Mary C Zanarini1,2, Christina M Temes1,2, Laura R Magni3, Garrett M Fitzmaurice1,2, Blaise A Aguirre1,2, Marianne Goodman4,5. 1. McLean Hospital, Belmont, MA, USA. 2. Department of Psychiatry, Harvard Medical School, Boston, MA, USA. 3. Unit of Psychiatry, St. John of God Clinical Research Centre, Brescia, Italy. 4. Icahn School of Medicine at Mount Sinai, New York, NY, USA. 5. James J. Peters Veterans Affairs Medical Center, New York, NY, USA.
Abstract
OBJECTIVE: The validity of borderline personality disorder (BPD) in children and adolescents has not been studied in a rigorous manner reflecting the criteria of Robins and Guze first detailed in 1970. This paper and the others in this series address some aspects of this multifaceted validation paradigm, which requires that a disorder has a known clinical presentation, can be delimited from other disorders, 'runs' in families, and something of its aetiology, treatment response and course is known. METHODS: Three groups of subjects were studied: 104 adolescent inpatients meeting the Revised Diagnostic Interview for Borderlines and DSM-IV criteria for BPD, 60 psychiatrically healthy adolescents and 290 adult inpatients meeting the Revised Diagnostic Interview for Borderlines and DSM-III-R criteria for BPD. RESULTS: Adolescents with BPD had significantly higher prevalence rates of 22 of the 24 symptoms studied than psychiatrically healthy adolescents. Only rates of serious treatment regressions and countertransference problems failed to reach the Bonferroni-corrected level of 0.002. Adolescents and adults with BPD had only four symptomatic differences that reached this level of significance, with adolescents with BPD reporting significantly lower levels of quasi-psychotic thought, dependency/masochism, devaluation/manipulation/sadism and countertransference problems than adults with BPD. CONCLUSIONS: Taken together, the results of this study suggest that adolescents report BPD as severe as that reported by adults. They also suggest that BPD in adolescents is not a tumultuous phase of normal adolescence.
OBJECTIVE: The validity of borderline personality disorder (BPD) in children and adolescents has not been studied in a rigorous manner reflecting the criteria of Robins and Guze first detailed in 1970. This paper and the others in this series address some aspects of this multifaceted validation paradigm, which requires that a disorder has a known clinical presentation, can be delimited from other disorders, 'runs' in families, and something of its aetiology, treatment response and course is known. METHODS: Three groups of subjects were studied: 104 adolescent inpatients meeting the Revised Diagnostic Interview for Borderlines and DSM-IV criteria for BPD, 60 psychiatrically healthy adolescents and 290 adult inpatients meeting the Revised Diagnostic Interview for Borderlines and DSM-III-R criteria for BPD. RESULTS: Adolescents with BPD had significantly higher prevalence rates of 22 of the 24 symptoms studied than psychiatrically healthy adolescents. Only rates of serious treatment regressions and countertransference problems failed to reach the Bonferroni-corrected level of 0.002. Adolescents and adults with BPD had only four symptomatic differences that reached this level of significance, with adolescents with BPD reporting significantly lower levels of quasi-psychotic thought, dependency/masochism, devaluation/manipulation/sadism and countertransference problems than adults with BPD. CONCLUSIONS: Taken together, the results of this study suggest that adolescents report BPD as severe as that reported by adults. They also suggest that BPD in adolescents is not a tumultuous phase of normal adolescence.
Authors: Mary C Zanarini; Laura R Magni; Christina M Temes; Katherine E Hein; Blaise A Aguirre; Marianne Goodman Journal: J Pers Disord Date: 2020-01-28
Authors: Mary C Zanarini; Argyro Athanasiadi; Christina M Temes; Laura R Magni; Katherine E Hein; Garret M Fitzmaurice; Blaise A Aguirre; Marianne Goodman Journal: J Pers Disord Date: 2021-01-21