Free tests. Personality disorder, mental disorder: Ammon structural test How does it manifest itself?

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Borderline personality disorder (BPD) most often develops during adolescence or early adulthood. It manifests itself in emotional instability, impulsive behavior, a distorted perception of one’s personality, a tendency towards unstable relationships (both with people and with school or work) and suicidal tendencies. The latter often follows from a combination of previous factors, since living with all this (especially if the disorder manifests itself in a serious form) is quite difficult.

Borderline personality disorder has been little studied, and the International Classification of Diseases calls it “borderline type of emotionally unstable personality disorder.” The word “borderline” in this case means that the disorder itself is on the border between mental and emotional (mood disorder), and although the original meaning has already lost its relevance (BPD is included in the official list of mental disorders), the name remains. In Russian, there is even a slang name for people with this diagnosis - some call them “borderliners”, from the English term “Borderline Personality Disorder”.

It is believed that the reasons for the development of borderline personality disorder may be genetic characteristics, an unfavorable emotional environment (according to some researchers, psychological and physical violence suffered in the early years of life greatly increases the likelihood of developing this disorder) and disturbances in the production of serotonin - the so-called “ hormone of happiness."

How does this manifest itself?

In fact, any mental disorder is a kind of prism through which a person perceives the world. It distorts in one way or another what we feel and think, not only about the people around us, work or study, but also about ourselves. And the main feature of borderline personality disorder is instability, which affects all areas of life.

Unstable self-perception

A person with borderline personality disorder is constantly searching for their identity, and this search may be accompanied by a feeling of fear. Such people often change jobs (and not just change one company for another, but radically change areas of activity), rush to learn different things, try on all possible religions, try to join certain social groups (in most cases, unsuccessfully). Sometimes during the search it seems to them that they have finally hit the bull’s eye, but more often than not they end up disappointed, and euphoria gives way to despondency, self-loathing and real depression.

Inappropriate emotions

If you often hear from different people (namely, from different people) that you perceive everything too acutely, perhaps you should think about it. If, because of some insignificant trifle, you can fall into melancholy for several days or even weeks, and nothing can “get you out” of this melancholy, you should think again. If the transition from a good mood to a terrible one happens with the snap of a finger, guess what is worth doing. If you constantly feel angry and easily “explode”, especially out of the blue, the same thing. And finally, if the emotional echoes of a “bad” event, especially a nonsense one, do not leave you for months, then yes, this is also a reason to tense up.

Feeling empty

And not just emptiness, but emptiness inside. People with borderline personality disorder often use this word to describe their feelings. They feel like there is nothing inside them. Not a single emotion. Not even a hint of emotion. “It’s like a black hole in the soul. You sit and try to feel at least something, but you can’t,” this is how one of the people with this diagnosis writes about his feelings.

Self harm

Cuts, burns, banging your head against the wall (literally) are one of the signs of this disorder (although it can also be a sign of many other things - we’ll clarify for those who are especially suspicious). “It’s better to feel physical pain than to feel nothing at all,” many people with BPD agree. It can also be used as a way to replace emotional pain. Physical pain attracts all the body’s resources, because at least at the subconscious level, the instinct of self-preservation is very strong. And at this moment, the emotional pain seems to recede and becomes less palpable and noticeable. Having said that, voluntarily harming yourself (even minor ones) is in any case an extremely serious symptom, and in this case we highly, highly recommend talking to someone. Better - with a specialist.

Fear of abandonment

People with borderline personality disorder have a very strong fear that a loved one will leave them. This thought leads to despair, and any little thing can serve as a trigger for inappropriate behavior, be it a delay at work for half an hour or a proposal to reschedule a meeting for another day. A person with BPD begins to frantically “cling” to a person dear to him (this can be not only a beloved man, but also a friend or girlfriend), check what he “really” does, get jealous out of the blue, and so on. The worst thing is that the other person, and in the end, exactly what scared the most happens: he leaves.

