A common pattern of marked impulsivity and inconsistency in interpersonal relationships, self-image, and affect, beginning in early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

-Frantically trying to avoid a real or imaginary breakup (abandonment)

A pattern of inconsistent and tense interpersonal relationships that fluctuate between extremes of exaggeration and desecration.

-Identity confusion: A marked and persistent, inconsistent sense of self or sense of self. Impulsivity in at least two self-harming areas (eg, spending, sex, substance abuse, unsafe driving, binge eating).

-Repetitive suicidal behaviors, attempts or intimidation or self-mutilation.

-Inconsistency in affect due to marked reactivity of mood (eg, intense periodic dysphoria, irritability, or anxiety that usually lasts for a few hours, but rarely for more than a few days). A constant sense of emptiness. Inappropriate, intense anger or difficulty controlling anger (eg, frequently showing anger, being constantly angry, frequently getting into fights).

Temporary suspicious thoughts or severe dissociative symptoms related to the strain.