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  • A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
    • frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
    • a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
    • identity disturbance: markedly and persistently unstable self-image or sense of self
    • impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.
    • recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
    • affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
    • chronic feelings of emptiness
    • inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
    • transient, stress-related paranoid ideation or severe dissociative symptoms

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