From the Research
Borderline personality disorder (BPD) is not typically diagnosed in children under 18, but early signs may appear during childhood and adolescence, and the most recent and highest quality study suggests that warning signs include intense emotional reactions, difficulty regulating emotions, and impulsive behaviors 1.
Early Signs of BPD in Children
The early signs of BPD in children can be identified through various behaviors, including:
- Intense emotional reactions
- Difficulty regulating emotions
- Fear of abandonment
- Unstable self-image
- Impulsive behaviors
- Self-harm
- Suicidal thoughts
- Black-and-white thinking
- Intense anger outbursts
- Unstable relationships Children may show these traits through extreme reactions to perceived rejection, difficulty calming down after being upset, risky behaviors, dramatic mood swings, and identity confusion.
Importance of Early Intervention
It's essential to note that these behaviors must be persistent, cause significant distress, and differ from typical developmental behaviors. Many of these symptoms overlap with other childhood conditions like ADHD, anxiety, depression, and trauma responses, making diagnosis complex. Early intervention through dialectical behavior therapy (DBT) or mentalization-based therapy adapted for younger individuals can be beneficial, as suggested by a recent study 2.
Treatment and Assessment
No specific medications treat BPD directly, though some may help manage specific symptoms like mood instability or impulsivity. If these signs are observed, consultation with a child psychiatrist or psychologist experienced in personality development is essential for proper assessment and treatment planning, as emphasized by a recent review 1. A comprehensive assessment and treatment plan can help alleviate symptoms and improve the child's quality of life.
Key Considerations
The development of BPD is related to both genetic factors and adverse childhood experiences, such as sexual and physical abuse, as highlighted by a study on the etiology of BPD 3. Emerging evidence has begun to highlight the complex, heterotypic pathways to the development of BPD, with key heritable vulnerability factors possibly interacting with aspects of the rearing environment to produce worsening emotion dysregulation and an adolescent trajectory consisting of self-damaging behaviors and eventual BPD, as discussed in a study on emotion dysregulation in BPD 4.