Early detection and intervention for borderline personality disorder in adolescence

Schmeck, Klaus; Schlüter-Müller, Susanne

doi:10.24869/spsih.2017.30

Cited by 3 publications

(4 citation statements)

References 10 publications

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“…Research by numerous authors (11)(12)(13)(14)(15)(16) describes how the emotional environment and emotional influences affect the hippocampus, which is responsible for inadequate evaluation of sensory information. According to Van der Kolk (17), traumatic experiences trigger pro-Pitanje koje se postavlja je odnos emocionalnih problema i traume te sekundarno dolazi do organskih promjena na mozgu ili su primarno promjene na mozgu dovele do problema u funkcioniranju, kako ponašajnom tako i emocionalnom (19,20).…”

Section: Relationship Between Emotional and Neurobiological Changesmentioning

confidence: 99%

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Specificity of Diagnosing Dissociative Disorders in Children and Adolescents

Hercigonja¹,

Novković²,

Koren³

et al. 2019

Soc psih

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Disocijativni poremećaji mogu se definirati kao raskol u obično cjelovitim funkcijama svijesti, pamćenju, identitetu i opažanju, dakle disocijativni poremećaj karakterizira prekid normalne integracije svijesti. Kada se govori o djeci i adolescentima, najčešći su konverzivni poremećaji kao i poremećaji identiteta koji uključuju značajan diskontinuitet doživljaja selfa uz promjene afekta i ponašanja što se najčešće opaža kao poremećaj pamćenja, koncentracije i privrženosti, što dovodi do značajnog oštećenja u socijalnom, radnom i drugim važnim područjima funkcioniranja. Uzroci se nalaze u traumatskim događajima zlostavljanja, ali i brojnim drugim traumatskim iskustvima, kao što su hospitalizacije, preseljenja, gubitak važnih osoba i sl. Neurobiološka istraživanja traumatizirane djece pokazuju abnormalnosti (funkcijske i strukturne) u razvoju limbičkog sustava, kao i kortikalne promjene. Van der Kolk u svojim istraživanjima navodi da povećana razina emocionalne pobuđenosti dovodi do promjena u hipokampusu koji je odgovoran za neadekvatno evaluiranje senzornih informacija. Važno je naglasiti da djeca normalno pokazuje fantaziju i maštanje u ponašanju što je teškoća u dijagnostičkom procesu u odnosu na patološku disocijaciju. Poseban su problem diferencijalna dijagnoza, kao i komorbidne bolesti. / Dissociative disorders can be defined as disruptions in the usually complete functions of consciousness, memory, identity and perception, therefore characterized by the disruption of normal consciousness integration. When talking about children and adolescents, the most common are conversion disorders as well as identity disorders, which include a significant discontinuity of self-experience with changes in affect and behaviour, most commonly observed as memory disorder, concentration and attachment disorder, leading to significant impairment in social, work and other important areas of functioning. Causes are found in traumatic events of abuse, but also in many other traumatic experiences, such as hospitalization, relocation, loss of important persons, etc. Neurobiological studies of traumatized children show abnormalities (functional and structural) in the development of the lymphatic system as well as cortical changes. In his research, Van der Kolk states that an increased level of emotional upheaval leads to changes in the hippocampus responsible for inadequate evaluation of sensory information. It is important to emphasize that children normally exhibit fantasy and imagination in behaviour, which presents difficulties in the diagnostic process in relation to pathological dissociation. A special problem is differential diagnosis, as well as comorbid diseases.

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Section: Relationship Between Emotional and Neurobiological Changesmentioning

confidence: 99%

“…There is the question of the relationship between emotional problems and trauma, and secondary organic changes in the brain and primary brain changes have led to problems in both behavioural and emotional functioning (19,20).…”

Section: Diferencijalna Dijagnostikamentioning

confidence: 99%

Specificity of Diagnosing Dissociative Disorders in Children and Adolescents

Hercigonja¹,

Novković²,

Koren³

et al. 2019

Soc psih

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“…This could validate the needs of the adolescents as well as develop and offer customized therapy approaches regarding the necessary complexity and flexibility of the treatment (e.g., change between treatment settings—outpatient, partial inpatient, and online therapy modules). In particular, low-threshold therapy programs [ 2 , 14 , 45 , 48 , 49 , 50 ] promise to become important early and preventive interventions to counteract a chronification of impairment in disorders such as BPD, or PTSD [ 4 ] and other emotion regulation disorders.…”

