Given its history, it is not surprising that the DSM borderline overlaps a variety of other personality disorders. The first diagnostic criterion, frantic efforts to avoid abandonment, resonates with the dependent and histrionic personalities. The dependent desperately needs an instrumental surrogate, without which feelings of panic quickly rise to the surface. Histrionics need an instrumental surrogate as well, but they also need to feel physically attractive, to be the center of attention, and to believe that they themselves are idealized by their companions. Abandonment is thus double jeopardy for histrionics, being both a separation and a commentary on the insufficiency of their attractive power. The avoidant could be included here because avoidants need a mate who is will- ing to face a world where they feel shamed, defective, and incapable.
As to the second diagnostic criterion, dependents, histrionics, narcissistics, and negativists are particularly prone to idealize romantic encounters, and narcissists are particularly likely to devalue those who are no longer admiring, who withhold “narcissistic supplies” for any reason. The dependent and histrionic are likely to have a poorly developed sense of self, and the histrionic, narcissistic, and negativistic personalities are beset with a highly unstable sense of self, the third borderline criterion. Narcissistic, histrionic, and negativistic personalities are particularly prone as well to emotional extremes, including anger. More pathological narcissistic and histrionic personalities are also likely to experience chronic feelings of emptiness. Finally, borderline, schizotypal, and paranoid personalities exhibit paranoid fears, and borderline and histrionic personalities are prone to dissociative episodes. The highest overlap may be with the DSM-III-R self-defeating personality (Gunderson, Zanarini, & Kisiel, 1995), perhaps because their interpersonal chaos and self-destructive behavior certainly have the quality of setting borderlines up for painful experiences and failure.
However, contrasts can also be created with many of these same constructs. The regressive thought disorder of the borderline often resembles the schizotypal personality, but the borderline is famous for its unstable mood and its association with depression; the schizotypal is not. Moreover, the borderline disorganizes in connection with interpersonal themes, whereas schizotypal thought may seem eccentric about almost anything. Transient psychotic episodes in the borderline are thus more reactive to the character of external events. Both borderlines and histrionics are emotionally labile and attention seeking. Both may sexualize their relationships, but the borderline more easily gives way to anger and more readily experiences feelings of emptiness and loneliness, which is typically repressed in the histrionic. Both borderline and paranoid personalities exhibit paranoid fears, but the paranoid makes a rigid impression and wants to be left alone. In contrast, the borderline seems labile and fluid and fears being left alone. Moreover, borderlines are often overtly self-destructive and sometimes self-accusing, whereas the paranoid accuses others. Both borderlines and antisocials can be impulsive in self-damaging ways. However, antisocials typically lack remorse for their actions and pursue impulsive gratification as an end in itself. In contrast, impulsivity in the borderline personality is more often used to assuage feelings of emptiness and worthlessness. Finally, both borderlines and dependents fear abandonment. However, dependents react to threats of separation by becoming more submissive and pleasing, whereas the borderline reacts with angry demands intended to coerce nurturance.
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