deviate markedly from the expectations of the individual's culture. This enduring pattern is inflexible and pervasive across a broad range of personal and social situations.

This enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning. Proposed New Diagnostic Criteria: The individual is at least 18 years of age. Moderate or greater impairment in personality functioning, manifested by characteristic difficulties in two or more of the following four areas: Markedly impoverished, poorly developed, or unstable self-image, often associated with excessive self-criticism, chronic feelings of emptiness; dissociative states under stress.

Instability in goals; aspirations, values, or career plans. Compromised ability to recognize the feelings and needs of others associated with interpersonal hypersensitivity i. Intense, unstable, and conflicted close relationships, marked by mistrust, neediness, and anxious preoccupation with real or imagined abandonment; close relationships often viewed in extremes of idealization and devaluation and alternating between overinvolvement and withdrawal.

Four or more of the following seven pathological personality traits, at least one of which must be impulsivity, risk taking, or hostility. Persistent or frequent angry feelings; anger or irritability in response to minor slights and insults. Disinhibition Reckless Risk Taking: Engagement in dangerous, risky, and potentially self-damaging activities, unnecessarily and without regard for consequences; lack of concern for one's limitations and denial of the reality of personal danger.

Acting on the spur of the moment in response to immediate stimuli; acting on a momentary basis without a plan or consideration of outcomes; difficulty establishing and following plans; a sense of urgency and self-harming behavior under emotional distress. Negative Emotion Emotional Instability: Intense feelings of nervousness, tenseness, or panic, often in reaction to social situations; worry about the negative effects of past unpleasant experiences and future negative possibilities; feeling fearful, apprehensive, or threatened by uncertainty; fears of embarrassment; fears of falling apart or losing control.

Empirically Derived Taxonomy for Personality Diagnosis: Are emotionally unstable, and overreact to stress with extremes of sadness, anxiety, and anger. Their emotions tend to change rapidly and unpredictably. Are angry or hostile, and feel misunderstood, mistreated, or victimized. Feel like an outcast or outsider; feel inadequate, inferior, or a failure; are overly needy or dependent. May act on self-destructive impulses, including self-mutilating behavior, "cry for help" suicidal threats or gestures, and genuine suicidality, especially when an attachment relationship is disrupted or threatened.

Become irrational when strong emotions are stirred up, showing a significant decline from their usual level of functioning. Lack a stable sense of self. Their attitudes, values, goals, and feelings about themselves may seem unstable or ever-changing. Have difficulty maintaining stable, balanced views of others. When upset, they see others in extreme, black-or-white terms. Consequently, their relationships tend to be unstable, chaotic, and rapidly changing. Fear rejection and abandonment, fear being alone, and tend to become attached quickly and intensely. May repeatedly re-experience or re-live a past traumatic event e.

Can play the role of "victim", often eliciting intense emotions in other people who they manipulate into playing the role of "villan" or "rescuer". Stir up conflict or animosity between other people. Their work life or living arrangements may be chaotic and unstable.