Clinical and Psychopathological Features of Borderline Personality Disorder in Adolescence
https://doi.org/10.30629/2618-6667-2022-20-2-32-41
Abstract
Background: Borderline personality disorder (BPD) in adolescence has a high prevalence and a signicant polymorphism of the psychopathological structure which creates considerable difculties to conduct differential diagnostics and assessing comorbidity with other disorders. To date, special research has not been carried out to explore BPD in adolescents that highlights the relevance of the present study. Objectives: identication of the borderline personality disorder (BPD) clinical features, leading psychopathological syndromes and differential diagnostics criteria in adolescence. Patients and methods: 71 young patients (16–25 years old) with borderline personality disorder were examined by clinical psychopathological and psychometrical methods (PBQ-BPD, TAS, BIS-11). This study includes 28 women (39%) and 43 men (61%) who were examined as inpatient or outpatient in the Mental Health Research Centre in 2019–2021. Results: key symptoms complexes were identied and presented by affective instability, dissociative state with identity disturbance and addictive behavior. Based on the analysis of the clinical picture and the discovered patterns, three types of BPD in adolescents were identied: with an “affective storm” (type I); with a dominance of impulsive and addictive features such as “adrenaline addiction” (type II); with a dominance of “cognitive dissociation” and self-identity disorder (type III). Distinctive features of the clinical pictures of affective and behavioral disorders for each type of BPD in adolescence were found and psychopathological signs and their impact on further dynamics were determined, taking into account an auto-aggressive behavior and a high level of suicidality. Conclusions: the found psychopathological patterns of BPD formation in adolescence help to assess the disorders of personality and social functioning and to predict the risk of auto- aggression and suicidal activity for the diagnostic and prognostic assessment of borderline personality disorder in adolescence.
About the Author
A. A. Kuleshov
FSBSI “Mental Health Research Centre”
Russian Federation
Russian Federation
Alexey A. Kuleshov, MD, Postgraduate Student (Med.)
Moscow
References
1. Sharp C, Fonagy P. Practitioner Review: Borderline personality disorder in adolescence — Recent conceptualization, intervention, and implications for clinical practice. J Child Psychol Psychiatry. 2015;56(12):1266–1288. doi: 10.1111/jcpp.12449
2. Ha C, Balderas JC, Zanarini MC, Oldham J, Sharp C. Psychiatric comorbidity in hospitalized adolescents 40 with borderline personality disorder. J Clin Psychiatry. 2014;75(5):457–464. doi: 10.4088/JCP.13m08696
3. Kaess M, Brunner R, Chanen A. Borderline personality disorder in adolescence. Pediatrics. 2014;134(4):782– 793. doi: 10.1542/peds.2013-3677
4. Guilé JM, Boissel L, Alaux-Cantin S, Garny de La Rivière S. Borderline personality disorder in adolescents: prevalence, diagnosis, and treatment strategies. Adolesc Health Med Ther. 2018;9:199–210. doi: 10.2147/ ahmt.s156565
5. Hawton K, Bergen H, Geulayov G, Waters K, Ness J, Cooper J, Kapur N. Impact of the recent recession on self-harm: Longitudinal ecological and patient-level investigation from the Multicentre Study of Selfharm in England. J Affect Disord. 2016;191:132–138. doi: 10.1016/j.jad.2015.11.001
6. Plener PL, Kaess M, Schmahl C, Pollak S, Fegert JM, Brown RC. Nonsuicidal Self-Injury in Adolescents. Dtsch Arztebl Int. 2018;115(3):23–30. doi: 10.3238/ arztebl.2018.0023 PMID: 29366448; PMCID: PMC5787659.
