Clinical and psychosocial outcomes of borderline personality disorder in childhood and adolescence: a systematic review

2015 ◽  
Vol 45 (11) ◽  
pp. 2237-2251 ◽  
Author(s):  
C. Winsper ◽  
S. Marwaha ◽  
S. T. Lereya ◽  
A. Thompson ◽  
J. Eyden ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Rank Order ◽  
Empirical Studies ◽  
Psychosocial Outcomes ◽  
Later Life ◽  
Borderline Personality ◽  
Considerable Proportion ◽  
Childhood And Adolescence ◽  
Educational Work

BackgroundWhile there is a growing body of research on borderline personality disorder (BPD) in children and adolescents, controversy remains regarding the validity and diagnosis of the disorder prior to adulthood.MethodMEDLINE, EMBASE, Psych INFO and PubMed databases were systematically searched for articles pertaining to the clinical and psychosocial outcomes (i.e. predictive validity) of BPD first diagnosed in childhood or adolescence (i.e. prior to 19 years of age). All primary empirical studies were included in the review. A narrative synthesis of the data was completed.ResultsA total of 8200 abstracts were screened. Out of 214 full-text articles, 18 satisfied the predetermined inclusion criteria. Quality assessment indicated that most studies had high risk of bias in at least one study domain. Consistent with the adult literature, the diagnostic stability of BPD prior to the age of 19 years was low to moderate, and mean-level and rank-order stability, moderate to high. Individuals with BPD symptoms in childhood or adolescence had significant social, educational, work and financial impairment in later life.ConclusionsStudies indicate that borderline pathology prior to the age of 19 years is predictive of long-term deficits in functioning, and that a considerable proportion of individuals continue to manifest borderline symptoms up to 20 years later. These findings provide some support for the clinical utility of the BPD phenotype in younger populations, and suggest that an early intervention approach may be warranted. Further prospective studies are needed to delineate risk (and protective) factors pertinent to the chronicity of BPD across the lifespan.

An object relations perspective on borderline personality

2002 ◽  
Vol 14 (2) ◽  
pp. 76-80 ◽  
Author(s):  
F. E. Yeomans ◽  
K. N. Levy
Keyword(s):  
Clinical Practice ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Cognitive Science ◽  
Object Relations ◽  
Empirical Research ◽  
Developmental Psychology ◽  
Empirical Studies ◽  
Borderline Personality ◽  
Object Relations Theory

One of the principal formulations of borderline personality disorder is based on object relations theory, a component of psychoanalytic theory. To remain relevant, psychoanalytic formulations must find support from empirical research. After summarizing the object relations understanding of borderline personality, the authors review studies in biological neuroscience, developmental psychology and cognitive science related to the fundamental concepts of object relations theory as it aplies to borderline pathology. This review suggests that these empirical studies support psychoanalytic formulations originally derived from clinical practice and observation.

Le rôle de la famille dans le développement du trouble de la personnalité limite

1993 ◽  
Vol 38 (9) ◽  
pp. 611-616 ◽  
Author(s):  
Pierre Gagnon
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Recognition Memory ◽  
Social Influences ◽  
Empirical Studies ◽  
Borderline Personality ◽  
Regulatory Effect ◽  
Parental Overprotection ◽  
Theoretical Concepts

The role of family in the development of borderline personality disorder is examined with an emphasis on dimensions of family functioning. A synthesis of theoretical concepts implicating such factors, derived mostly from psychoanalysis, is proposed with an emphasis on separation-individuation, early frustrations, regression to recognition memory, oscillations in attachment and social influences. Empirical studies are reviewed. Affective neglect and parental overprotection are often cited, although dysfunctional behaviour control may have a regulatory effect on these factors and a crucial impact on psychic reality of the patient recalling his childhood.

scholarly journals Validity, utility and acceptability of borderline personality disorder diagnosis in childhood and adolescence: survey of psychiatrists

2011 ◽  
Vol 35 (1) ◽  
pp. 19-22 ◽  
Author(s):  
Mark Griffiths
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Questionnaire Survey ◽  
Clinical Utility ◽  
Child And Adolescent ◽  
Borderline Personality ◽  
Clinical Implications ◽  
Childhood And Adolescence ◽  
Empirical Validity

Aims and methodTo establish the views of child and adolescent psychiatrists (n = 52) regarding the conceptual and empirical validity, clinical utility and acceptability of the diagnosis of borderline personality disorder in child and adolescent populations. A questionnaire survey was carried out.ResultsThe child and adolescent psychiatrists' perception of the validity of borderline personality disorder for adult populations was relatively high (82% felt it to be valid). Significantly fewer of those considered borderline personality disorder to be valid for adolescent populations (37%). Strikingly different results were obtained when the questions related to child (<12 years) populations (2%).Clinical implicationsGiven the views expressed by these consultant child and adolescent psychiatrists, it would seem appropriate to approach with caution suggestions that the borderline personality disorder category should have extended use with adolescent and child populations.