Section: Discussionmentioning

confidence: 99%

“…With regard to the development of personality disorders, identity diffusion is understood to be an important factor in pathological development [ 3 , 4 , 5 , 6 ]; in fact, a central criterion of BPD is a disturbance of emotional regulation and identity development [ 7 ]. Identity development plays a central role in healthy and disturbed development from childhood [ 8 , 9 ], and identity diffusion is related to personality disorders [ 10 ], oftentimes associated with unstable attachments, experiences of invalidation, and negative childhood experiences [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of a Standardized DBT—A Program on Identity Development in Adolescents

Dixius,

Möhler

2023

Brain Sciences

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Background: Identity diffusion plays a central role in the onset of borderline personality disorders. Dialectical Behavioral Therapy for Adolescents (DBT-A) is a treatment program for adolescents with emotional instability and dysregulation. The interest of this study is to examine the potential effects of a standardized and certified DBT-A therapy program on the identity development of adolescents in an inpatient setting. Methods: A total of 138 adolescents aged 13 to 18 years with symptoms of severe emotional instability were assessed before and after a certified and standardized 12-week in-patient DBT-A program targeting emotional regulation with the following standardized instruments: the Assessment of Identity Development in Adolescence (AIDA), Scale of the Experience of Emotions (SEE), and Symptom Checklist (SCL-90-R). Results: The results indicate a significant change in identity development, emotion regulation, and general symptoms of psychopathology after treatment with DBT-A. Conclusions: In this large sample of adolescents, DBT-A significantly improved identity development and reduced identity diffusion, however, without a treatment-as-usual control group as a limitation. Nevertheless, our results may become clinically relevant for the prevention of chronic impairment in emotionally unstable adolescents.

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Psychisches Strukturniveau im Jugendalter und der Zusammenhang mit späterer psychischer Erkrankung – eine Langzeitstudie

Bock

Huber

Müller

et al. 2019

Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapi

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Zusammenfassung. Fragestellung: Psychische Krankheiten manifestieren sich häufig bereits im Jugendalter. Die Krankheitsverläufe sind dabei aufgrund vielfältiger Einflussfaktoren heterogen, remittierend bis chronifizierend. Ziel der Studie war es, zu untersuchen, ob mit dem Strukturniveau der Operationalisierten Psychodynamischen Diagnostik im Kindes- und Jugendalter (OPD-KJ) ein Zusammenhang zu späterer psychischer Belastung besteht. Methodik: In der vorliegenden Langzeitstudie wurde das psychische Strukturniveau entsprechend der OPD-KJ von 60 Jugendlichen (M = 15.6 Jahre; SD = 0.9) erhoben. Bei einem zweiten Erhebungszeitpunkt 7 Jahre später wurden bei 73.3 % der damals Jugendlichen die symptomatische Belastung auf Achse I und II (SKID-Interviews) sowie die generelle Belastung (GAF, BSI-GSI) erhoben. Ergebnisse: Es zeigen sich hohe korrelative Zusammenhänge zwischen defizitärer Struktur im Jugendalter und psychischer Symptomatik und Belastung im jungen Erwachsenenalter. Schlussfolgerung: Bei der Nachuntersuchung 7 Jahre später fanden sich signifikante Zusammenhänge, die für einen prädiktiven Wert des Strukturniveaus sprechen. Dies legt nahe, dass ein gezieltes, frühes und spezifisches Eingreifen, durch zum Beispiel intensive Psychotherapie, dringend angezeigt ist, um diesem Verlauf entgegenzuwirken.

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Early detection and intervention for borderline personality disorder in adolescence

Cited by 3 publications

References 10 publications

Specificity of Diagnosing Dissociative Disorders in Children and Adolescents

Specificity of Diagnosing Dissociative Disorders in Children and Adolescents

Effects of a Standardized DBT—A Program on Identity Development in Adolescents

Psychisches Strukturniveau im Jugendalter und der Zusammenhang mit späterer psychischer Erkrankung – eine Langzeitstudie

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