Free tests. Personality disorder, psyche: Ammon's 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 to unstable relationships (both with people and with studies or work) and suicidal tendencies. The latter often follows from a combination of the previous factors, since living with all this (especially if the disorder manifests itself in a serious form) is quite difficult.

Borderline personality disorder is little studied, and the International Classification of Diseases calls it "a borderline type of emotionally unstable personality disorder." The word “borderline” in this case means that the disorder itself is on the verge 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 has remained. The Russian language even has a slang name for people with this diagnosis - some call them "borderliners", from the English term "Borderline Personality Disorder".

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

How is it shown?

In fact, any mental disorder is a kind of prism through which a person perceives the world. In one way or another, it distorts 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 in search of his identity, and this search may be accompanied by a sense 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, in the process of searching, it seems to them that they have finally hit the bull's-eye, but more often than not, they end up disappointed, and euphoria is replaced by despondency, self-hatred and real depression itself.

Emotions that are inappropriate

If you often hear from different people (precisely from different people) that you perceive everything too sharply, it may be worth considering. If, due to some minor trifle, you can fall into melancholy for several days or even weeks, and nothing can “pull” you out of this melancholy, you should think again. If the transition from a good mood to a terrible one happens at the snap of a finger, guess what to do. If you constantly experience a feeling of anger 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 describe their feelings with this word. 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, ”one of the people with this diagnosis writes about his feelings.

Self harm

Cuts, burns, banging your head against a wall (literally) is one of the signs of this disorder (although it can also be a sign of many other things - for those who are especially suspicious, we specify). “It’s better to feel physical pain than to feel nothing,” many people with BPD agree. It can also be used as a way to replace emotional pain. Physical pain attracts all the resources of the body, 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, it becomes not so tangible and noticeable. That being said, voluntary self-harm (even minor) is in any case an extremely serious symptom, and in this case, we strongly, strongly advise you to talk to someone. Better - with a specialist.

Fear of being abandoned

People with borderline personality disorder have a very strong fear that a loved one will leave them. This thought leads to despair, and any trifle can serve as a trigger for inappropriate behavior, whether it is a delay at work for half an hour or a proposal to reschedule a meeting to 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 frightened the most happens: he leaves.

Unstable emotions in relationships

If you constantly rush from love to hate (and vice versa) in relation to all the significant people in your life, this can also be a sign of borderline personality disorder. Yesterday you extolled a man to the skies, today you tell with malicious rapture 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 you are just as quickly and irrevocably disappointed in a person. You are like a child who tells his mother “I hate you”, but at the same time requires hugs. Which, in principle, is more or less OK for a child, but for an adult - well, how can I tell you. For most, not so much.

Feeling the unreality of what is happening

In a severely stressful situation, people with borderline personality disorder often have the feeling that what is happening is unrealistic. They seem to be in a movie, and they see themselves and their actions from the outside, not 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, the one that potentially leads to self-destruction - psychological, physical, emotional, financial, and whatever else. If you have more than once or twice voluntarily got into situations related to unprotected sex with unfamiliar (or unfamiliar) people, reckless driving, drugs, large (very large) amounts of alcohol, losing large sums of money in gambling, etc. - Perhaps borderline personality disorder is most relevant to you.

Surely you have found at least one of these signs in yourself, but there is no need to panic. In theory, to put yourself at "increased risk" for 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 going to a psychotherapist is very much worth it. Because if it's not BPD, then it's clearly not a very fun life for you, and it's better to seek professional help. Well, if you are still BPD - do not despair either. There are many psychotherapeutic techniques - from cognitive behavioral therapy to medication - that can really help, and make life not just bearable, but really good. Checked.

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Why is Borderline Personality Disorder 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, most mental health practitioners who graduated before 2000 were not trained in the diagnosis and treatment of this complex disorder as part of their professional curricula.

In addition, 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 criteria groups

ev, of which any group is diagnostic for BPD. Within these constellations, there are high-functioning borderlines that perform well in society and whose disorders are not very obvious to new acquaintances or casual observers. Also within these constellations are the low-functioning borderline constellations, which are more obvious as they cannot stay in place and are prone to self-harm. Suicidal attempts or suicidal ideation and anorexia/bulimia are some of the most serious aspects of this disorder - yet many carriers of the disorder do not show it.

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

Below we have listed the resources available for defining BPD as well as several characterizations of this disorder by professional bodies.

The Borderline Diagnostic Interview (DIB-R) is the best-known "test" for diagnosing BPD. The DIB is a semi-structured clinical interview that takes 50-90 minutes. The test, designed to be administered by experienced clinicians, consists of 132 questions and observations using 329 summary statements. The test looks at areas of work related to borderline personality disorder. The four areas of operation include:
-influence (chronic / deep 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

desires, manipulativeness, dependence, devaluation, masochism / sadism, exactingness, rights).

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 DSM-IV Axis II language - criteria for personality disorder. There are 12 groups of questions corresponding to these 12 personality disorders. Traits, their absence, subthreshold value, reliability or unreliability of information are counted. A questionnaire is available from American Psychiatric Publishing ($60.00).

The Personality Disorder Beliefs Questionnaire is a short, self-administered test that looks for trends associated with a personality disorder. People with borderline disorder are more likely to respond positively to questions.

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). In addition, there are several free, unofficial but useful tests available.

Borderline Personality Disorder Symptoms According to the National Institutes of Health

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

violent attachment, their relationship to family, friends and loved ones can suddenly move from idealization (strong admiration and love) to depreciation (strong anger and dislike). Thus, they may form a quick attachment and idealize the other person, but when a little 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 towards members of their own family, reacting with anger and stress even with mild separations such as vacations, business trips, or sudden changes in plans. These fears of rejection seem to be related to the difficulty of experiencing feelings of attachment to significant people at a time when loved ones are physically absent and the person with borderline disorder feels abandoned and useless. Threats and suicide attempts can occur along with anger at perceived rejection and disappointment.