Unstable emotions in relationships

If you constantly swing from love to hate (and back again) in relation to all the significant people in your life, this may also be a sign of borderline personality disorder. Yesterday you praised a man to the skies, today you tell him with malicious delight what a scoundrel he is. Yesterday you admired his achievements, today you consider him a nonentity, tomorrow you admire him again. You fall in love in one second and so much that your head is literally spinning, but just as quickly and irrevocably you become disappointed in the person. You are like a child who tells his mother “I hate you” but still demands a hug. Which, in principle, is more or less ok for a child, but for an adult - well, how can I tell you. For most - not very much.

Feeling of unreality

In severely stressful situations, people with borderline personality disorder often have a feeling that what is happening is unreal. It’s as if they are in a film, and see themselves and their actions from the outside, without being able to influence anything. This is a rather scary feeling, and if you have ever experienced it, then you now understand exactly what it is about.

Impulsive behavior and self-destruction

No, not just impulsive behavior. Namely, one that potentially leads to self-destruction - psychological, physical, emotional, financial and anything else. If you have voluntarily gotten yourself into situations more than once or twice involving unprotected sex with strangers (or strangers), careless driving, drugs, large (very large) quantities of alcohol, losing large sums of money in gambling, etc. – perhaps borderline personality disorder has a lot to do with you.

Surely you have discovered at least one of the listed signs, but there is no need to panic. To theoretically put yourself at "increased risk" of borderline personality disorder, you need to score at least five - no less. And even if you scored all eight, there is no need to panic either. But it’s very worth going to a psychotherapist. Because even if it’s not BPD, then you’re clearly not having much fun in your life, and it’s better to seek professional help. Well, if you still have BPD, don’t despair either. There are a lot of psychotherapeutic techniques - from cognitive behavioral therapy to medication - that can really help and make life not just bearable, but truly good. Verified.

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Why Borderline Personality Disorder is Difficult to Diagnose

Borderline personality disorder is a relatively recent addition to the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association and the International Statistical Classification of Diseases and Related Health Problems (ICD) of the World Health Organization. Accordingly, the majority of mental health practitioners who completed training before 2000 were not trained in the diagnosis and treatment of this complex disorder as part of their professional training programs.

Additionally, the clinical definition of Borderline Personality Disorder is very broad. The DSM-IV defines it in terms of nine criteria, of which 5 or more are indicative of a disorder. This results in 256 criterion groups

ev, of which any group is diagnostic for BPD. Within these constellations there are high functioning borderlines who function well in society and whose disorders are not very obvious to new acquaintances or the casual observer. Also within these constellations there are low functioning borderlines who are more obvious as they cannot hold down a job and are prone to self-harm. Suicidal attempts or suicidal ideation and anorexia/bulimia are among the most serious aspects of this disorder - yet many carriers of the disorder do not exhibit this.

The correct diagnosis and treatment of borderline personality disorder is, at best, merely known within the community of health professionals, marriage and family counselors, and family therapists, who are often hesitant to diagnose or treat the disorder. As a result, most borderlines are diagnosed or treated for other illnesses, such as depression or PTSD. If you suspect borderline personality disorder, it is best to use a professional.

Below we have listed available resources for how BPD is defined, as well as several characteristics of the disorder by professional organizations.

The Diagnostic Interview for Borderline (DIB-R) is the best known “test” for diagnosing BPD. The DIB is a semi-structured clinical interview that takes 50-90 minutes to complete. Designed to be administered by experienced clinicians, the test consists of 132 questions and observations using 329 summary statements. The test examines areas of activity associated with borderline personality disorder. The four areas of operation include:
-impact (chronic/major depression, helplessness, hopelessness, worthlessness, guilt, anger, anxiety, loneliness, boredom, emptiness),
-cognition (strange looks, unusual sensations, non-delusional paranoia, quasi-psychosis),
-impulsive actions (substance abuse/addiction, sexual deviations, manipulative suicide attempts, other impulsive behavior),
-interpersonal relationships (intolerance of loneliness, abandonment, absorption, fears of destruction, -anti-dependence, stormy relationships

behavior, manipulativeness, dependence, depreciation, masochism/sadism, demandingness, entitlement).

