The Accuracy of Borderline Personality Diagnosis

(Citations Underlined)

Before examining the accuracy of BPD's diagnosis it is important to recognize that the disorder does in fact exist, what is to be contested however is its diagnosis. This article seeks to evaluate the extent to which it is similar and disimilar from other disorders — cluster B or otherwise — and why it is so misdiagnosed.

The DSM-5 designates Borderline Personality Disorder as a pattern of "chronic instability in early adulthood, with episodes of serious affective and impulsive dyscontrol and high levels of use of health and mental health resources" (663). This sentence describes the main demographic of those diagnosed with BPD, however it is clear that such behaviors are present in other disorders. Histrionic Personality Disorder for instance may manifest the same behaviors as its main feature is "pervasive and excessive emotionality and attention-seeking behavior." The attention seeking behavior of HPD and the impulsivity in the face of abondonment present in BPD can manifest in the same behaviors, for instance clinging on to others or the documented 'favorite person'.

Another contributing factor to misdiagnosis is what initially draws people with BPD to treatment. The facors that lead people to seek psychiatric treatment for personality disorders are twofold; the first is threat to self, manifesting in suicidal ideation or attempt; the second is when friends or family find themselves unable to care for the person affected by the disorder. What leads a person with BPD to be treated is similar to most other disorders; suicidal ideation, trauma, and non-constant sense of self. Similarities between disorders past this initial push for treatment come in the form of patient behaviors, and past that are stigma (even among doctors) associated with BPD.

BPD is not just misdiagnosed for those with other disorders, it is also underdiagnosed in many demographics. Due to the way neurotic behavior manifests in either sex, women are misdiagnosed with BPD more often, and men are underdiagnosed. There does not seem to be a biological compenent leading women to have such a disorder at higher rates than men. What instead influences such misdiagnosis is the harmful stereotype of women as hysterical or overemotional, and men as stoic or uncaring.

Borderline Personality Disorder as a category — regardless of its accuracy at describing a collection of symptoms — is misused in its application. Due to cultural bias, vague diagnostic criteria, and lack of treatment, the diagnosis has lost utility for patients. Patients may not just be treated for the wrong thing, but also they may receive treatment that is innefficient to even suit those with BPD.