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Does the concept of borderline personality features have clinical utility in childhood?

Hawes, David J.

Current Opinion in Psychiatry: January 2014 - Volume 27 - Issue 1 - p 87–93
doi: 10.1097/YCO.0000000000000018
Edited by Richard Williams and Philip Hazell

Purpose of review: Phenotypic features of borderline personality disorder may first emerge during childhood, alongside symptoms of common externalizing and internalizing disorders. Children with these borderline personality features (BPF) are, therefore, likely to come into contact with clinical services prior to adolescence. This raises the question of whether BPF may be clinically informative with respect to the formulation and treatment of childhood psychopathology.

Recent findings: BPF in late childhood appear to be highly heritable, while also predicted by environmental risk factors that overlap with those related to both externalizing and internalizing disorders. These risk factors include hostile parenting, maternal insensitivity to infant attachment cues, and early peer victimization, thereby implicating both family and peer processes that play out across early development. Children with BPF appear to be further characterized by social–cognitive factors including social perspective coordination deficits, a shame-prone self-concept, and hypermentalizing, which may represent potential therapeutic targets.

Summary: Clinical research into the implications of BPF for the treatment of childhood psychopathology is a current priority. It is proposed that the research designs that have contributed to recent evidence for the clinical utility of childhood psychopathic traits may likewise aid in understanding the potential clinical utility of BPF in children.

School of Psychology, University of Sydney, Sydney, New South Wales, Australia

Correspondence to David J. Hawes, PhD, School of Psychology, University of Sydney, Sydney, NSW 2006, Australia. Tel: +61 2 9351 4068; fax: +61 2 9036 5223; e-mail: david.hawes@sydney.edu.au

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins