What is a common first DSM 5 criterion for borderline personality disorder?

Unstable relationships are a hallmark characteristic of borderline personality disorder (BPD) as specified in the DSM-5. Individuals with BPD often experience intense and unstable interpersonal relationships that can swing dramatically between extremes of idealization and devaluation. This instability stems from a fear of abandonment and difficulties in regulating emotions, which causes individuals to vacillate in their perceptions of others. They may see someone as a perfect friend one moment and then feel wronged by that same person soon after, leading to turbulent interactions and difficulties maintaining long-lasting relationships.

The other options, while relevant to various aspects of personality disorders or other conditions, do not serve as the primary criteria for BPD:

• Impulsive behavior is indeed one of the criteria but occurs after the core issues of unstable relationships and self-image.

• Grandiosity is more associated with narcissistic personality disorder rather than BPD.

• Attention-seeking behavior pertains to histrionic personality disorder and is not a defining feature of BPD.

Thus, the presence of unstable relationships not only signifies the complexity of the disorder but is a leading symptom that can guide diagnosis and treatment strategies.