BORDERLINE PERSONALITY DISORDER TEST ONLINE IDIOTISM – DON’T BE FOOLED!
I often see websites online providing so called borderline personality disorder test (BPD test), and I kind of picture how people fall for these tests & may start believing that they might actually have a borderline personality disorder. It’s actually funny & sad at the same time; the results of taking such test seriously can lead to dire consequences. The reality is that there is no such thing as borderline personality disorder test. There are however questionnaires that some mental health professionals use for patients to help them with diagnosis (such as PDQ, PDQ-R, MMPI-2, MCMI-III, Rorschach Psychodiagnostic Test, TAT), so they are not borderline personality disorder specific tests and these may be used only if the mental health professional has a reasonable cause to believe that the person has any kind of personality disorder in the first place. In addition these tests should be performed by the psychologist/psychiatrist – not an individual who suddenly decided that he/she might be suffering from BPD. The data collected from these tests serves as a factor for leading the clinician in the right direction, so different patients with different histories &situational factors will have different diagnosis despite of the possibility of having the same test results. And even then only about 1/3 of individuals that are diagnosed with borderline personality disorder by qualified professionals are believed to actually have the disorder.
Any psychiatric diagnosis requires a pretty long period of empirical testing before the diagnosis are definitively established. An initial diagnosis is given by following a set of criteria established from accepted metal health manuals, theory, factor-analytic studies & experienced clinicians’ initial suspicion. Later this must be empirically evaluated/corrected. Different clinicians may take different approaches from different disciplines.
Some key elements, symptoms that are believed to be shared by those who suffer from BPD are:
- Unstable, intense relationships
- Intense, uncontrolled anger
- Paranoid or irrational thinking under stress
- Identity disturbance
- Affective instability
- Intolerance or fear of being alone
- Physically self-damaging behavior
- Feelings of chronic boredom or emptiness
Borderline Syndromes (Olin, Keatinge):
Impulsiveness; Idealization, instability, lability
Poor affect regulation, depression, anger
The full criteria for diagnosing borderline personality disorder from DSM IV (DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS FOURTH EDITION) is quoted below. A person with BPD needs to be matching five or more of the criteria.
(1) frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
(2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
(3) identity disturbance: markedly and persistently unstable self-image or sense of self
(4) impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
(5) recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
(6) 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)
(7) chronic feelings of emptiness
(8) inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
(9) transient, stress-related paranoid ideation or severe dissociative symptoms
If you believe you match the criteria, take a deep breath & don’t panic. Many people find themselves matching about 70% of criteria for different disorders in DSM IV, yet they don’t have any personality disorders. It’s difficult for an individual to keep an objective perspective & separate personality traits from personality disorders; for instance feeling down doesn’t mean you are suffering from a full blown clinical depression. Your actions from this point would be making an appointment with a doctor, write down things that are bothering you (since by the time you get there you’ll most likely forget half of what you wanted to ask), consider having a BPD a slight possibility. The only reason for worries would be if you are having suicidal thoughts &/or self-harming behavior. In that case contact a doctor immediately & don’t stay alone. If you feel you are having a crisis go to the nearest emergency room or call 1-800-273-8255 (National Suicide Prevention Lifeline). You can find a helpline if you are out of US here http://www.befrienders.org/
So to recap, while it might be convenient to fill a so called online borderline personality disorder test / quiz, there really isn’t one exist to give even a remotely close idea whether you have a borderline personality disorder or not. Unless you want a false train of thoughts pushed into your brains, stay away from borderline personality disorder tests online or offline.
BORDERLINE PERSONALITY DISORDER
Fundamentals of abnormal psychology By Ronald J. Comer
“People with borderline personality disorder often form intense, conflict-ridden relationships with people who do not necessarily share their feelings (Modestin & Villiger, 1989). They often violate the boundaries of relationships (Skodol et a!., 2002) and may become furious when their expectations are not met; yet they remain very attached to the relationships, paralyzed by a fear of being left alone (Bender et al., 2001). Sometimes they cut themselves or carry out other self-destructive acts to prevent partners from leaving.”
