DSM and ICD Descriptions of BPD Identity Disturbance and Feelings of Emptiness
| . | DSM-III . | DSM-III-R9 . | DSM-IV, DSM-IV-TR, DSM-5 . | AMPD in DSM-5 Section III . | ICD-10 . |
|---|---|---|---|---|---|
| Identity criterion | ID manifested by uncertainty about several issues relating to identity, such as self-image, gender identity, longterm goals or career choice, friendship patterns, values, and loyalties, eg, “Who am I?”, “I feel like I am my sister when I am good.” | Marked and persistent ID manifested by uncertainty about at least 2 of the following: self-image, sexual orientation, long-term goals or career choice, type of friends desired, preferred values. | ID: markedly and persistently unstable self-image or sense of self. | Identity: Markedly impoverished, poorly developed, or unstable self-image, often associated with excessive self-criticism; chronic feelings of emptiness; dissociative states under stress. Self-direction: Instability in goals, aspirations, values, or career plans. | Disturbances in and uncertainty about self-image, aims, and internal preferences (including sexual). |
| Emptiness criterion | Chronic feelings of emptiness or boredom | [As in DSM-III] | Chronic feelings of emptiness | [See above] | Chronic feelings of emptiness |
| Descriptive Section | A profound ID may be manifested by uncertainty about several issues relating to identity, such as self-image, gender identity, or long-term goals or values. There may be problems tolerating being alone, and chronic feelings of emptiness or boredom. | A marked and persistent ID is almost invariably present. This is often pervasive, and is manifested by uncertainty about several life issues, such as self-image, sexual orientation, long-term goals or career choice, types of friends or lovers to have, or which values to adopt. The person often experiences this instability of self-image as chronic feelings of emptiness or boredom. | There may be an ID characterized by [… see criterion above]. There are sudden and dramatic shifts in self-image, characterized by shifting goals, values, and vocational aspirations. There may be sudden changes in opinions and plans about career, sexual identity, values, and types of friends. These individuals may suddenly change from the role of a needy supplicant for help to a righteous avenger of past mistreatment. Although they usually have a self-image that is based on being bad or evil, individuals with this disorder may at times have feelings that they do not exist at all. Such experiences usually occur in situations in which the individual feels a lack of a meaningful relationship, nurturing, and support. These individuals may show worse performance in unstructured work or school situations. […] Individuals with Borderline Personality Disorder may be troubled by chronic feelings of emptiness […]. Easily bored, they may constantly seek something to do. | The patient’s own self-image, aims, and internal preferences (including sexual) are often unclear or disturbed. There are usually chronic feelings of emptiness. | |
| Glossary of Technical Terms | Identity: The sense of self, providing a unity of personality over time. Prominent disturbances in identity or the sense of self are seen in Schizophrenia, Borderline Personality Disorder, and Identity Disorder Self: No definition | Identity: [As in DSM-III] Self: No definition | Identity: No definition in DSM-IV and DSM-IV-TR [DSM-5 see next column] Self: No definition | Identity: Experience of oneself as unique, with clear boundaries between self and others; stability of self- esteem and accuracy of self-appraisal; capacity for, and ability to regulate, a range of emotional experience. Self: No definition |
| . | DSM-III . | DSM-III-R9 . | DSM-IV, DSM-IV-TR, DSM-5 . | AMPD in DSM-5 Section III . | ICD-10 . |
|---|---|---|---|---|---|
| Identity criterion | ID manifested by uncertainty about several issues relating to identity, such as self-image, gender identity, longterm goals or career choice, friendship patterns, values, and loyalties, eg, “Who am I?”, “I feel like I am my sister when I am good.” | Marked and persistent ID manifested by uncertainty about at least 2 of the following: self-image, sexual orientation, long-term goals or career choice, type of friends desired, preferred values. | ID: markedly and persistently unstable self-image or sense of self. | Identity: Markedly impoverished, poorly developed, or unstable self-image, often associated with excessive self-criticism; chronic feelings of emptiness; dissociative states under stress. Self-direction: Instability in goals, aspirations, values, or career plans. | Disturbances in and uncertainty about self-image, aims, and internal preferences (including sexual). |
| Emptiness criterion | Chronic feelings of emptiness or boredom | [As in DSM-III] | Chronic feelings of emptiness | [See above] | Chronic feelings of emptiness |
