Assessment of borderline personality disorder: considering a diagnostic strategy
Article first published online: 1 JUL 2002
Volume 14, Issue 2, pages 55–59, April 2002
How to Cite
Schotte, C. K. W. (2002), Assessment of borderline personality disorder: considering a diagnostic strategy. Acta Neuropsychiatrica, 14: 55–59. doi: 10.1034/j.1601-5215.2002.140201.x
- Issue published online: 1 JUL 2002
- Article first published online: 1 JUL 2002
- personality disorder;
- DSM-IV axis II;
Background: Borderline personality disorder (BPD) represents a highly prevalent, severe and difficult-to-treat mental health problem.
Objective: This paper considers methods, instruments and strategies for assessing BPD as described within the frame of the DSM-IV classification.
Conclusions: Following the general diagnostic approach introduced by Van Praag in biological psychiatry, a two-tier diagnostic strategy for the descriptive diagnostic assessment of BPD is recommended. Axis one results in a DSM-IV Axis II categorical diagnosis, whereas axis two refers to a symptomatological, dimensional or functional approach, in which the psychological dysfunctions of the nosological syndrome are depicted. Moreover, in a clinical context a basic aim of the diagnostic evaluation is to obtain therapeutically valid information that leads to a constructive conceptual framework, to a case formulation in which therapeutic interventions are understood, selected and implemented. This framework should be based on a biopsychosocial theoretical model and its application in the clinical context involves feedback to the patient, in which the descriptive evaluation is integrated with etiological; and pathogenic elements using an idiographic approach. This therapeutically orientated diagnostic strategy is illustrated by the use of the ADP-IV (Assessment of DSM-IV personality disorders) questionnaire within a cognitive behavioral orientation.