International Journal of Emergency Mental Health and Human Resilience
Open Access

Abstract

Adolescence is characteristically seen as a time of turmoil and change; however, those who are resilient will swim through this tide of difficulty, while others will show worsening features of disorder and difficulty. It is important that we distinguish psychopathology from normative development in this age group. Adolescents are not exempt from personality disturbance, as we see in routine clinical practice. Early diagnosis is important if we are to stave off more serious difficulties in adolescents so affected, in order to reduce morbidity and associated mortality. Borderline personality disorder does exist in adolescence, and is endorsed by the DSM task force and has been included since DSM-1V-TR. Inflexible, maladaptive, chronic ways of thinking, feeling and behaving with difficulties in affect regulation and identity disturbance lead to significant functional impairment and chronic distress. Regardless of age, the required criteria when met should prompt us to make the diagnosis and institute appropriate treatment. There is often significant discussion among different sections of the mental health community who wish to avoid pathologizing what may seem to be difficult behavior in adolescence; however the diagnosis of BPD in adolescence has important advantages when clinically appropriate. Earlier diagnosis leads to earlier interventions and therefore decreases in associated morbidity. The first manifestations of the disorder occur in adolescence or early adulthood. Management must address stabilization, affective disturbance, identity difficulties and interpersonal relationships, and a range of therapeutic endeavors may be employed and pharmacotherapy is useful when indicated. Early intervention is the key phrase.

Biography

Joan Haliburn is a Consultant child, adolescent & family Psychiatrist. She is a Clinical Senior Lecturer at University of Sydney and Senior Supervisor of Complex Trauma Unit, Westmead Hospital and is also in private practice. She was the President of Australia and New Zealand Association of Psychotherapy between 2000 and 2003 and Director of its training division for 10 years. She has published numerous papers, presented workshops and papers in Australia and internationally. She has contributed chapters to several books. She is an International Fellow, American Psychiatry Association and is currently on the Board of Directors, International Society for the Study of Trauma and Dissociation.

Email: jhalibur@bigpond.net.au