Can a child have borderline personality disorder?

A coworker and I were discussing a client’s presenting symptoms; black and white thinking, rapid mood changes, fear of abandonment, difficulties forming relationships, and projection of negative feelings onto others. We clearly thought Borderline Personality Disorder, but it’s such as difficult diagnosis to give to a child. And it’s a difficult condition to treat. The reality is that children are diagnosed with BPD. But as professionals we need to approach this diagnosis with caution, and explore all options before diagnosing a child. The best we can do is continue to educate ourselves in efforts of creating UNDERSTANDING of others needs and AWARENESS.

I included this video because it provides facts, examples, symptoms, and helpful suggestions for professionals and family members.

CAN A CHILD HAVE A BORDERLINE PERSONALITY DISORDER?

The quick answer is yes, but under no circumstances should that be the complete answer.

First of all, it is important to note that “borderline personality disorder” is a term used to define a collection of specific personality traits present in an individual that results in impaired functioning. It is possible for anyone to have certain personality traits that that are symptomatic of BPD, but do not meet the diagnostic criteria for BPD. It is also true that these traits can be common in children and teens, while not being pathological (related to a mental disorder).

A person’s personality is defined as the pattern of behavioral characteristics of the individual. The emotional, mental, social, and physical aspects of a person impact these characteristics. While there remain many unanswered questions about personality and its development, it is generally accepted that the personalities of children and teens are still developing. As a result, extreme caution should be taken prior to diagnosing a child or adolescent with any personality disorder, including BPD.

However, there are some instances where the BPD can be evident and diagnosed before the age of 18. The DSM-IV states: “To diagnose a personality disorder in an individual under 18 years, the features must have been present for at least 1 year”. In other words, it is possible to diagnosis borderline personality disorder in children and teens, but only if the symptoms have been present, continuously, for over a year.

In terms of the diagnosis, it is unclear how helpful diagnosing a child or teen with BPD would be. There is some evidence that BPD diagnosed in adolescence is consistent in adulthood. It is possible that the diagnosis, if applicable, would be helpful in creating a more effective treatment plan for the child or teen.

So again, the answer is yes, a child can have borderline personality disorder, but the specific diagnosis should be given with extreme caution. In addition, problematic behaviors, or difficulty with emotional regulation, in children and teens may not be pathological in nature and may decrease with age.

For more information: Borderline Personality Disorder

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