BORDERLINE PERSONALITY DISORDER PREVALENCE, ORIGINS, HISTORY
Borderline Personality Disorder is the most commonly diagnosed personality disorder in modern practice (up to 3% of general population, nearly 25% of psychotherapeutical inpatients & 15% of outpatients). The origins of the BPD diagnosis are usually traced to psychoanalyst Adolf Stern (1938), who found a subgroup of his patients not fitting into existing classifications at that time. Robert Knight (1953, 1954) explained the term “borderline” from relating to only the border with neurosis to being equally relevant to the border with psychosis. After this, many clinicians used this term for troublesome patients that weren’t psychotic or neurotic. In 1967 Otto Kernberg introduced borderline personality organization (BPO), which he placed between psychotic & neurotic personality organizations, and defined it as healthier state than psychotic, but sicker than neurotic. He characterized borderline personality organization by formation of weak identity, primitive defense mechanism, reality testing that bounced into psychotic state once under stress. Many believe that narcissistic & borderline personality disorders have the same origin, with narcissistic handling the reality testing differently than borderline. In 1968 Grinker was the first to give BPD a criteria set in his “The Borderline Syndrome”:
The Borderline Syndrome (Grinker 1968)
1) Failure of self-identity
2) Anaclitic relationships
3) Depression based on loneliness
4) The predominance of expressed anger
In 1975 another breakthrough was “Defining Borderline Patients: An Overview” by Gunderson & Singer, which was followed by studies of Gunderson & Kolb in 1978 & and finally in 1981 Gunderson released “Diagnostic Interview for Borderline Patients” which served as a primary source for Spitzer for classifying borderline personality disorder in DSM-III (1980). Spitzer added “identity diffusion” from Kernberg studies to complete the classification and for the first time it was defined as a disorder.
BORDERLINE PERSONALITY DISORDER IN DSM-III DEFINITION
The essential feature is a Personality Disorder in which there is instability in a variety of areas, including interpersonal behavior, mood, and selfimage. No single feature is invariably present. Interpersonal relations are often intense and unstable, with marked shifts of attitude over time. Frequently there is impulsive and unpredictable behavior that is potentially physically selfdamaging. Mood is often unstable, with marked shifts from a normal mood to a dysphoric mood or with inappropriate, intense anger or lack of control of anger. A profound identity disturbance may be manifested by uncertainty about several issues relating to identity, such as self-image, gender identity, or longterm goals or values. There may be problems tolerating being alone, and chronic feelings of emptiness or boredom.
DSM-III CRITERIA SET FOR BPD
Diagnostic criteria for Borderline Personality Disorder
The following are characteristic of the individual’s current and long-term functioning, are not limited to episodes of illness, and cause either significant impairment in social or occupational functioning or subjective distress.
A. At least five of the following are required:
- impulsivity or unpredictability in at least two areas that are potentially self-damaging, e.g., spending, sex, gambling, substance use, shoplifting, overeating, physically self-damaging acts
- a pattern of unstable and intense interpersonal relationships, e.g., marked shifts of attitude, idealization, devaluation, manipulation (consistently using others for one’s own ends)
- inappropriate, intense anger or lack of control of anger, e.g., frequent displays of temper, constant anger
- identity disturbance manifested by uncertainty about several issues relating to identity, such as self-image, gender identity, long term goals or career choice, friendship patterns, values, and loyalties, e.g., “Who am I?”, “I feel like I am my sister when I am good”
- affective instability: marked shifts from normal mood to depression, irritability, or anxiety, usually lasting a few hours and only rarely more than a few days, with a return to normal mood
- intolerance of being alone, e.g., frantic efforts to avoid being alone, depressed when alone
- physically self-damaging acts, e.g., suicidal gestures, self-mutilation, recurrent accidents or physical fights
- chronic feelings of emptiness or boredom
B. If under 18, does not meet the criteria for Identity Disorder
In DSM-III they cited impairment caused by borderline personality disorder as a considerable interference with social or occupational functioning. No information about familial pattern or predisposing factors was given; BPD was believed to be common & more diagnosed in women, with no specifics given.
Possible Complications Listed in DSM-3:
- Dysthymic Disorder
- Major Depression
- Psychotic disorders such as Brief Reactive Psychosis
BORDERLINE PERSONALITY DISORDER
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 & is present in a variety of contexts.
