PYC4802 Assignment 3
(COMPLETE ANSWERS)
2025 - DUE August 2025
For assistance contact
Email:
,Challenges in Assessing and Diagnosing Borderline Personality Disorder: Applicability
within the South African Context
I. Introduction
Personality disorders are characterized by enduring patterns of inner experience and behavior
that deviate significantly from cultural expectations. These patterns are pervasive, inflexible,
stable over time, and lead to significant distress or impairment across various life domains,
including cognition, affectivity, interpersonal functioning, and impulse control. Among these,
Borderline Personality Disorder (BPD) stands as a particularly complex, severe, and often
stigmatized mental illness. BPD is defined by a pervasive pattern of profound instability across
crucial areas of an individual's life, encompassing affect regulation, impulse control,
interpersonal relationships, and self-image. This inherent instability profoundly impacts an
individual's ability to function effectively in daily life, leading to significant challenges in
personal, social, and occupational spheres.
This report aims to systematically discuss the established diagnostic criteria and hallmark
features of both general personality disorders and, more specifically, Borderline Personality
Disorder as outlined in the DSM-5. Furthermore, it will critically examine the multifaceted
challenges clinicians routinely encounter in accurately identifying and diagnosing BPD. A
crucial aspect of this discussion will involve exploring the unique relevance and applicability of
these challenges within the specific socio-cultural and healthcare context of South Africa. This
approach allows for a nuanced understanding that extends beyond a purely Western-centric view
of mental health diagnosis, acknowledging the intricate intersection of clinical, systemic, and
cultural complexities.
II. Diagnostic Criteria and Hallmark Features of Personality Disorder and Borderline
Personality Disorder
General DSM-5 Diagnostic Criteria for Personality Disorders
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and its
subsequent text revision (DSM-5-TR), provide a comprehensive framework for diagnosing
personality disorders. While maintaining a categorical approach, the DSM-5 also introduces an
Alternative Dimensional Model, acknowledging the inherent complexity and frequent overlap
among these conditions.
For a general personality disorder diagnosis, five main criteria (A-E) must be met:
Criterion A: Significant Impairments in Self and Interpersonal Functioning. This
criterion requires substantial difficulties in two key areas. Firstly, self-functioning
encompasses challenges with identity, such as an unstable self-image, a fragmented sense
of self, or rapidly shifting goals and values. It also includes impairments in self-direction,
manifested by unrealistic standards for behavior or a reluctance to pursue goals.
Secondly, interpersonal functioning involves difficulties with empathy, such as
preoccupation with criticism or distorted interpretations of others' perspectives as
negative. It also includes challenges with intimacy, characterized by an unwillingness to
, engage in relationships unless certain of being liked, or diminished mutuality within
intimate connections due to fears of shame or ridicule.
Criterion B: Pathological Personality Traits. This criterion focuses on the presence of
specific maladaptive personality traits. These traits are organized into five higher-order
domains: Negative Affectivity, Detachment, Antagonism, Disinhibition versus
Compulsivity, and Psychoticism. These broad domains further encompass 25 lower-order
traits or facets, providing a detailed and nuanced description of the individual's
personality pathology.
Criterion C: Stability Across Time and Situations. The observed impairments in
personality functioning and the expression of personality traits must be relatively stable
over time and consistent across a variety of personal and social situations. This criterion
emphasizes the enduring nature of personality disorders, distinguishing them from
transient states or reactions.
Criterion D: Not Culturally or Developmentally Normative. The identified
impairments in personality functioning and trait expression must not be better understood
as typical for the individual's developmental stage or socio-cultural environment. This
criterion is particularly vital in diverse contexts, such as South Africa, where cultural
variations in behavior and expression must be carefully considered.
Criterion E: Rule Out Medical or Substance-Related Causes. It is essential to ensure
that the personality problems are not solely attributable to the direct physiological effects
of a substance (e e.g., a drug of abuse, medication) or another general medical condition
(e.g., severe head trauma).
The broad and qualitative nature of these general personality disorder criteria, particularly
Criterion A and B, presents an initial diagnostic hurdle. The reliance on terms like "significant
impairments" and the extensive list of 25 lower-order facets mean that manifestations are
incredibly diverse. This breadth, while aiming for comprehensiveness, makes it inherently
challenging for clinicians to consistently identify and agree upon a diagnosis, requiring a deep
understanding of personality theory and considerable clinical experience.
Detailed DSM-5-TR Categorical Criteria for Borderline Personality Disorder
Borderline Personality Disorder (BPD) is specifically diagnosed when an individual exhibits a
pervasive pattern of instability in interpersonal relationships, self-image, and affects, coupled
with marked impulsivity. This pattern must begin by early adulthood and be evident in a variety
of contexts. For a diagnosis of BPD, five or more of the following nine specific criteria must be
met :
1. Frantic efforts to avoid real or imagined abandonment. Individuals with BPD often
go to extreme lengths to prevent separation or rejection, even when their fears of
abandonment are unfounded.