Age and clinical presentation of patients at onset of borderline personality disorder in a mental health unit

2011 ◽  
Vol 26 (S2) ◽  
pp. 1017-1017
Author(s):  
J.M. Garcia Tellez ◽  
L. Gonzalez Saavedra ◽  
J.M. Sanchez-Moyano Lea
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Medical Records ◽  
Early Adulthood ◽  
Depressive Mood ◽  
Borderline Personality ◽  
Clinical State ◽  
Childhood And Adolescence ◽  
Main Complaint ◽  
Over Time

OjectiveBorderline Personality disorder is a well recognised syndrome. These patients show a clear emotional unstability, lack of control impulse, unpredictible auto and heteroaggresive behaviour, poor interpersonal realitionships and self image as well as brief psychotic episodes.The unspecific symtomatology and diagnostic difficulty derived from different nosographic frames makes their diagnosis and treatment a challenge. Through the analysis of their medical records we aim to know the age they sought specialized help, the symptomatology at first consultation, the treatment given and the outcome after years of therapy.MethodologySystematic review of all BPD patient's medical records treated in our Unit with a particular reference to age and symptoms at the start of treatment and at present. Medical records from the Childhood and Adolescence Psychiatric Unit were also reviewed to determine the most prominent symptoms at that time.ResultsWe found that the vast majority of cases contacted the psychiatric services in their adolescence and early adulthood, probably in relation to demands of daily life at that age. The most relevant symptoms at onset of illness were depressive mood and anxiety. As time went on depressive symptoms were the main complaint. The clinical state remained fairly stable over time.ConclusionsThere is a clear early onset of symptoms, in particular, affective ones (depression and anxiety) being prominent in childhood and preadolescence. Also there is a stable psychopathology over time which keep the patients on long term follow ups. This medical demand seemed to diminish at their fifth decade.

scholarly journals A systematic review of the neurobiological underpinnings of borderline personality disorder (BPD) in childhood and adolescence

2016 ◽  
Vol 27 (8) ◽  
pp. 827-847 ◽  
Author(s):  
Catherine Winsper ◽  
Steven Marwaha ◽  
Suzet Tanya Lereya ◽  
Andrew Thompson ◽  
Julie Eyden ◽  
...  
Keyword(s):  
Systematic Review ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Repeated Measures ◽  
Twin Studies ◽  
Borderline Personality ◽  
Childhood And Adolescence ◽  
Gene Environment ◽  
Increase Risk ◽  
Chronic Morbidity

AbstractContemporary theories for the aetiology of borderline personality disorder (BPD) take a lifespan approach asserting that inborn biological predisposition is potentiated across development by environmental risk factors. In this review, we present and critically evaluate evidence on the neurobiology of BPD in childhood and adolescence, compare this evidence to the adult literature, and contextualise within a neurodevelopmental framework. A systematic review was conducted to identify studies examining the neurobiological (i.e. genetic, structural neuroimaging, neurophysiological, and neuropsychological) correlates of BPD symptoms in children and adolescents aged 19 years or under. We identified, quality assessed, and narratively summarised 34 studies published between 1980 and June 2016. Similar to findings in adult populations, twin studies indicated moderate to high levels of heritability of BPD, and there was some evidence for gene-environment interactions. Also consistent with adult reports is that some adolescents with BPD demonstrated structural (grey and white matter) alterations in frontolimbic regions and neuropsychological abnormalities (i.e. reduced executive function and disturbances in social cognition). These findings suggest that neurobiological abnormalities observed in adult BPD may not solely be the consequence of chronic morbidity or prolonged medication use. They also provide tentative support for neurodevelopmental theories of BPD by demonstrating that neurobiological markers may be observed from childhood onwards and interact with environmental factors to increase risk of BPD in young populations. Prospective studies with a range of repeated measures are now required to elucidate the temporal unfurling of neurobiological features and further delineate the complex pathways to BPD.

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