Abstract
The validity of borderline personality disorder (BPD) has become an urgent issue in psychiatric nosology, with some proposing its absorption into complex posttraumatic stress disorder and others questioning its utility due to stigma. With planning for DSM-6 underway, reassessing the validity of BPD is both timely and necessary. This paper applies Robins and Guze’s classic diagnostic validators—symptom specificity, genetics, course of illness, biological markers, and treatment response—to the case of BPD. Evidence demonstrates that BPD has a distinctive clinical presentation, strong familial and genetic underpinnings, a characteristic longitudinal course of symptom improvement with continued functional impairment, measurable neurobiological correlates, and robust response to specialized psychotherapies. Taken together, these findings affirm BPD as a scientifically valid psychiatric disorder. Efforts to eliminate or subsume the diagnosis risk undermining decades of research and treatment progress. BPD should be retained as a distinct entity in future classification systems.
Keywords
Borderline personality disorder, BPD, Classification, Nosology, DSM