How does borderline personality disorder differ from dissociative identity disorder or antisocial personality disorder?

Rivka Levy

Rivka Levy, www.spiritualselfhelp.org

Répondu il y a 157w · L'auteur dispose de réponses 459 et de vues de réponses 702.5k

There’s a few different ways to answer your question.
The first is to list the ‘official’ symptoms required for each personality disorder.
You can find a full list for Borderline Personality Disorder (BPD), with plain English descriptions of what the terms actually mean, here [LINK].
Borderline Personality Disorder, or BPD, for short is one of the four main 'Cluster B' personality disorders defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM).

How is the diagnosis for BPD made?

The DSM sets out the following 9 criteria for Borderline Personality Disorder, and you'd have to meet at least 5 of them, to be considered as having BPD. The criteria used by mental health professionals are as follows:

APA 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 five (or more) of the following:

1) Frantic efforts to avoid real or imagined abandonment.Note: Do not include suicidal or self-mutilating behaviour covered in criterion 5.

2) A pattern of unstable and intense interpersonal relationships, characterised by alternating between extremes of idealisation 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 (eg, spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behaviour covered in criterion 5.

5) Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour.

6) Affective instability due to a marked reactivity of mood (eg, 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 (eg, frequent displays of temper, constant anger, recurrent physical fights.)

9) Transient, stress-related paranoid ideation or severe dissociative symptoms.

The essential feature of Borderline Personality Disorder (BPD) is a pervasive pattern of instability or interpersonal relationships, self-image and affects, and marked impulsivity that begins by early adulthood and is present in a variety of contexts.

Anti-Social Personality Disorder diagnostic criteria

The DSN definitions for Anti-Social Personality Disorder as follows:

Currently, mental health professionals diagnose AsPD using a 7-point list of symptoms and other criteria below. A person must have TROIS or more of these symptoms and meet the additional criteria listed below them to receive a diagnosis of Antisocial Personality Disorder (AsPD).

_____________________________________________________________________________

APA DIAGNOSTIC CRITERIA

A pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by TROIS (or more) of the 7 symptoms below, in addition to the other listed items needed:

1. failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest;

2. deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure

3. impulsivity or failure to plan ahead

4. irritability and aggressiveness, as indicated by repeated physical fights or assaults

5. reckless disregard for safety of self or others

6. consistent irresponsibility, as indicated by repeated failure to sustain steady work or honor financial obligations

7. lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another

The manual lists the following additional necessary criteria:

  • The individual is at least age 18 years.
  • There is evidence of conduct disorder with onset before age 15 years.
  • The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or a manic episode.

DID Diagnostic Criteria:

Lastly, here’s the official criteria for Disassociative Identity Disorder (DID):

Dissociative Identity DisorderSymptoms

The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self).

At least two of these identities or personality states recurrently take control of the person's behavior.

Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.

The disturbance is not due to the direct physiological effects of a substance (e.g., blackouts or chaotic behavior during Alcohol Intoxication) or a general medical condition (e.g., complex partial seizures). Note: In children, the symptoms are not attributable to imaginary playmates or other fantasy play.

Criteria summarized from:
Association américaine de psychiatrie. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.

As a side note, DID is probably the most controversial 'disorder' out there, which is saying something.

The Alternative Health View

So far so good, but there are some other ideas that I want to flag for your consideration.

In his book called: Does Stress Damage the Brain? J. Douglas Bremner PhD, a psychologist and prolific mental health researcher, brings together a lot of very convincing scientific studies to make the case that 2 of the 3 personality disorders mentioned above, namely BPD and DID, are extremely extreme reactions to ongoing, chronic and severe Post-Traumatic Stress Disorder (PTSD).

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Trouble de stress post-traumatique - on Wikipedia

Again, to sum things up as succinctly as possible, many things can cause lasting stress and trauma to human beings, which in turn can severely affects the way their brains start to react and work.

The main issues involve the areas of the brain called the hippocampus and the frontal lobe. In his book, Bremner suggests that the mental health paradigm is missing this huge ‘energetic’ component of the picture that contributes to many mental health issues, especially depression, Borderline Personality Disorder and DID.

What’s causing the stress?

While there may be some genetic tendency that makes one person more susceptible to developing PTSD, it’s exposure to chronic or acute stress that actually triggers it. One of those triggers is child abuse of all stripes, including verbal, physical and sexual abuse, and also chronic parental neglect.

Bremner sets out a list of symptoms for PTSD, and argues convincingly that depression, PTSD itself, and some personality disorders like BPD and DID are actually just on the spectrum of emotional responses to trauma.

For example, when someone has PTSD, they often have a pronounced ‘startle’ reaction, feel permanently on edge and are very easily provoked as a result. When someone has been given a BPD diagnosis, they’re often displaying exactly the same behavior as just described, just the official terms for it are different.

