Modern Diagnostics of Borderline Personality Disorder: the Relationship between Categorical and Dimensional Approaches

Background: the transition from a categorical diagnostics to a dimensional model based on the characteristics of personality trait domains and assessment of clinical symptoms severity has created difficulties in differentiating borderline personality disorder. The aim of the study is to analyze published works on the categorial approach and features of the dimensional characteristics of trait domains associated with borderline personality disorder. Materials and Methods: the keywords «borderline personality disorder», «categorial and dimensional models», «diagnosis of personality disorders» used to search for articles in Russian and English in the PubMed and e-Library databases for the period from 2000 to 2024. Conclusion: the analysis of published works shows that the diagnosis of borderline personality disorder requires taking into account clinical heterogeneity, dynamic variability of symptoms, and comorbidity with other mental disorders. Using only a categorical approach in diagnostics does not fully cover the complexity and variability of clinical features of borderline personality disorder. The used five-factor model of assessing the domains of personality traits has limitations in the diagnosis of borderline personality disorder due to use of self-report questionnaires, non-specificity of dimensional factors, as well as the presence of additional dimensional characteristics that go beyond the five-factor model, but have high sensitivity to the manifestations of the borderline pattern. The need for research on the correspondence of categorial, prototypical characteristics of borderline personality disorder, dimensional not limited by the framework of the five-factor model is substantiated.

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