Differential Diagnosis: Borderline Personality Disorder DSM IV Diagnostic Criteria –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 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 in 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 and only rarely more than a few days). Chronic feelings of emptiness. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights). Transient, stress-related paranoid ideation or severe dissociative symptoms.

Why Consider Borderline Personality Disorder? Impulsivity in at least two areas that are potentially self-damaging –Shops for clothes and jewelries, maxing out her 2 credit cards –Went to SM mall of asia and spent at least 14,000 for shopping –Tendency to shoplift things Chronic feelings of emptiness –She was approached by a man who told her she looks miserable and sick (2002)

Why Consider Borderline Personality Disorder? Transient, stress-related paranoid ideation –When they got stuck on traffic, she got out of the car and ran away because she thought there was a coup d’etat going on

Why It Is Not Borderline Personality Disorder? Only 3 out of the required 5 or more criteria