Disassociation, when someone feels ‘spaced out’, disconnected, walking around in a dream state, are also prime symptoms in depression, BPD and DID itself, although clearly the disassociation has reached a severe extreme by the time we arrive at a diagnosis for DID.

BUT THE UNDERLYING CAUSE OF THE PROBLEM IS THE SAME, NAMELY AN UNRECOGNISED AND UNTREATED REACTION TO EXTREME STRESS.

The good news: PTSD is pretty easy to treat and permanently fix

PTSD is the poster boy for energy psychology approaches to emotional health issues. If you take a look at this video, you’ll see how a couple of days of ‘tapping’ or Emotional Freedom Technique (EFT) sessions with combat vets in the US had a massive impact on reducing the severity and amount of PTSD they were experiencing.

You can see the video here:

and it’s highly recommend viewing, as nothing beats seeing something work with your own eyes.

By contrast, traditional ‘talk therapy’ approaches for depression, BPD and DID often take years, and even then are not always very successful.

There’s a lot of evidence out there to suggest an holistic approach to these things based on energy psychology, the body’s energy meridians, and acceptance of the idea that people develop BPD, DID and depression as a result of some sort of extreme stress in their environment could go a long way to helping a lot of people make some serious headway in making these issues a thing of the past.

What about Anti-Social Behaviour Personality Disorder?

I have yet to see, read or experience anything that suggests that ASPD could be treated holistically in the same way. A huge problem with ASPD and Narcissistic Personality Disorder (NPD), another cluster ‘B’ issue, is that the people who have them don’t feel any need to change, admit their flaws, or work on improving their behavior, belief and character.

Where people with BPD and DID often suffer A LOT and are keen to try anything to alleviate their hurt, people with ASPD and NPD don’t feel their pain, don’t see that anything is wrong, and continue to make the people around them suffer a lot, as opposed to actually feeling the problem in themselves.

I’m currently researching some possible energetic approaches to NPD and ASPD, but my view at the moment is that if caught early enough by caring parents, these conditions can ameliorate, and in rare cases, disappear.

At present there doesn’t seem to be anything out there that ‘works’ to cure ASPD in adults short of an open miracle – which can definitely happen!. (I’d be very happy to be proved wrong, if anyone reading this has scientific evidence or studies showing an approach that’s been proven to work without open Divine intervention.)

So that’s a big difference between ASPD and BPD and DID: the latter two can be cured, albeit with a lot of time, effort and inner work, while the ASPD apparently cannot be.

How is schizophrenia different from Disassociative Personality Disorder?

Lots of people think that schizophrenia means that someone has a split personality. That’s not at all the case across the whole spectrum of schizophrenia-related disorders.

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Si vous allez à Mental Health, Depression, Anxiety, Wellness, Family & Relationship Issues, Sexual Disorders & ADHD Medications you can read up about all the different types of schizophrenia-related disorders – with the caveat that it’s all coming from the standard mental health perspective that doesn’t take body or soul into account, when discussing mental and emotional issues.

J'espère que c'est utile
Rivka Levy

Jewish Emotional Health Institute

Kevin Painter

Kevin Painter, Oil and Gas Sales Manager with Built In Team.

Répondu il y a 4w

We feel very qualified to respond to this, as we have spent mucho dinero, on therapists to make this determination. We have read and suffered. Here is what was explained to us, as we believed we were a raging Borderline, Not DID.

The core issue in BPD, begins as a lack of attachment to the mother. The child also develops a lack of object constancy, as defined by Freud. Severe trauma, although can be present in many cases of BPD, is not a pre-requisite, as it is in the case of Dissociative Identity Disorder. The lack of maternal bond os more present in women, as the instinctive bond for a little girl, is to her father. Sons typically bond more with the mothers. This is a simple behavior that is caused from gender specific instincts, as well as environmental factors.

Our therapist, who has been practicing since Woodstock, would say” Borderlines do drama, for the sake fo drama. The need for attention will supersede all other needs. The alter that can appear to have BPD or NPD, as it win more cases with males, is usually reproducing unhealthy behaviors that have been imprinted on him. These behaviors are in response to stress, and the need to survive either real or perceived threats. As in the case with any trauma related disorder, the worse the fear, the worse the symptoms. This is not exclusive to any disorder.

Other things to take note of, the subtle differences. Both people with any of the disorders, and others, we are talking about here, can present as moody, eccentric, depressed, suicidal, angry, controlling, etc, etc. Most people that are aware the person has some sort of “mental illness”, will write this off to just the crazy guy we all know. Other people, that either do not have to, or by choice, can limit their exposure to the patient, will quietly do so. Due to hyper-vigelence, the patient, will usually notice this even before the people backing away. Most people actually dissociate their own, guilt laden behaviors. When you wonder how someone lives with themselves? This s is how. The other option is a lack of conscience. That is another article entirely, and not applicable here.

