Levels of borderline functioning in children: Etiological and treatment considerations.

Abstract

It has been noted frequently in the literature that the term "borderline pathology" denotes a range of disturbances. While borderline patients are characterized by severe object relations problems, there is an extremely wide range of ego functioning in these patients. Stemming from work with borderline children, this paper describes this range of varied functioning and develops inferences, based on clinical material, regarding the etiology of these differences.

Infantile Trauma and the Psychoses

“…Kernberg, 1984;Gampel, 1988;Cohen, 1995). In speaking of issues of differential diagnosis between borderline and psychotic conditions in children, Chethik (1985) suggests that in psychosis there is no discernible differentiation between self-and object-images, whereas in the borderline case there has been some emergence out of primary identification, with a rudimentary capacity to acknowledge objects as external. This is in line with Kernberg's (1985) formulations, but I believe there is reason to doubt whether the stable ego pathology identified by Kernberg in the adult case is applicable to the children we are considering.…”

The borderline spectrum and psychoanalytic perspectives

“…A similar point of view in the assessment of developmental aspects of borderline functioning in children has been advanced by Chethik (1986).…”

The Borderline Syndrome in Children—is It a Clinical Entity?

“…He prefers to use the term as a descriptive comment on other diagnoses Downloaded by [Central Michigan University] at 13:40 13 October 2014 rather than a diagnosis on itself and he suggests that the term "borderline children" be used to alter the notion that "borderline" represents a single unified entity. Chethik (1986) described borderline children in terms of their level of functioning. He refers to the "typical" borderline child and the "highly functioning" borderline child.…”