Certain assessment issues relevant to all personality disorders
should be considered when diagnosing borderline personality disorder.
For the diagnosis to be made, the personality traits must cause
subjective distress or significant impairment in functioning. The
traits must also deviate markedly from the culturally expected and
accepted range, or norm, and this deviation must be manifested in
more than one of the following areas: cognition, affectivity, control
over impulses, and ways of relating to others. Therefore, multiple
domains of experience and behavior (i.e., cognition, affect, intrapsychic
experience, and interpersonal interaction) must be assessed to determine
whether borderline traits are distressing or impairing. The clinician
should also ascertain that the personality traits are of early onset,
pervasive, and enduring; they should not be transient or present
in only one situation or in response to only one specific trigger.
It is important that borderline personality disorder be assessed
as carefully in men as in women.