Summary Debate about borderline personality disorder (BPD) has intensified, with some proposing its absorption into complex post-traumatic stress disorder and others questioning whether the diagnosis is harmful. These debates often obscure the central issue of construct validity. This paper evaluates whether BPD constitutes a coherent clinical entity. Drawing on Robins and Guze’s classic diagnostic validators – symptom specificity, heritability, course of illness, biological markers and treatment response – the evidence demonstrates that BPD is a robustly validated psychiatric disorder that should be retained in future classification systems. Concerns about stigma and dimensional models are considered but do not undermine its empirical grounding.
Mark L. Ruffalo (Tue,) studied this question.