People with borderline personality disorder tend to exhibit other forms of impulsive behavior, such as excessive spending, overeating, and risky sexual behavior. Borderline personality disorder often co-occurs with other psychiatric problems, such as bipolar disorder, depression, anxiety disorders, drug addiction, and other personality disorders.

Borderline Personality Disorder Symptoms - Mayo Clinic

People with borderline personality disorder often have an unstable idea of ​​who they are. That is, their self-image and self-image changes frequently and rapidly. They generally 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 tend to be chaotic. People with borderline personality disorder often experience love-hate relationships with others. They can

idealize someone at one moment, and then abruptly and radically turn to rage and hatred against the background of resentment or even misunderstanding. This is due to the fact that people with borderline disorder find it difficult to perceive "gray" areas - things in their perception can 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 risk-taking behavior. This behavior often ends up causing harm - emotional, physical and financial. For example, they may drive recklessly, have unsafe sex, take illegal drugs, spend money, gamble. It is also not uncommon for people with borderline personality disorder to engage in suicidal behavior or self-injurious acts intentionally 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-image that is easily destroyed and fragmented under stress and results in an experience of lack of identity or a chronic sense 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-hatred, 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 occur, usually in response to negative interpersonal events associated with loss or disappointment.

Relationships are based on the fantasy of needing others for survival, overdependence, and fear of rejection and/or rejection. Addiction includes both insecure attachment, consisting of difficulty experiencing loneliness, and intense fear of loss, rejection, or rejection by significant others; and an urgent need to contact significant others in a state of stress or grief, accompanied by sometimes very submissive, submissive behavior. At the same time, the intense, intimate involvement of another person

This leads to the fear of losing one's identity. Thus, interpersonal relationships are highly unstable, with alternations of overdependence and avoidance of involvement. Empathy is severely impaired.

Basic emotional traits and interpersonal behavior may be associated with impaired cognitive regulation, that is, cognitive functions may be weakened 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-harmful acts (eg, cuts, burns), suicidal thoughts, suicide attempts, tend to occur in the context of intense distress and dysphoria, especially in the context of feelings of abandonment when important relationships are destroyed. Intense stress can also lead to other forms of risky behavior, in 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 occurrence of thoughts and behaviors associated with self-harm (for example, deliberate cuts or burns) 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; anxiety about past unpleasant events and future negative opportunities; feeling of fear and

uncertainty.

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

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

7. Antagonism/Resistance: Hostility
Irritability, impulsivity; malevolence, rudeness, coldness, vicious, 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 militancy or vindictiveness; domination 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 and foreseeing results, difficulty in planning, inability to learn from experience.

10 Schizotypy: predisposition to dissociation
A tendency to experience an 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); experience of what is happening around 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 outlined in the DSM. The DSM criteria note that people with borderline personality disorder have a pattern of unstable relationships, self-image and mood, and impulsive behavior. They usually begin in early adulthood. This guide is published by the American Psychiatric Association and is used by mental health professionals to diagnose mental conditions and by insurance companies to help reimburse treatment costs.

Borderline Personality Disorder is a deep pattern of unstable interpersonal relationships, self-esteem, and emotions, and is characterized by impulsivity that begins in early adulthood and is present in a variety of contexts. For diagnosis, it is necessary to highlight five or more signs from the following.

1. Desperate efforts to avoid real or imagined rejection. Note: (not including suicide or self-injurious acts - Criterion 5 addresses these).

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

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

4. Impulsiveness in at least two areas that are potentially harmful (eg, spending money, sex, drug addiction, reckless driving, overeating). Note: (not including suicide or self-injurious acts - Criterion 5 addresses these).

5 Repetitive suicidal behavior, gestures, threats, boot-damaging actions.

6. Emotional instability

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

7. Chronic feeling of emptiness.

8. Inappropriate, intense anger or difficulty managing anger (eg, frequent displays of character, persistent anger,

repeated physical collisions).

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

Schizotypal disorder refers to a group of schizophrenia-like illnesses, including schizophrenia proper, schizotypal and other delusional disorders. Schizotypal personality disorder is similar in its manifestations to schizophrenia. Its symptoms include behavioral abnormalities, emotional inadequacy, eccentricity. Often there are obsessions, avoidance of communication, paranoid disorders. Delusional and hallucinatory episodes are possible. However, there are no clear signs of schizophrenia.

The main difference between schizotypal disorder and schizophrenia is the predominance of positive symptoms. It is characterized by delusions, hallucinations, obsessions without the development of a personality defect. There are no such symptoms characteristic of schizophrenia 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 a personality deficit is necessary. The diagnosis of schizophrenia must also be excluded. Information about the diseases of the next of kin can help in establishing a diagnosis - the presence of schizophrenia in them serves as confirmation of schizotypal disorder.

It is important to avoid both overdiagnosis and underdiagnosis. The misdiagnosis of schizophrenia is especially dangerous. In this case, the patient will receive unreasonably intensive treatment, and when information is disseminated among acquaintances, 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 Questionnarie) 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 features of this disease according to ICD-10. A score of more than 41 is considered a sign of schizotypal disorder. More than half of the 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 psychotism by Eysenck, a scale for assessing general and social anhedonia, possible perceptual disturbances and a tendency to schizophrenia. However, only in SPQ all the signs of schizotypal disorder are brought together and presented in a form convenient for work.

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,
• decrease 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 to screen 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 in order to detect aggravation or relief of symptoms. Test questions can be used by patients for self-control - far from always patients perceive their condition as pathological and make appropriate complaints, but with the help of a test they can be easily identified.