A 32-year-old woman has a pattern of intense unstable relationships (idealising then devaluing), chronic emptiness, impulsive spending and binge eating, recurrent self-cutting, rapid mood shifts lasting hours, and an intense fear of abandonment. Her symptoms span multiple areas of life since adolescence. Which cluster does her personality disorder belong to in DSM-5?

• A Cluster B (dramatic/emotional/erratic) ✓
• B Cluster A (odd/eccentric)
• C Cluster C (anxious/fearful)
• D This is a mood disorder, not a personality disorder

Explanation

Borderline Personality Disorder (BPD) belongs to DSM-5 Cluster B personality disorders, which are characterised by dramatic, emotional, and erratic behaviour. Cluster B includes: Borderline, Narcissistic, Histrionic, and Antisocial personality disorders. BPD's defining features include: identity disturbance, affective instability, impulsivity, self-harm, abandonment fears, and unstable intense relationships. Cluster A (Paranoid, Schizoid, Schizotypal) — odd/eccentric; Cluster C (Avoidant, Dependent, OCPD) — anxious/fearful. Onset in adolescence/early adulthood and persistence across life contexts distinguish it from episodic mood disorders.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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Written and medically reviewed by the StethoPrep medical team.