Emotional instability personality disorder: symptoms, types and treatments.

This disorder associated with mood states appears in the ICD-10 manual.

Personality disorders appear when the way of being, thinking and feeling of the person is far from normal, altering their daily functioning, causing discomfort and preventing them from adapting to everyday life situations (social, professional, personal,...).

Today we will know a very specific disorder, the disorder of emotional instability of the personalitycharacterized by a marked impulsivity together with an unstable and capricious mood.

The disorder in ICD-10 and DSM-5

The disorder of emotional instability of the personality is a disorder included in the ICD-10, but not in the DSM-5. (Diagnostic and Statistical Manual of Mental Disorders). The ICD-10 classification of personality disorders, in comparison with the DSM-5, is more complex and structured.

ICD-10 (International Classification of Diseases) groups personality disorders into different categories:

• Specific personality disorders (where Emotional Instability Disorder is found).
• Mixed and other personality disorders.
• Persistent personality transformations.

Defines the Emotional Instability Disorder of the personality as the existence of a marked predisposition to act in an impulsive way, regardless of the consequences regardless of the consequences, together with an unstable and capricious mood.

In this pattern of behavior, planning capacity is minimal and intense outbursts are frequent. the occurrence of intense outbursts of anger is frequent.These are easily provoked when receiving criticism or when the subject is frustrated in his impulsive acts.

Two variants of this personality disorder are differentiated, which share the general aspects of impulsivity and lack of self-control. They are the following.

Emotional instability personality disorder of impulsive type

It is characterized by emotional instability and lack of impulse control.. In addition, there are frequent outbursts of violence or threatening behavior, especially in the face of criticism from third parties.

It includes for its diagnosis the explosive and aggressive personality and the explosive and aggressive personality disorder, and excludes for its diagnosis the dissocial personality disorder.

Emotional instability disorder of borderline personality type

It shows characteristics of emotional instability, as well as distortions of body image, self-objectives and intimate image. distortions of the corporal image, of the own aims and of the intimate image (that appear (which are presented in a confused or altered form).

There is also a feeling of emptiness and the facility to be involved in intense and unstable interpersonal relationships, which can generate repeated emotional crises and be accompanied by a succession of suicidal threats or self-harming acts. Self-destructive acts can also occur without clear precipitating factors. A tendency to self-injury thus appears..

Borderline personality and borderline personality disorder are included for diagnosis.

In the DSM-5, the ICD-10 Borderline Personality Emotional Instability Disorder of Borderline Personality corresponds to Borderline Personality Disorder (BPD).

Impulsivity and Impulse Control Treatment

Let's see how these two personality disorders can be treated in the clinical setting.

Focusing on the first subtype, impulsive emotional instability personality disorder, we can differentiate two areas to be treated: impulsivity and impulse control.

For impulsivity we have proposed training techniques in self-instructions and problem-solving (although the former are more focused (although the former are more focused on children and adolescents, they can also be used in adults).

Self-instruction training is a technique by which the subject gives himself a set of orders or instructions for the autonomous regulation of his own behavior.

The objective is to provide the child or adolescent a way to act quickly and efficiently in order to achieve success in a task or in a behavior, preventing him/her from acting in aavoiding impulsive actions.

The problem-solving technique, on the other hand, aims to solve problems through well-defined steps. solving problems through well-defined steps and by dividing the problem into small parts. and with the division of the problem in small parts.

For impulse control, at the psychological and behavioral level, the following techniques can be used exposure techniques with response prevention (e.g. for pathological gambling (e.g. for pathological gambling associated with such a personality disorder), together with cognitive therapy.

At the pharmacological level, the following can be used for impulse control: neuroleptics, antidepressants, Lithium and antiepileptics, among others.

Treatment of borderline personality disorder

The therapy that to date has proven most effective for borderline personality disorder is dialectical behavioral therapy, developed by psychiatrist Marsha Linehan in the late 1990s.

The therapy approaches BPD as a disorder of emotional dysregulation. It follows an integrative approach, and is based on behavioral and cognitive principles, together with elements of Mindfulness. together with elements of Mindfulness.

It is suitable for cases of BPD where suicide attempts have been manifested; it also treats the symptoms of depression, anxiety, anger, impulsivity and impulse control, characteristic of the disorder. It consists of 3 fundamental strategies: change, acceptance and dialectical understanding. The 4 treatment modalities are: individual therapy, telephone contact, therapist consultation and group skills training.