| Descriptive Section | A profound ID may be manifested by uncertainty about several issues relating to identity, such as self-image, gender identity, or long-term goals or values. There may be problems tolerating being alone, and chronic feelings of emptiness or boredom. | A marked and persistent ID is almost invariably present. This is often pervasive, and is manifested by uncertainty about several life issues, such as self-image, sexual orientation, long-term goals or career choice, types of friends or lovers to have, or which values to adopt. The person often experiences this instability of self-image as chronic feelings of emptiness or boredom. | There may be an ID characterized by [… see criterion above]. There are sudden and dramatic shifts in self-image, characterized by shifting goals, values, and vocational aspirations. There may be sudden changes in opinions and plans about career, sexual identity, values, and types of friends. These individuals may suddenly change from the role of a needy supplicant for help to a righteous avenger of past mistreatment. Although they usually have a self-image that is based on being bad or evil, individuals with this disorder may at times have feelings that they do not exist at all. Such experiences usually occur in situations in which the individual feels a lack of a meaningful relationship, nurturing, and support. These individuals may show worse performance in unstructured work or school situations. […] Individuals with Borderline Personality Disorder may be troubled by chronic feelings of emptiness […]. Easily bored, they may constantly seek something to do. | The patient’s own self-image, aims, and internal preferences (including sexual) are often unclear or disturbed. There are usually chronic feelings of emptiness. | |
| Glossary of Technical Terms | Identity: The sense of self, providing a unity of personality over time. Prominent disturbances in identity or the sense of self are seen in Schizophrenia, Borderline Personality Disorder, and Identity Disorder Self: No definition | Identity: [As in DSM-III] Self: No definition | Identity: No definition in DSM-IV and DSM-IV-TR [DSM-5 see next column] Self: No definition | Identity: Experience of oneself as unique, with clear boundaries between self and others; stability of self- esteem and accuracy of self-appraisal; capacity for, and ability to regulate, a range of emotional experience. Self: No definition |
Note: ID, Identity disturbance.
DSM and ICD Descriptions of BPD Identity Disturbance and Feelings of Emptiness
| . | DSM-III . | DSM-III-R9 . | DSM-IV, DSM-IV-TR, DSM-5 . | AMPD in DSM-5 Section III . | ICD-10 . |
|---|---|---|---|---|---|
| Identity criterion | ID manifested by uncertainty about several issues relating to identity, such as self-image, gender identity, longterm goals or career choice, friendship patterns, values, and loyalties, eg, “Who am I?”, “I feel like I am my sister when I am good.” | Marked and persistent ID manifested by uncertainty about at least 2 of the following: self-image, sexual orientation, long-term goals or career choice, type of friends desired, preferred values. | ID: markedly and persistently unstable self-image or sense of self. | Identity: Markedly impoverished, poorly developed, or unstable self-image, often associated with excessive self-criticism; chronic feelings of emptiness; dissociative states under stress. Self-direction: Instability in goals, aspirations, values, or career plans. | Disturbances in and uncertainty about self-image, aims, and internal preferences (including sexual). |
| Emptiness criterion | Chronic feelings of emptiness or boredom | [As in DSM-III] | Chronic feelings of emptiness | [See above] | Chronic feelings of emptiness |
| Descriptive Section | A profound ID may be manifested by uncertainty about several issues relating to identity, such as self-image, gender identity, or long-term goals or values. There may be problems tolerating being alone, and chronic feelings of emptiness or boredom. | A marked and persistent ID is almost invariably present. This is often pervasive, and is manifested by uncertainty about several life issues, such as self-image, sexual orientation, long-term goals or career choice, types of friends or lovers to have, or which values to adopt. The person often experiences this instability of self-image as chronic feelings of emptiness or boredom. | There may be an ID characterized by [… see criterion above]. There are sudden and dramatic shifts in self-image, characterized by shifting goals, values, and vocational aspirations. There may be sudden changes in opinions and plans about career, sexual identity, values, and types of friends. These individuals may suddenly change from the role of a needy supplicant for help to a righteous avenger of past mistreatment. Although they usually have a self-image that is based on being bad or evil, individuals with this disorder may at times have feelings that they do not exist at all. Such experiences usually occur in situations in which the individual feels a lack of a meaningful relationship, nurturing, and support. These individuals may show worse performance in unstructured work or school situations. […] Individuals with Borderline Personality Disorder may be troubled by chronic feelings of emptiness […]. Easily bored, they may constantly seek something to do. | The patient’s own self-image, aims, and internal preferences (including sexual) are often unclear or disturbed. There are usually chronic feelings of emptiness. | |