People with Trauma spectrum disorders, will almost always have a heightened sense of others emotions. BPD?NPD cannot really relate or even get an accurate read on these. So they tend to appear obnoxious, and push you away before you can see how scared they really are. But when you try and leave, OMG! the dam breaks and they will move mountains to keep you from leaving, or, to get you back. Folks with DID, will have very swiftly changing views, on many subjects. At times you will think they every together, and other times have no idea what happened to them. Folks with DID, will usually be reclusive and quiet, except for the alter that are designed to fill that gap. They have a better gauge for emotions than most, they're always aware fo the eminent threat, but are always doing good things. In many cases the alters will completely contradict each other in minutes. All with complete dedication, and confidence they are right!.

We have not touched on the fact, DID, is actually designed as a defense system, to allow the body to continue to survive. Even if someone has multiple alters, they most likely, unless they've been in therapy, have no idea. We were in therapy for years. Our alters kept us completely hidden to the world. We were always on the move, changing places. Always working where we could travel frequently, to hide us all. Just the fact that you or the person you are concerned about has no idea, applies to any disorder. Especially the trauma disorders. The mind is shielding itself, and the core conscience mind, from whatever heinous things happened to it. The real truth can be found looking at the body, not the mind.

In a nutshell, the first thing to do is insult a good therapist. One that has been certified by the IATP. Then, do some research, make sure thy actually have some hours dealing with trauma, BPD, DID etc. I would NEVER do the in a hospital setting where insurance is being billed. You would get a more accurate evaluation at a State Hospital! Find a good therapist. Thats the best thing. Trying to self diagnose will drive all of you more crazy than you feel now. The leading authority in the field fo Trauma and Dissociation, is Dr VanderKolk. HE has a book, “The Body Keeps the Score”, considered by most to be the goto text in the field today. Read the book. See a good therapist, and always keep an open mind and be honest. Stay Safe.

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Angela Essary

Angela Essary, mental health counselor, trying to find the middleway

Répondu il y a 158w · L'auteur dispose de réponses 557 et de vues de réponses 262.7k

You know, I've never heard the first three compared to one another. In VERY general terms:
• the primary characteristics of borderline personality disorder are fear of abandonment, emotional instability (being very reactive to the actions of others for instance), and having an unstable identity (like being an actor just fitting in to different roles - trying to be what others would expect)
• the primary characteristics for dissociative identity disorder are losing time - black outs during which a person has been appeared functional but they can't remember ANYTHING about it - then having "alters" who identify themselves as different people
• the primary characteristics for antisocial personality disorder is a disrespect for the rules of sociaety, disregard for others, recklessness with the safety of others, and a lack of empathy toward others. People with these characteristics may find the emotions of others overblown or silly.
To sum up, people with these diagnoses would have very different relationships with other people.

What can be far more difficult to distinguish is borderline from bipolar. The grandiosity and recklessness and mood fluctuations can make them difficult to tell apart.

Again, this is a very general statement, but I think the only people who tend to confuse schizphrenia with DID (formerly multiple personality disorder) are people who print T-shirts (I hear voices and so do I). I have never met a mental health professional who found that funny, because it's so so far off base. People with DID are generally not talked to by their alters, particularly without many years of therapy first.

When therapists or other psychological professionals are just starting out, they may rely heavily on the decision trees in the back of the DSM. The first thing I consider is the "spirit" of the symptoms or what seems to be pushing these symptoms.

Lee Ritchie

Lee Ritchie, PhD Psychology & Anthropology, Harvard University (1973)

Répondu il y a 154w · L'auteur dispose de réponses 565 et de vues de réponses 527.5k

Three personality disorder clusters - A,B and C. BPD and AsPD Are both in cluster B. Borderlines can, at intervals, show signs of ALL personlaity disorders. It is situation and mod driven manifestations of various traits. So, a Borderline can most easily be a bit of all personlaity disorders listed in cluster B. AsPD, HPD, NPD, BPD.

Next, personlaity disorders tend to be able to have dual diagnosis and Cluster B is found between A and C. Adjacent clusters are possible comorbity, but A and C, because they are not adjacent, are not comorbid as a rule.

A person can be BPD and have DID episodes and also be AsPD.

So what is the difference? The mood and the situation, is the difference I have found. Though there are some Borderlines that are codependent and dependent and are hermit and needy soouls and act inward and self-harm and can keep disturbingly silent. These types can disassociate.

Shay Posey

Shay Posey, Appreciates a little healthy fantasy

Répondu il y a 25w · L'auteur dispose de réponses 956 et de vues de réponses 760.7k

I came across this study that is very interesting; that they may be indistinguishable from each other in the more complex cases: https://www.cambridge.org/core/s...

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