Theme: Borderline Personality Disorder
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UNISA, 2026
INTRODUCTION
Borderline personality disorder (BPD) is a complex mental disorder characterised by
persistent difficulties involving emotional regulation, interpersonal relationships, self-
image and impulse control. Although established diagnostic criteria provide clinicians
with a framework for identifying BPD, assessment and diagnosis can be challenging
because many of its features overlap with other psychological disorders and may be
influenced by trauma and social circumstances. These challenges are further
complicated within the South African context by cultural and linguistic diversity, different
understandings of mental illness, socioeconomic inequalities and unequal access to
mental-health services. This essay first discusses the general diagnostic criteria and
hallmark features of personality disorders before focusing specifically on BPD. It then
critically examines the challenges clinicians experience when identifying and diagnosing
BPD and considers how these challenges are relevant within the South African context,
with particular attention to cultural factors that may influence psychological assessment
and diagnosis.
PART A: DIAGNOSTIC CRITERIA AND HALLMARK FEATURES OF PERSONALITY
DISORDERS AND BPD
1. Personality Disorders: General Diagnostic Criteria and Hallmark Features
Personality disorders should first be discussed at a general level before narrowing the
discussion to BPD. According to the DSM-5-TR, a personality disorder involves an
enduring pattern of inner experience and behaviour that deviates markedly from the
expectations of the individual's culture. This pattern is manifested in areas such as
cognition, affectivity, interpersonal functioning and impulse control. The pattern is
generally inflexible and pervasive across a broad range of personal and social
situations, leads to clinically significant distress or impairment, is stable and of long
duration, and can be traced back to adolescence or early adulthood. It must also not be
better explained by another mental disorder, substance use or another medical
condition.
Key points to develop in your own writing
, Your paragraph should explain that personality disorders generally involve:
Enduring patterns rather than temporary reactions;
Cognitive disturbances, such as persistent ways of interpreting oneself or
others;
Affective disturbances, including problematic emotional patterns;
Interpersonal difficulties, such as unstable or dysfunctional relationships;
Problems with impulse control or behavioural regulation;
Pervasiveness across situations;
Inflexibility;
Clinically significant distress or impairment;
Long-term stability, usually beginning by adolescence or early adulthood;
The need to exclude alternative explanations such as substances, medical
conditions or other mental disorders.
The important critical point is that personality disorders should not be diagnosed simply
because a person displays one difficult characteristic. Diagnosis requires a persistent,
pervasive and clinically significant pattern.
2. Borderline Personality Disorder: Specific Diagnostic Criteria and Hallmark
Features
After discussing personality disorders generally, the argument should narrow directly to
BPD. BPD is characterised by a pervasive pattern of instability in interpersonal
relationships, self-image and affect, together with marked impulsivity. The DSM-5-TR
diagnostic framework identifies a pattern involving several characteristic features, with
the required threshold of symptoms needing to be met for diagnosis.
Your discussion should cover the following BPD features:
2.1 Fear of abandonment
Individuals may experience intense fears of real or imagined abandonment and may
engage in efforts to avoid it. A clinically important point is that the perceived threat of
abandonment may be experienced as extremely significant, even when another person
does not intend to leave.
2.2 Unstable and intense interpersonal relationships
Relationships may shift between idealising and devaluing others. This is often described
as a pattern of interpersonal instability.
2.3 Disturbed identity