Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision Personality Disorders > Introduction > Cluster B Personality Disorders > 301.83 Borderline Personality Disorder Topics Discussed: borderline personality disorder; elevated mood; impulsivity; self mutilation. Excerpt: "The essential feature of Borderline Personality Disorder is a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity that begins by early adulthood and is present in a variety of contexts.Individuals with Borderline Personality Disorder make frantic efforts to avoid real or imagined abandonment (Criterion 1). The perception of impending separation or rejection, or the loss of external structure, can lead to profound changes in self-image, affect, cognition, and behavior. These individuals are very sensitive to environmental circumstances. They experience intense abandonment fears and inappropriate anger even when faced with a realistic time-limited separation or when there are unavoidable changes in plans (e.g., sudden despair in reaction to a clinician's announcing the end of the hour; panic or fury when someone important to them is just a few minutes late or must cancel an appointment). They may believe that this "abandonment" implies they are "bad." These abandonment fears are related to an intolerance of being alone and a need to have other people with them. Their frantic efforts to avoid abandonment may include impulsive actions such as self-mutilating or suicidal behaviors, which are described separately in Criterion 5...." DOI: 10.1176/appi.books.9780890423349.3831; 10.1176/appi.books.9780890423349.4005 The content above is only an excerpt. For full access subscribe now or log into your account below. You can also purchase 24- or 48-hour access; learn more Username: Password:   FORGOT your subscriber username and/or password? Get a reminder via email: The email I registered with is:  Not a subscriber? Subscribe Today PsychiatryOnline is a powerful website that features DSM-IV-TR® and The American Journal of Psychiatry as the cornerstones of an unsurpassed collection of psychiatric references, including books, journals, and self-assessment tools. PsychiatryOnline’s innovative platform makes these resources easy and convenient to use, offering Precise and powerful searching across books and journals. Quick pathways to related material. Mobile access from any computer with a Web connection. Ability to download any book section to PDA. Links from bibliographic references to the full text of journal articles. References to material not located in the PsychiatryOnline collection lead you to PubMed. Learn more about PsychiatryOnline Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).