| Glossary of Technical Terms | Identity: The sense of self, providing a unity of personality over time. Prominent disturbances in identity or the sense of self are seen in Schizophrenia, Borderline Personality Disorder, and Identity Disorder Self: No definition | Identity: [As in DSM-III] Self: No definition | Identity: No definition in DSM-IV and DSM-IV-TR [DSM-5 see next column] Self: No definition | Identity: Experience of oneself as unique, with clear boundaries between self and others; stability of self- esteem and accuracy of self-appraisal; capacity for, and ability to regulate, a range of emotional experience. Self: No definition |
| . | DSM-III . | DSM-III-R9 . | DSM-IV, DSM-IV-TR, DSM-5 . | AMPD in DSM-5 Section III . | ICD-10 . |
|---|---|---|---|---|---|
| Identity criterion | ID manifested by uncertainty about several issues relating to identity, such as self-image, gender identity, longterm goals or career choice, friendship patterns, values, and loyalties, eg, “Who am I?”, “I feel like I am my sister when I am good.” | Marked and persistent ID manifested by uncertainty about at least 2 of the following: self-image, sexual orientation, long-term goals or career choice, type of friends desired, preferred values. | ID: markedly and persistently unstable self-image or sense of self. | Identity: Markedly impoverished, poorly developed, or unstable self-image, often associated with excessive self-criticism; chronic feelings of emptiness; dissociative states under stress. Self-direction: Instability in goals, aspirations, values, or career plans. | Disturbances in and uncertainty about self-image, aims, and internal preferences (including sexual). |
| Emptiness criterion | Chronic feelings of emptiness or boredom | [As in DSM-III] | Chronic feelings of emptiness | [See above] | Chronic feelings of emptiness |
| Descriptive Section | A profound ID may be manifested by uncertainty about several issues relating to identity, such as self-image, gender identity, or long-term goals or values. There may be problems tolerating being alone, and chronic feelings of emptiness or boredom. | A marked and persistent ID is almost invariably present. This is often pervasive, and is manifested by uncertainty about several life issues, such as self-image, sexual orientation, long-term goals or career choice, types of friends or lovers to have, or which values to adopt. The person often experiences this instability of self-image as chronic feelings of emptiness or boredom. | There may be an ID characterized by [… see criterion above]. There are sudden and dramatic shifts in self-image, characterized by shifting goals, values, and vocational aspirations. There may be sudden changes in opinions and plans about career, sexual identity, values, and types of friends. These individuals may suddenly change from the role of a needy supplicant for help to a righteous avenger of past mistreatment. Although they usually have a self-image that is based on being bad or evil, individuals with this disorder may at times have feelings that they do not exist at all. Such experiences usually occur in situations in which the individual feels a lack of a meaningful relationship, nurturing, and support. These individuals may show worse performance in unstructured work or school situations. […] Individuals with Borderline Personality Disorder may be troubled by chronic feelings of emptiness […]. Easily bored, they may constantly seek something to do. | The patient’s own self-image, aims, and internal preferences (including sexual) are often unclear or disturbed. There are usually chronic feelings of emptiness. | |
| Glossary of Technical Terms | Identity: The sense of self, providing a unity of personality over time. Prominent disturbances in identity or the sense of self are seen in Schizophrenia, Borderline Personality Disorder, and Identity Disorder Self: No definition | Identity: [As in DSM-III] Self: No definition | Identity: No definition in DSM-IV and DSM-IV-TR [DSM-5 see next column] Self: No definition | Identity: Experience of oneself as unique, with clear boundaries between self and others; stability of self- esteem and accuracy of self-appraisal; capacity for, and ability to regulate, a range of emotional experience. Self: No definition |
Note: ID, Identity disturbance.
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