The test is available free of charge by contacting John Gunderson M.D. McLean Hospital in Belmont Massachusetts (617-855-2293).

The Structured Clinical Interview (now SCID-II) was formulated in 1997 by First, Gibbon, Spitzer, Williams, Benjamin. It is close to the language of the DSM-IV Axis II personality disorder criteria. There are 12 groups of questions corresponding to these 12 personality disorders. Features, their absence, subthreshold value, reliability or unreliability of information are calculated. The questionnaire is available from American Psychiatric Publishing ($60.00).

The Personality Disorder Beliefs Questionnaire is a short, self-administered test that identifies tendencies associated with a personality disorder. People with borderline disorder are more likely to answer questions positively.

Other commonly used tests are the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD), the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD). There are several free, unofficial, but useful tests available.

Symptoms of Borderline Personality Disorder according to the National Institutes of Health

People with borderline personality disorder often have very unstable patterns of social relationships. While they may develop intense but

intense attachment, their attitude towards family, friends and loved ones can suddenly shift from idealization (intense admiration and love) to devaluation (intense anger and hostility). Thus, they may form a quick attachment and idealize the other person, but when a slight separation or conflict occurs, they suddenly go to the other extreme and angrily accuse the other person of not caring about them at all.

People with borderline personality disorder are very sensitive to rejection, even from their own family members, reacting with anger and experiencing stress even during mild events such as vacations, business trips, or sudden changes in plans. These fears of abandonment seem to be related to the difficulty of experiencing feelings of attachment to significant others at a time when loved ones are physically absent, and the person with borderline disorder feels abandoned and worthless. Suicide threats and attempts may occur along with anger when perceived rejection and disappointment.

People with borderline personality disorder also tend to exhibit other forms of impulsive behavior, such as excessive spending, binge eating, and risky sexual behavior. Borderline personality disorder often co-occurs with other psychiatric problems, particularly bipolar disorder, depression, anxiety disorders, substance abuse and other personality disorders.

Symptoms of Borderline Personality Disorder - Mayo Clinic

People with borderline personality disorder often have an unstable sense of who they are. That is, their self-esteem and self-image changes frequently and quickly. They usually see themselves as evil or bad, and sometimes they may feel as if they don't exist at all. This unstable self-image can lead to frequent changes in jobs, friendships, goals, values, and gender identity.

Relationships are usually chaotic. People with borderline personality disorder often experience love-hate relationships with others. They can

idealize someone at one moment, and then suddenly and radically move to rage and hatred against the backdrop of resentment or even misunderstanding. This is because people with borderline disorder have difficulty perceiving “gray” areas—things in their perception may be either black or white. For example, in the eyes of a person with borderline personality disorder, someone can be either good or bad. The same person can be good one day and evil the next.

In addition, people with borderline personality disorder are often prone to impulsive and risky behavior. This behavior often results in harm - emotional, physical and financial. For example, they may drive riskily, engage in unsafe sex, take illegal drugs, spend money, or gamble. People with borderline personality disorder are also often prone to suicidal behavior or intentionally self-harming behavior for the purpose of emotional relief.

Other signs and symptoms of borderline personality disorder may include:

Strong emotions that often increase or decrease.
Intense but brief episodes of anxiety or depression.
Inappropriate anger, sometimes escalating into physical confrontation.
Difficulties associated with self-control - managing your emotions and impulses.
Fear of loneliness.

Symptoms of Borderline Personality Disorder - American Psychiatric Association (DSM-5)

Individuals who fit this type of personality disorder have an extremely fragile self-concept that is easily destroyed and fragmented under stress and leads to the experience of a lack of identity or a chronic feeling of emptiness. As a result, they have an impoverished and/or unstable self-structure and difficulty maintaining stable intimate relationships. Self-esteem is often associated with self-loathing, rage and despair. People with this disorder experience rapidly changing, intense, unpredictable and reactive emotions and may become extremely anxious or depressed. They may also become angry, hostile, and feel unappreciated, mistreated, or victimized. They may engage in verbal or physical acts of aggression when angry. Emotional reactions typically occur in response to negative interpersonal events associated with loss or disappointment.

