The key diagnostic criteria for Borderline Personality Disorder (BPD) according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), include a pervasive pattern of instability in interpersonal relationships, self-image, and affects, as well as marked impulsivity, beginning by early adulthood and present in a variety of contexts. This is indicated by five (or more) of the following: frantic efforts to avoid real or imagined abandonment; a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation; identity disturbance; impulsivity in at least two areas that are potentially self-damaging; recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior; affective instability due to a marked reactivity of mood; chronic feelings of emptiness; inappropriate, intense anger or difficulty controlling anger; and transient, stress-related paranoid ideation or severe dissociative symptoms.
The DSM-5 outlines specific criteria for diagnosing BPD, which include patterns of instability in relationships, self-image, and emotions, as well as impulsive behaviors and other symptoms that must be present in various contexts and not attributable to another mental disorder or substance use.