Clinical and Psychopathological Features of Borderline Personality Disorder in Adolescence

Abstract

Background: Borderline personality disorder (BPD) in adolescence has a high prevalence and a signicant polymorphism of the psychopathological structure which creates considerable difculties 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: identication 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 identied 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 identied: 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.