Other personality disorders. Other personality disorders may be confused with border- line personality disorder because they have certain features in common. It is therefore im- portant to distinguish among these disorders based on differences in their characteristic features. However, if an individual has personality features that meet criteria for one or more personality disorders in addition to borderline personality disorder, all can be diag— nosed. Although histrionic personality disorder can also be characterized by attention seek- ing, manipulative behavior, and rapidly shifting emotions, borderline personality disorder is distinguished by self-destructiveness, angry disruptions in close relationships, and chronic feelings of deep emptiness and loneliness. Paranoid ideas or illusions may be pres- ent in both borderline personality disorder and schizotypal personality disorder, but these symptoms are more transient, interpersonally reactive, and responsive to external structur- ing in borderline personality disorder. Although paranoid personality disorder and narcis- sistic personality disorder may also be characterized by an angry reaction to minor stimuli, the relative stability of self-image, as well as the relative lack of self-destmctiveness, impul- sivity, and abandonment concerns, distinguishes these disorders from borderline person- ality disorder. Although antisocial personality disorder and borderline personality disorder are both characterized by manipulative behavior, individuals with antisocial personality disorder are manipulative to gain profit, power, or some other material gratification, whereas the goal in borderline personality disorder is directed more toward gaining the con— cern of caretakers. Both dependent personality disorder and borderline personality disorder are characterized by fear of abandonment; however, the individual with borderline person- ality disorder reacts to abandonment with feelings of emotional emptiness, rage, and de- mands, whereas the individual with dependent personality disorder reacts with increasing appeasement and submissiveness and urgently seeks a replacement relationship to provide caregiving and support. Borderline personality disorder can further be distinguished from dependent personality disorder by the typical pattern of Lmstable and intense relationships.
Personality change due to another medical condition. Borderline personality disor- der must be distinguished from personality change due to another medical condition, in which the traits that emerge are attributable to the effects of another medical condition on the central nervous system.
Substance use disorders. Borderline personality disorder must also be distinguished from symptoms that may develop in association with persistent substance use.
Identity problems. Borderline personality disorder should be distinguished from an identity problem, which is reserved for identity concerns related to a developmental phase (e.g., adolescence) and does not qualify as a mental disorder.
.. Histrionic Personality Disorder
Diagnostic Criteria 301.50 (F60.4)
A pervasive pattern of excessive emotionality and attention seeking, beginning by early adult- hood and present in a variety of contexts, as indicated by five (or more) of the following: 1. Is uncomfortable in situations in which he or she is not the center of attention.
2. Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior.
Displays rapidly shifting and shallow expression of emotions.
Consistently uses physical appearance to draw attention to self.
Has a style of speech that is excessively impressionistic and lacking in detail.
Shows self-dramatization, theatricality, and exaggerated expression of emotion.
Is suggestible (i.e., easily influenced by others or circumstances).
Considers relationships to be more intimate than they actually are.
The essential feature of histrionic personality disorder is pervasive and excessive emotion- ality and attention-seeking behavior. This pattern begins by early adulthood and is pres- ent in a variety of contexts.