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Borderline Personality Disorder and DSM-5: New Directions and Hopes for the Future

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Handbook of Borderline Personality Disorder in Children and Adolescents

Abstract

In DSM-5, there are two classification frameworks presented for diagnosing borderline personality disorder (BPD). The first is in Section II of the manual and presents the historical, medical-categorical diagnostic criteria, unchanged from DSM-IV. In Section III of the DSM-5, which presents Emerging Measures and Models, there is a novel, trait-based model for diagnosing personality disorders (PDs), and a trait-based diagnostic criteria-set for BPD. This hybrid model represents a transition from the traditional, categorical diagnosis to a dimensional model of classification. In this chapter, we discuss the motivations for these changes in diagnosing PDs, and specifically, the impact that such changes could have for how we conceptualize, research, and treat BPD. In particular, moving toward a more dimensional model could have positive repercussions for how we provide services to children and adolescents who are suffering from BPD or BPD traits.

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Suggested Reading

  • Krueger, R. F., Deringer, J., Markon, K. E., Watson, D., & Skodol, A. E. (2012). Initial construction of a maladaptive personality trait model and inventory for DSM-5. Psychological Medicine, 42, 1879–1890. (This article introduces the PID-5, or the Personality Inventory for DSM-5, which provides an assessment tool for the personality traits described in Section III of DSM-5. This instrument is copyrighted by the APA (American Psychiatric Association) but it is freely available for use in clinical and research settings by downloading it from: http://www.psychiatry.org/practice/dsm/dsm5/online-assessment-measures#Personality.)

  • Livesley, W. J. (2012). Moving beyond specialized therapies for borderline personality disorder: The importance of integrated domain-focused treatment. Psychodynamic Psychiatry, 40, 47–74. (This article offers an argument for a more integrated and less specialized approach for treating BPD patients. Given well-established problems with DSM-IV and DSM-5 Section II personality disorder diagnoses and the changes suggested in Section III of DSM-5, this model for a more fluid attitude toward treating BPD patients provides a useful lens for thinking about treatment in light of suggested changes.)

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  • Markon, K. E., Krueger, R. F., & Watson, D. (2005). Delineating the structure of normal and abnormal personality: An integrative hierarchical approach. Journal of Personality and Social Psychology, 88, 139–157. (This article provides a useful model for understanding the integration of normal and abnormal personality. The model of personality pathology presented in Section III of DSM-5 moves towards this integration, which is important for better synthesizing the currently disparate literatures of personality pathology and normal personality.)

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  • Tackett, J. L. (2006). Evaluating models of the personality-psychopathology relationship in children and adolescents. Clinical Psychology Review, 26, 584–599. (In this article, Tackett explains how the personality and personality disorder literature pertain to adolescents and children, who are often left out of these models.)

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  • Widiger, T. A., & Trull, T. J. (2007). Plate tectonics in the classification of personality disorder: Shifting to a dimensional model. American Psychologist, 62, 71–83. (This is a concise discussion of the most pressing intellectual and clinical problems found in the personality disorder model from DSM-IV, which has been carried to Section II of DSM-5.)

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  1. Department of Psychology, University of Minnesota, Minneapolis, MN, USA

    Merav H. Silverman & Robert F. Krueger

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  1. Merav H. Silverman
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  2. Robert F. Krueger
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Correspondence to Merav H. Silverman .

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  1. Dept. Psychology, University of Houston, Houston, Texas, USA

    Carla Sharp

  2. Dept. Psychology, University of Houston, Houston, Texas, USA

    Jennifer L. Tackett

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Silverman, M.H., Krueger, R.F. (2014). Borderline Personality Disorder and DSM-5: New Directions and Hopes for the Future. In: Sharp, C., Tackett, J. (eds) Handbook of Borderline Personality Disorder in Children and Adolescents. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0591-1_27

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