Emotional lability personality disorder: what is it?

Personality disorders appear when the person's way of being, thinking and feeling deviate from normality, altering their daily functioning, causing him discomfort and preventing him from adapting to daily life situations (socially, professionally, staff,...).

Today we will know a very specific disorder, emotional instability personality disorder, characterized by a marked impulsiveness together with an unstable and capricious mood.

• Related article: "The 8 types of emotions (classification and description)"

The disorder in ICD-10 and DSM-5

Emotional lability personality disorder It 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 for personality disorders, compared to that of the DSM-5, is more complex and structured.

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

• Specific personality disorders (where the Emotional lability disorder is found).
• Mixed disorders and other personality disorders.
• Persistent personality transformations.

Define Emotional Instability Personality Disorder as the existence of a marked predisposition to act in an impulsive way without taking into account the consequences, together with an unstable and capricious mood.

In this pattern of behavior, planning capacity is minimal and the appearance of intense outbursts of anger is frequent, which lead to violent attitudes or explosive demonstrations; These are easily provoked by receiving criticism or by being frustrated by the subject in his impulsive acts.

There are two variants of this personality disorder, which share the general aspects of impulsiveness and lack of self-control. They are the following.

Emotional lability disorder of the impulsive type personality

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

It includes for its diagnosis Explosive and Aggressive Personality and Explosive and Aggressive Personality Disorder, and excludes Conduct Disorder for its diagnosis.

Borderline emotionally unstable personality disorder

Characteristics of emotional instability appear in it, and in addition distortions of body image, of one's own objectives and of the intimate image (which are presented in a confused or altered way).

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

Includes for diagnosis borderline personality and borderline personality disorder.

In the DSM-5, the ICD-10 Borderline Emotional Instability Disorder corresponds to the ICD-10 Borderline personality disorder (TLP).

Treatment of impulsivity and impulse control

We are going to see how these two personality disorders can be treated in the clinical setting.

Focusing on the first subtype, the emotional lability disorder of the impulsive type personality, we can differentiate two areas to treat: impulsivity and impulse control.

For impulsivity, they have raised training techniques in self-instruction and problem solving (Although the first ones are more focused on children and adolescents, they can also be used in adults).

Self-instruction training is a technique through 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 quick and effective way of acting to achieve success in a task or behavior, preventing him from acting impulsively.

The problem solving technique, for its part, has the objective of solve problems through well-defined steps and with the division of the problem in small parts.

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

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

Treatment of borderline personality disorder

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

The therapy frames BPD as an emotional dysregulation disorder. It follows an integrative approach, and is based on behavioral and cognitive principles. 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, impulsiveness, and impulse control, typical 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.