Relationships are based on fantasies of needing others for survival, excessive dependence, and fear of rejection and/or rejection. Dependency includes both insecure attachment, which involves difficulty experiencing loneliness and intense fear of loss, abandonment, or rejection by significant others; and the urgent need for contact with significant others in a state of stress or grief, is sometimes accompanied by very submissive, submissive behavior. At the same time, the intense, close involvement of another person

This leads to fear of loss of identity. Thus, interpersonal relationships are highly unstable, alternating between overdependence and escape from involvement. Empathy is seriously impaired.

Basic emotional traits and interpersonal behavior may be associated with cognitive dysregulation, that is, cognitive functioning may be impaired during moments of interpersonal stress, leading to information processing in a concrete, black-and-white, uncompromising way. Quasi-psychotic reactions, including paranoia and dissociation, may progress to transient psychosis. People of this type are characterized as impulsive, acting on the spur of the moment, and often engaging in activities with potentially negative consequences. Intentional self-harm (eg, cutting, burning), suicidal ideation, and suicide attempts typically occur in the context of intense distress and dysphoria, especially in the context of feelings of abandonment, when an important relationship is destroyed. Intense stress can also lead to other forms of risky behavior, including including substance abuse, reckless driving, binge eating or promiscuous sex.

1. Negative emotionality: emotional lability
Having unstable emotional experiences and mood changes; having emotions that arise due to high excitability, intensity and/or under the influence of events and circumstances.

2. Negative emotionality: self-harm
The emergence of thoughts and behaviors associated with self-harm (eg, deliberate cutting or burning) and suicide, including suicidal ideation, threats, gestures, attempts.

3. Negative emotionality: unsafe separation
Fear of rejection and/or separation from significant others; stress when significant others are absent or unavailable.

4. Negative emotionality: anxiety
Feelings of nervousness, tension, and/or being on edge; worry about past unpleasant events and future negative possibilities; feeling of fear and

uncertainty.

5. Negative emotionality: low self-esteem
Having a low opinion of yourself and your abilities; conviction of one's own uselessness and that one is worthless, self-dislike and a feeling of dissatisfaction with oneself, the conviction that one is not capable of anything and cannot do anything well.

6. Negative emotionality: depression
Frequent experiences of decline/unhappiness/depression/hopelessness; difficulties in getting out of such states, the belief that loneliness leads to depression.

7. Antagonism/resistance: hostility
Irritability, impulsiveness; unkindness, rudeness, unfriendlyness, spiteful, angry responses to minor insults and insults.

8. Antagonism/resistance: aggression
Tendency to stinginess, cruelty and heartlessness; verbal, sexual or physical violence, humiliation of others, willing and conscious participation in acts of violence against persons and objects; active and open belligerence or vindictiveness; dominance and intimidation for the purpose of control.

9 Disinhibition: Impulsivity
Acting on the spur of the moment in response to immediate stimuli, without a plan or anticipation of results, difficulty planning, inability to learn from experience.

10 Schizotypy: predisposition to dissociation
Tendency to experience interruption in the flow of conscious experience; loss of time intervals (“loss of time”, for example, a person does not know how he ended up in this place); experiencing what is happening around you as strange or unreal.

Symptoms of Borderline Personality Disorder - American Psychiatric Association (DSM-IV)
A personality disorder is diagnosed based on symptoms and a thorough psychological evaluation. To be diagnosed with borderline personality disorder, a person must meet the criteria described in the DSM. DSM criteria note that people with borderline personality disorder have a pattern of unstable relationships, self-esteem and mood, as well as impulsive behavior. They usually begin in early adulthood. These guidelines are published by the American Psychiatric Association and are used by mental health professionals to diagnose mental conditions and by insurance companies for reimbursement purposes.

