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ESCAP Expert Article: Borderline personality disorder in adolescence: An expert research review with implications for clinical practice

Fonagy, P; Speranza, M; Luyten, P; Kaess, M; Hessels, C; Bohus, M; (2015) ESCAP Expert Article: Borderline personality disorder in adolescence: An expert research review with implications for clinical practice. European Child & Adolescent Psychiatry , 24 (11) pp. 1307-1320. 10.1007/s00787-015-0751-z. Green open access

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Abstract

Borderline personality disorder (BPD) has onset in adolescence, but is typically first diagnosed in young adulthood. This paper provides a narrative review of the current evidence on diagnosis, comorbidity, phenomenology and treatment of BPD in adolescence. Instruments available for diagnosis are reviewed and their strengths and limitations discussed. Having confirmed the robustness of the diagnosis and the potential for its reliable clinical assessment, we then explore current understandings of the mechanisms of the disorder and focus on neurobiological underpinnings and research on psychological mechanisms. Findings are accumulating to suggest that adolescent BPD has an underpinning biology that is similar in some ways to adult BPD but differs in some critical features. Evidence for interventions focuses on psychological therapies. Several encouraging research studies suggest that early effective treatment is possible. Treatment development has just begun, and while adolescent-specific interventions are still in the process of evolution, most existing therapies represent adaptations of adult models to this developmental phase. There is also a significant opportunity for prevention, albeit there are few data to date to support such initiatives. This review emphasizes that there can be no justification for failing to make an early diagnosis of this enduring and pervasive problem.

Type: Article
Title: ESCAP Expert Article: Borderline personality disorder in adolescence: An expert research review with implications for clinical practice
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s00787-015-0751-z
Publisher version: http://dx.doi.org/10.1007/s00787-015-0751-z
Language: English
Additional information: The final publication is available at Springer via http://dx.doi.org/10.1007/s00787-015-0751-z
Keywords: Borderline personality disorder, Adolescence, Neurobiology, Psychotherapy, Pharmacotherapy.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery.ucl.ac.uk/id/eprint/1470157
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