Preventive Strategies for Borderline Personality Disorder in Adolescents

Abstract

Personality disorder has been shown to be common in adolescence and most notable for its continuity with and similarities to adult personality disorder. This has legitimized the diagnosis of personality disorder, particularly borderline personality disorder, in adolescence. The first wave of indicated prevention (targeting those showing early signs and symptoms) and early intervention (those with full-syndrome disorder) studies for borderline personality disorder in adolescence are notable for challenging fears about diagnosing and treating borderline personality disorder in young people, and demonstrating that appropriate diagnosis and intervention can lead to clinically meaningful improvements for patients. However, dropout rates from these interventions are high and the specific role for individual psychotherapeutic interventions within treatment programs is unclear. Common elements of structured, high quality early intervention for borderline personality disorder might also be effective and applicable to a variety of treatment settings, independent of individual psychotherapy. Given the limited evidence base for pharmacotherapy as a primary treatment for borderline personality disorder in adults, this form of treatment cannot be recommended in adolescents.