DSM-5 Borderline Personality Disorder: At the Border Between a Dimensional and a Categorical View

Abstract

Recently, the DSM-5 Personality Disorders Workgroup offered its proposed revision for borderline personality disorder (BPD) and other personality disorder types (http://www.dsm5.org). According to the workgroup, this revision reflects an attempt to address excessive comorbidity among personality disorders, place personality pathology on continua, and replace individual behavioral criteria with personality traits. Essentially, the committee proposes a hybrid model of BPD (ie, categorical and dimensional)—one that combines the notion of a borderline “type” with supplemental dimensional ratings of relevant personality traits. In this article, we review recent findings on the dimensionality of BPD from phenotypic, genetic, and endophenotypic perspectives. Finally, we evaluate the current DSM-5 proposal for diagnosing BPD—one that ostensibly combines a categorical and dimensional perspective—in light of these findings.