Borderline personality disorder is a profound pattern of unstable interpersonal relationships, self-esteem, and emotional functioning, and is characterized by impulsivity that begins in early adulthood and is present in a variety of contexts. For diagnosis, five or more of the following symptoms must be identified.

1. Desperate efforts to avoid real or imagined rejection. Note: (not including suicide or self-harm - these are covered in criterion 5).

2. A pattern of unstable and intense interpersonal relationships, characterized by alternating extremes - idealization and devaluation.

3. Identity disorders - obvious and persistently unstable self-esteem and sense of self.

4. Impulsivity in at least two areas that are potentially harmful (eg, spending money, sex, drug addiction, reckless driving, overeating). Note: (not including suicide or self-harm - these are covered in criterion 5).

5 Repeated suicidal behavior, gestures, threats, self-harming actions.

6. Emotional instability

and due to marked mood reactivity (eg, intense episodic dysphoria, irritability, or anxiety, typically lasting several hours and only rarely lasting more than a few days).

7. Chronic feeling of emptiness.

8. Inappropriate, intense anger or difficulty managing anger (eg, frequent temper tantrums, constant anger,

repeated physical collisions).

9 . Transient stress-related paranoid ideas or severe dissociative symptoms.

Schizotypal disorder refers to a group of schizophrenia-like diseases, including schizophrenia itself, schizotypal and other delusional disorders. Schizotypal disorder is somewhat similar in its manifestations to schizophrenia. Its symptoms include behavioral abnormalities, emotional inadequacy, and eccentricity. Obsessive ideas, avoidance of communication, and paranoid disorders are common. Delusional and hallucinatory episodes are possible. However, there are no obvious signs of schizophrenia.

The main difference between schizotypal disorder and schizophrenia is the predominance of positive symptoms. It is characterized by delusions, hallucinations, and obsessions without the development of a personality defect. There are no symptoms characteristic of schizophrenia, such as emotional flattening, decreased intelligence, and sociopathy.

Diagnosis of schizotypal disorder

To establish this diagnosis, a long-term (more than two years) presence of characteristic symptoms in the absence of personality deficit is necessary. The diagnosis of schizophrenia should also be excluded. Information about illnesses of close relatives can help in establishing a diagnosis - the presence of schizophrenia in them serves as confirmation of schizotypal disorder.

It is important to avoid both over- and under-diagnosis. An erroneous diagnosis of schizophrenia is especially dangerous. In this case, the patient will receive unreasonably intensive treatment, and, when information is disseminated among friends, social isolation, which contributes to the aggravation of symptoms.

There are a number of methods that help clarify the diagnosis of schizotypal personality disorder. The SPQ (Schizotypal Personality Questionnaire) test is one of the easiest ways to do this.

Test description

The test for schizotypal personality disorder includes 74 questions that cover 9 main signs of this disease according to ICD-10. A score of more than 41 points is considered a sign of schizotypal disorder. More than half of respondents who exceeded the diagnostic level on the test were subsequently diagnosed with schizotypal disorder.

There are also separate tests for diagnosing the level of psychoticism authored by Eysenck, scales for assessing general and social anhedonia, possible disturbances of perception and a tendency to schizophrenia. However, only in the SPQ are all the signs of schizotypal disorder collected together and presented in an easy-to-use form.

The questions in the test for schizotypal traits are divided into the following scales:

• impact ideas,
• excessive social anxiety,
• strange ideas or magical thinking,
• experience of unusual perception,
• strange or eccentric behavior
• lack of close friends,
• unusual sayings,
• reduction in emotions
• suspicion.

This test demonstrated good reproducibility and reliability of results in different groups of subjects.

The SPQ test can be used both to confirm the diagnosis of schizotypal disorder and for screening healthy people at risk. This is a fairly reliable and psychologically comfortable way to identify the presence of a disorder at its first symptoms.

The test is also convenient for dynamic monitoring to identify worsening or alleviating symptoms. The test questions can be used by patients for self-control - patients do not always perceive their condition as pathological and make corresponding complaints, but with the help of the test they can be easily identified.