Borderline Personality Disorder (BPD) is a serious mental illness characterized by unstable moods, behavior, and relationships. People with this disorder also have higher risks of co-occuring disorders, such as depression, anxiety disorders, substance abuse, and eating disorders. They can also lead to self-harm and suicidal behavior.
Clinicians are usually reluctant to diagnose BPD to preteens or teens because one’s personality is not fully developed in childhood or adolescence. It is around the age of 25 that the brain itself is fully developed.
However, researchers do realize that 19 year olds don’t develop a mental disorder over the course of one night and wake up the day of their 19th birthday with Borderline Personality Disorder. Obviously, there are precursors.
So, even though psychologists cannot diagnose a child or adolescent with BPD, they can watch for signs of development of the disorder and work to control these symptoms. This is exactly what Carla Sharp, an associate professor and director of the Developmental Psychopathology Lab in clinical psychology at the University of Houston aimed to do.
“Why does someone with borderline personality disorder key a car, if doing so will not lead to good consequences? What compels her to make that decision?” said Sharp. “I am trying to understand the development of the disorder and what happens in the brain, and what happens in the minds of these children as they develop to put them on a different trajectory compared to their peers.”
The main goal of her research was to explain the reasoning behind the actions of teens with BPD who tend to misbehave. She also intended to correct this behavior from an early age. Her research involved studying 111 adolescents between the ages of 12 and 17 over a period of 2 years.
The UH research team used a newly developed tool called the Movie for the Assessment of Cognition (MASC) as well as self-report measures of emotion to study their patients. Their subjects were instructed to closely watch a 15-minute film and analyze the characters. They were then told that choosing from four different emotions, they would describe the possible thoughts and feelings of the characters.
The team discovered that only about 23% of their subjects actually had BDP. Most of these had the tendency to “hypermentalize.” Mentalizing is the ability to infer and attribute thoughts and feelings to comprehend and predict another person’s behavior. Those who hypermentalize tend to exaggerate their predictions.
“This research study is groundbreaking in that it’s the first to provide empirical evidence of the link between BPD and mentalizing in adolescents. By identifying precursors and treating BPD early in adolescence, we can use validated treatments to help these children,” Sharp said. “The danger of not recognizing precursors of BPD in adolescents is that it can lead to years of confusion and pain for family members and the individual with misdiagnosis and lack of appropriate treatment. These families often go through years of assessment, and people might think it’s bipolar disorder, depression, conduct disorder or comorbidity.”
