Transformation of the diagnostic criteria for borderline personality disorder: historical analysis and current perspectives
Keywords:
DIAGNÓSTICO; MANUAL DIAGNÓSTICO Y ESTADÍSTICO DE LOS TRASTORNOS MENTALES; TRASTORNO DE PERSONALIDAD LIMÍTROFE; TRASTORNOS MENTALES., DIAGNOSIS; DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS; BORDERLINE PERSONALITY DISORDER; MENTAL DISORDERS., DIAGNÓSTICO; MANUAL DIAGNÓSTICO E ESTATÍSTICO DE TRANSTORNOS MENTAIS; TRANSTORNO LIMITE DA PERSONALIDADE; TRANSTORNOS MENTAIS.Abstract
Introduction: borderline personality disorder constitutes one of the most complex psychiatric conditions, characterized by emotional instability, impulsivity, and interpersonal difficulties, which generates significant clinical challenges.
Objective: to analyze the evolution of the diagnostic criteria for borderline personality disorder between the fourth and fifth editions of the Diagnostic and Statistical Manual of Mental Disorders.
Methods: a systematic review of the scientific literature was carried out in various databases. The search was conducted using an algorithm with keywords and Boolean operators, allowing the identification of relevant sources. The selected studies, after applying selection criteria, were critically analyzed considering recency, methodological quality, and thematic relevance, and were integrated into the final synthesis of the review.
Results: the findings show that the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders introduces greater specificity and differentiation of symptoms compared to the previous edition, separating suicidal behaviors from impulsivity and clarifying the influence of culture on clinical presentation. Changes in the description of identity, affective reactivity, and interpersonal relationships are highlighted, which favors more precise diagnoses. The literature emphasizes the importance of detailed criteria to improve clinical validity and therapeutic intervention.
Conclusions: the transition between the fourth and fifth editions of the manual represents an advance in the understanding of the disorder by offering clearer and more differentiated criteria. These changes strengthen diagnostic accuracy and facilitate specific therapeutic strategies, although challenges remain, requiring complementary assessment tools and future research.
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