DIAGNOSTIC CRITERIA FOR BORDERLINE PERSONALITY DISORDER
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, indicated by five (or more) of the given criteria. Please, see the criteria cited on the right side panel.
BORDERLINE PERSONALITY DISORDER SYMPTOMS & ASSOCIATED FEATURES
(A) Individuals with Borderline Personality Disorder may have a pattern of undermining themselves at the moment a goal is about to be realized:
- dropping out of school just before graduation
- regressing severely after a discussion of how well therapy is going
- destroying a good relationship just when it is clear that the relationship could last
(B) Some individuals develop psychotic-like symptoms when under stress:
- body image distortions, ideas of reference
- hypnagogic phenomena
(C) Individuals with BPD may feel more secure with transitional objects than in interpersonal relationships:
- a pet or inanimate possession
(D) Premature death from suicide may occur in individuals with this disorder, especially in those with co-occurring Mood Disorders or Substance-Related Disorders.
(E) Physical handicaps may result from self-inflicted abuse behaviors or failed suicide attempts.
*(D,E) the risk of suicide are greater in the young adulthood and gradually decrease with age. During their 30-40s, the majority of people with BPD accomplish better stability in their relationships & occupational functioning.
(F) Recurrent job losses, interrupted education, and broken marriages are common.
(G) Physical and sexual abuse, neglect, hostile conflict, and early parental loss or separation are more common in the childhood.
The causes of borderline personality disorder vary. The most common pattern is one of chronic instability in early adult years, with episodes of serious affective and impulsive dyscontrol and high levels of use of health & mental health resources.
COMMON CO-OCCURRING DISORDERS
- Mood Disorders
- Substance-Related Disorders
- Eating Disorders (notably Bulimia)
- Posttraumatic Stress Disorder
- Attention-Deficit/Hyperactivity Disorder
BPD frequently co-occurs with the other personality disorders.
FAMILIAL PATTERN – BPD IN FAMILY HISTORY
Borderline Personality Disorder is about five times more common among first-degree biological relatives of those with the disorder than in the general population. There is also an increased familial risk for Substance-Related Disorders, Antisocial Personality Disorder, and Mood Disorders.
BORDERLINE PERSONALITY DISORDER MULTIDIMENSIONAL THEORY
Borderline personality disorder is caused by biological, psychological & social factors. Multidimensional theory suggests factors like temperament, traits & social impact. Temperament is an inborn set of reactions to external factors, which is being influenced while the child is growing up by psychological factors, thus forming personality traits. Depending on social impact on the formed set of traits a personality disorder may occur.
BORDERLINE PERSONALITY DISORDER, TEST RESULTS
Psychological Testing Data (L. Sperry)
Tests useful for diagnosing BPD & borderline personality style or trait:
- (MMPI-2) Minnesota Multiphasic Personality Inventory
- (MCMI-III) Millon Clinical Multiaxial Inventory
- Rorschach Psychodiagnostic Test
- (TAT) Thematic Apperception Test
COMMON TEST RESULTS EXPECTED OF A BORDERLINE PATIENT:
On the MMPI-2:
- 2 (depression)
- 4 (psychothemia)
- 6 (paranoia) – If emotional dysregulation, particularly of anger, is prominent
- 8 (schizophrenia)
- (social introversion)
- K (correction)
- F (frequency)
On the MCMI-III:
- C (borderline)
- 8A (passive-aggressive)
- A (anxiety)
- H (somatoform)
- N (bipolar-manic)
- D (dysthymia)
On the Rorschach:
- Illogical and fabulixed combinations
(e.g., “a horse’s head with two sea horses growing out of his ears” for card 10)
On the TAT:
- Primitive splitting
- Separation anxiety themes
- Extreme portrayals of affect
- Acting out rather than delayed gratification
Primitive splitting refers to characters being judged as bad extreme or good-bad characteristics are differentiated inconsistently.
These are some of the most common expectation from a pathological test data for a borderline patient, though these results are not required to be suffering from BPD. As mentioned at the begging of this page, borderline personality disorder test as such is not exist, in contrast, a complex set of data/information needs to be evaluated by an experienced mental health professional in order to diagnose a person with BPD.