Early Diagnosis and Intervention in Adolescents

Most patients with borderline personality disorder (BPD) experience symptoms beginning in childhood, with onset of self-injury most often before the teenage years. Understanding BPD in adolescents should therefore be considered a core competency in child and adolescent mental health care. Accurate recognition and disclosure of the diagnosis is crucial to the treatment of BPD in adolescence. This should be followed by thorough psychoeducation for patients, families, and other involved mental health and medical professionals to counter erroneous and stigmatized conceptualizations of the disorder. Psychoeducation should be grounded in a developmental context distinguishing clear signs of BPD from normative adolescent behavior. It is important to highlight the transactional nature of factors in the home that can perpetuate or exacerbate BPD’s course so that parents can seek effective coaching and support as well.