(COMPLETE ANSWERS)
2025 - DUE August 2025
For assistance contact
Email:
,Challenges in Assessing and Diagnosing Borderline Personality Disorder: Applicability
within the South African Context
I. Introduction
Personality disorders are characterized by enduring patterns of inner experience and behavior
that deviate significantly from cultural expectations. These patterns are pervasive, inflexible,
stable over time, and lead to significant distress or impairment across various life domains,
including cognition, affectivity, interpersonal functioning, and impulse control. Among these,
Borderline Personality Disorder (BPD) stands as a particularly complex, severe, and often
stigmatized mental illness. BPD is defined by a pervasive pattern of profound instability across
crucial areas of an individual's life, encompassing affect regulation, impulse control,
interpersonal relationships, and self-image. This inherent instability profoundly impacts an
individual's ability to function effectively in daily life, leading to significant challenges in
personal, social, and occupational spheres.
This report aims to systematically discuss the established diagnostic criteria and hallmark
features of both general personality disorders and, more specifically, Borderline Personality
Disorder as outlined in the DSM-5. Furthermore, it will critically examine the multifaceted
challenges clinicians routinely encounter in accurately identifying and diagnosing BPD. A
crucial aspect of this discussion will involve exploring the unique relevance and applicability of
these challenges within the specific socio-cultural and healthcare context of South Africa. This
approach allows for a nuanced understanding that extends beyond a purely Western-centric view
of mental health diagnosis, acknowledging the intricate intersection of clinical, systemic, and
cultural complexities.
II. Diagnostic Criteria and Hallmark Features of Personality Disorder and Borderline
Personality Disorder
General DSM-5 Diagnostic Criteria for Personality Disorders
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and its
subsequent text revision (DSM-5-TR), provide a comprehensive framework for diagnosing
personality disorders. While maintaining a categorical approach, the DSM-5 also introduces an
Alternative Dimensional Model, acknowledging the inherent complexity and frequent overlap
among these conditions.
For a general personality disorder diagnosis, five main criteria (A-E) must be met:
Criterion A: Significant Impairments in Self and Interpersonal Functioning. This
criterion requires substantial difficulties in two key areas. Firstly, self-functioning
encompasses challenges with identity, such as an unstable self-image, a fragmented sense
of self, or rapidly shifting goals and values. It also includes impairments in self-direction,
manifested by unrealistic standards for behavior or a reluctance to pursue goals.
Secondly, interpersonal functioning involves difficulties with empathy, such as
preoccupation with criticism or distorted interpretations of others' perspectives as
negative. It also includes challenges with intimacy, characterized by an unwillingness to
, engage in relationships unless certain of being liked, or diminished mutuality within
intimate connections due to fears of shame or ridicule.
Criterion B: Pathological Personality Traits. This criterion focuses on the presence of
specific maladaptive personality traits. These traits are organized into five higher-order
domains: Negative Affectivity, Detachment, Antagonism, Disinhibition versus
Compulsivity, and Psychoticism. These broad domains further encompass 25 lower-order
traits or facets, providing a detailed and nuanced description of the individual's
personality pathology.
Criterion C: Stability Across Time and Situations. The observed impairments in
personality functioning and the expression of personality traits must be relatively stable
over time and consistent across a variety of personal and social situations. This criterion
emphasizes the enduring nature of personality disorders, distinguishing them from
transient states or reactions.
Criterion D: Not Culturally or Developmentally Normative. The identified
impairments in personality functioning and trait expression must not be better understood
as typical for the individual's developmental stage or socio-cultural environment. This
criterion is particularly vital in diverse contexts, such as South Africa, where cultural
variations in behavior and expression must be carefully considered.
Criterion E: Rule Out Medical or Substance-Related Causes. It is essential to ensure
that the personality problems are not solely attributable to the direct physiological effects
of a substance (e e.g., a drug of abuse, medication) or another general medical condition
(e.g., severe head trauma).
The broad and qualitative nature of these general personality disorder criteria, particularly
Criterion A and B, presents an initial diagnostic hurdle. The reliance on terms like "significant
impairments" and the extensive list of 25 lower-order facets mean that manifestations are
incredibly diverse. This breadth, while aiming for comprehensiveness, makes it inherently
challenging for clinicians to consistently identify and agree upon a diagnosis, requiring a deep
understanding of personality theory and considerable clinical experience.
Detailed DSM-5-TR Categorical Criteria for Borderline Personality Disorder
Borderline Personality Disorder (BPD) is specifically diagnosed when an individual exhibits a
pervasive pattern of instability in interpersonal relationships, self-image, and affects, coupled
with marked impulsivity. This pattern must begin by early adulthood and be evident in a variety
of contexts. For a diagnosis of BPD, five or more of the following nine specific criteria must be
met :
1. Frantic efforts to avoid real or imagined abandonment. Individuals with BPD often
go to extreme lengths to prevent separation or rejection, even when their fears of
abandonment are unfounded.
