Borderline Syndrome in Children

introduction

The Borderline syndrome is a Personality disorder and is determined as such according to common diagnostic criteria only at the onset of adulthood. However, there are children who have similar symptoms and who are diagnosed with borderline personality disorder, even if this is only partially reflected in the official criteria for making the diagnosis. These children who suffer from borderline syndrome often have heavy loads in interpersonal relationships and in the family or traumatic events experienced. The children suffer from an unsteady, delayed or disturbed development, one Self-esteem disorder such as aggressiveness and impulsiveness. They are characterized by fearful clingy relationships with caregivers such as Contact problems with peers.

Symptoms

The Borderline Syndrome in Children is characterized by as in adults unstable human relationshipsthat alternately go hand in hand with the idealization of the partner or the devaluation of oneself. This includes a impaired self-esteem as well as persistent states of Empty and boredom and the inability to be alone. Selfharming behaviour up to Attempted suicide is also one of the characteristic symptoms.
Impulsive and partial aggressive behavior such as severe mood swings can also occur in borderline syndrome. In addition to the criteria for borderline personality disorder listed, it must be ensured that the disorder is persistent, pervasive and is considered unlikely to be limited to one level of development.

Mood swings e.g. can straight in the puberty occur more often, but in this context they are a natural phenomenon that is part of life. They must be clearly separated from pathological mood swings in order to enable correct therapy. This is made more difficult by the fact that the transition between normal and abnormal behavior is often fluid. Therefore, when it comes to borderline personality disorder, careful attention must be paid to how severe and how often the symptoms described above appear. As with many psychiatric diseases, the borderline syndrome combines a wide range of symptoms in the most varied of forms.

A difference between the sexes has also been demonstrated. girl are more vulnerable For selfharming behaviour, emotional instability and long-lasting feelings of loneliness and emptiness. Boys however, often suffer from one weak impulse control.

Also read more on the topic : Borderline symptoms

Aggressive behavior

Aggression and tantrums are typical symptoms of a borderline disorder. However, this also happens regularly in healthy children, especially when they are tired or have been denied something. Aggression due to childish selfishness is therefore normal. However, particularly frequent unprovoked aggression or unprovoked fits of anger without a trigger indicate an internal conflict in the child and are more common in borderline patients.

Selfharming behaviour

Self-harm is very common in borderline disorders, especially in adolescent patients. Such behaviors as scratches (self-harm with a blade or the like, mostly on arms or legs) are rather rare in children. But also kicking yourself or hitting your head against a wall count as self-harm and can be observed even in childhood. These symptoms indicate a serious disorder and clearly differentiate borderline syndrome from natural mood swings and the like at this age.

root cause

The causes of the borderline syndrome in children are seen to be an interplay between applied and external environmental influences. So can a certain Personality structure or that Occurrence psychiatric illness in the family promote the development of borderline syndrome.
However, they can also be beneficial Environmental influences, such as. the education, the B.education to parents and similar caregivers, traumatic experiences and Childhood Abuse, Act. Emotional coldness in the parent-child relationship, as well as neglect and abuse, can develop negative on the child's development, in particular on social skills affect and encourage the development of borderline personality disorder in children.
In particular sexual abuse plays a role in borderline syndrome, but also other traumatic experiences such as Fear of death or extreme helplessness can if they are not processed correctly.
Even if family circumstances play an important role in childhood, relationships with people of the same age play an equally important role in puberty. Difficulty dealing with peers in children can therefore also be important risk factors for the development or progression of a borderline syndrome. Some temperament characteristics in childhood also allow conclusions to be drawn about the later development of a borderline syndrome. So are shy childrenwho also have neurotic personality traits, i.e. to a negative worldview and overestimation of Stressors tend to be more prone. In children, however, these factors only play a role if these factors are not prevented in their pathological form by loving family relationships and learned social skills and stress management strategies.

What influence does upbringing have?

The causal or at least influencing factors of a borderline disorder are often traumatic events in childhood and self-esteem or self-perception problems. Thus, neglecting parenting can favor borderline disorder, while loving and encouraging parenting reduces the likelihood of symptoms occurring. Due to the many other influencing factors, however, this relationship cannot be clearly found in every patient.

Therapy of borderline syndrome in children

There are no drugs. that would affect the fundamental causes of borderline syndrome. To treat borderline symptoms like depression or Mood swings appropriate drugs can be used. These would be e.g. Antidepressants or the Mood stabilizer lithium.
Often there traumatic experiences Because of the cause of borderline syndrome in children, it is advisable to have one psychological therapy method to choose one that helps those affected to process their inner problems and experiences. An often used remedy is that DBT (dialectical behavioral therapy), which has a positive influence, especially with regard to changing harmful behavior.In the case of borderline syndrome, this would include self-harming and self-harming behavior, suicidal intentions and destructive behaviors on a partnership, family or social level.
One focus is that trustful and encouraging interaction within therapywho aims at a constructive and clearly defined working alliance with clear objectives regarding the desired behavioral change. The patient is not only held accountable, he should also be taught that his view of things is heard and understood. The therapeutic interventions take place particularly at the level of inner and outer mindfulness. Skills for adequately coping with stress and better control and regulation of emotions should be taught.
The applied therapy methods can be a Skills training, Group behavior therapy, Mindfulness group, Behavioral tests, self-help-oriented exercise groups and Social counseling include. Other forms of therapy such as Art- or Occupational therapy or Exercise therapy can be used.

Also read more on the topic : Therapy of borderline syndrome

diagnosis

The borderline syndrome is based on the criteria in "Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition“ (DSM 5) diagnosed. There are some semi-standardized tests in the form of Interviewswhich must be supported with clinical observations. The most important here is the SKID-2 questionnaire with the 12 different personality disorders can be queried.
There are some concerns about diagnosing the syndrome in childhood or adolescents. On the one hand, the validity of the diagnosis in children is controversial. Also kick Mood swings and disturbed feelings of self-worth in adolescents in the normal course of puberty and personality formation is not yet complete, but is still developing, which is one of the reasons why personality disorders were not diagnosed until after the age of 18 for a long time. The most important reason seems to be the feared social exclusion.
A previous detection of borderline syndrome is helpful for the patient, as early therapeutic intervention can positively influence the course of the disease. In addition, several studies have found that the symptoms of borderline are also constantly present in adolescents and are not subject to the fluctuations mentioned above.

forecast

The prognosis for borderline syndrome is quite favorable in the long run. Even if certain behaviors persist for a lifetime, studies have shown that after 10 years of control examinations, the majority of those affected no longer fall under the common diagnostic criteria for borderline syndrome. However, this is a prerequisite for a good prognosis Early detection and successful therapywhich is carried out without aborts. In the acute course of this syndrome, however, life-threatening situations can arise, as suicidal intentions play an important role in this disease and the likelihood of Suicide is higher in borderline patients than in the normal population.

prophylaxis

As with many psychiatric illnesses, it is difficult to make statements about the correct type of prophylaxis for borderline syndrome. It would be important for the children to carry out the risk factors mentioned above familial and social support and if necessary therapeutic help in the form of a psychological (Conversational)therapy to meet. For a successful early detection there is one social and personal awareness necessary for the clinical picture.