Version July 2025
| A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following: |
| 1. Frantic efforts to avoid real or imagined abandonment |
| 2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation |
| 3. Identity disturbance: markedly and persistently unstable self-image or sense of self |
| 4. Impulsivity in at least two areas that are potentially self-damaging (eg, spending, sex, substance abuse, reckless driving, binge eating) |
| 5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior |
| 6. Affective instability/marked reactivity of mood |
| 7. Chronic feelings of emptiness |
| 8. Inappropriate, intense anger or difficulty controlling anger |
| 9. Transient, stress-related paranoid ideation or severe dissociative symptoms |