7. Paris J. A History of Research on Borderline Personality Disorder in Childhood and Adolescence. In: Handbook of Borderline Personality Disorder in Children and Adolescents / Sharp C, Tackett JL, eds. Springer: New York. 2014:9–16. doi: 10.1007/978-1-4939-05911_2
8. Geselowitz B, Whalen DJ, Tillman R, Barch DM, Luby JL, Vogel A. Preschool Age Predictors of Adolescent Borderline Personality Symptoms. J Am Acad Child Adolesc Psychiatry. 2021;60(5):612–622. doi: 10.1016/j.jaac.2020.07.908
9. Akça ÖF, Wall K, Sharp C. Borderline personality disorder and attention decit/hyperactivity disorder in adolescence: Overlap and differences in a clinical setting. Borderline Personal Disord Emot Dysregul. 2020;7(1):1–9. doi: 10.1186/s40479-020-00122-w
10. Saxena K, Verrico CD, Kahlon R, Amin P, Arvind RP, Patel M, Sharp C, Williams L, Shah A. Borderline features in Youth with Bipolar Spectrum Disorders. Adolesc Psychiatry. 2018;8(3):174–184. doi: 10.2174/221067 6609666181203103443
11. Perugi G, Fornaro M, Akiskal HS. Are atypical depression, borderline personality disorder and bipolar II disorder overlapping manifestations of a common cyclothymic diathesis? World Psychiatry. 2011;10(1):45–51. doi: 10.1002/j.2051-5545.2011. tb00013.x
12. Zimmerman M, Morgan TA. Problematic boundaries in the diagnosis of bipolar disorder: The interface with borderline personality disorder. Curr. Psychiatry Rep. 2013;15(12):14–16. doi: 10.1007/s11920013-0422-z
13. Reich DB, Zanarini MC, Fitzmaurice G. Affective lability in bipolar disorder and borderline personality disorder. Compr Psychiatry. 2012;53(3):230–237. doi: 10.1016/j.comppsych.2011.04.003
14. Zandersen M, Henriksen MG, Parnas J. A recurrent question: What is borderline? J Pers Disord. 2019;33(3):341–369. doi: 10.1521/pedi_2018_32_348
15. Butler AC, Brown GK, Beck AT, Grisham JR. Assessment of dysfunctional beliefs in borderline personality disorder. Behav Res Ther. 2002;40:1231–1240. doi: 10.1016/S0005-7967(02)00031-1
16. Taylor GJ, Bagby M, Parker JDA. The Revised Toronto Alexithymia Scale: Some Reliability, Validity, and Normative Data. Psychother Psychosom. 1992;57(1– 2):34–41. doi: 10.1159/000288571
17. Enikolopov SN, Medvedeva TI. Approbation of the Russian-language version of the Barratt Impulsiveness Scale (BIS-11). E-journal «Psychology and law». 2015;5(3):75–89. (In Russ.). doi: 10.17759/psylaw.2015050307
18. Krylova ES, Bebur ishv i l i A A , Kaleda VG. Non-suicidal self-injury and its relation to suicidal behav ior in youth patient s with personality disorders. Suicidology (Russia). 2019;01(34):48–57. (In Russ.). doi: 10.32878/suiciderus.19-10-01(34)-48-57
19. Kernberg OF. The Management of Affect Storms in the Psychoanalytic Psychotherapy of Borderline Patients. J Am Psychoanal Assoc. 2003;51(2):517–545. doi: 10.1177/00030651030510021101
20. Korolenko TP, Ovchinnikov AA, Sultanova AN, Neustroeva AY. Social-psychological characteristics of different types addictive behavior. S.S. Korsakov Journal of Neurology and Psychiatry/Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2019;119(1):69. (In Russ.). doi: 10.17116/jnevro201911901169
21. Loas G, Guilbaud O, Perez-Diaz F, Verrier A, Stephan P, Lang F, Bizouard P, Venisse JL, Corcos M, Flament M, Jeammet P. Dependency and suicidality in addictive disorders. Psychiatry Res. 2005;137(1–2):103–111. doi: 10.1016/j.psychres.2004.06.022
22. Smulevich AB. Rasstroistva lichnosti. Traektoriya v prostranstve psikhicheskoi i somaticheskoi patologii. M. 2012:336 p. (In Russ.).
23. Sheldon WH. Body and temperament types. New York: Random House. 1940:104 p.
24. Napolitano LA, McKay D. Dichotomous thinking in borderline personality disorder. Cognit Ther Res. 2007;31(6):717–726. doi: 10.1007/s10608-007-9123-4
25. Il’ina NA, Volel’ BA. Klinicheskie aspekty pomeshatel’stva somnenii. S.S. Korsakov Journal of Neurology and Psychiatry/Zhurnal nevrologii i psihiatrii imeni S.S. Korsakova. 2002;1:30–36. (In Russ.).
26. Kaleda VG, Omelchenko MA. The Clinical Course and Prognostic Problems of Youth Depressions with Attenuated Schizophrenic Symptoms. Obozrenie psihiatrii i medicinskoj psihologii imeni V.M. Bekhtereva 2021;(1):42–52. (In Russ.). doi: 10.31363/2313-7053-2021-1-42-52
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For citations:
Kuleshov A.A. Clinical and Psychopathological Features of Borderline Personality Disorder in Adolescence. Psychiatry (Moscow) (Psikhiatriya). 2022;20(2):32-41. (In Russ.) https://doi.org/10.30629/2618-6667-2022-20-2-32-41
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