Pioneering Study Finds Precursors for BPD in Adolescents

Borderline personality disorder is a serious mental health condition characterized by behaviors and emotions best described as impulsive and unstable. Those with BPD may have strong fears of abandonment and have difficulty controlling their anger. This leads to rocky relationships with others. Inner insecurities may cause them to take impulsive actions or do what is known as splitting – view someone as either all good or all bad. It’s not uncommon for those with BPD to also resort to self-mutilation or become suicidal. Psychologist Dr. Carla Sharp of the University of Houston conducted a study to learn more about how the disorder develops over time and determine what causes children with BPD to take a different life course than others. Specifically, Sharp and her team wanted to know why individuals with BPD would consciously take certain actions if they were aware that the actions would result in negative outcomes. In the study, which occurred over the course of two years, Sharp and her colleagues examined 111 teens between the ages of 12 and 17 who were admitted for treatment to determine the relationship between BPD characteristics and the process of “hypermentalizing.” Mentalizing is the means by which individuals use cues and inferences to predict and interpret other people’s behavior. Sharp’s research focused on how the teen brain works and the evolution of disordered thought patterns, especially as they relate to adult personality disorder. Traditionally, BPD is not diagnosed in people under the age of 25. This is because that’s how long it takes for the adolescent brain to become fully developed. While diagnosis of BPD before the brain has matured is not reasonable, Sharp believes that there may be precursors of the disorder that should not be ignored. By doing so, she is confident that mental health professionals can offer better methods of intervention and treatment. As part of the study, respondents were made to watch scenes from movies, part of a new assessment tool called Movies for the Assessment of Cognition (MASC). After being introduced to four different characters through photos and a 15-minute video clip, subjects were asked to assess each character’s possible thoughts and emotions. Choices included four options, and researchers categorized participants based on their responses – no mentalizing, accurate mentalizaton, hypermentalizing or less mentalizing. Essentially, the adolescents with BPD (23 percent of the sample) had a greater tendency to over-mentalize responses than others. Additionally, those with BTD were more likely to misinterpret individuals’ thoughts, which in turn upset them and resulted in emotional disruptions. Poor emotional regulation has been tied to an escalation of BPD symptoms. The study is pioneering in that it’s the first of its kind to provide a concrete link between BPD and the process of teen mentalization. According to Sharp, ignoring the precursors of BPD can lead to wrong diagnoses (such as bipolar disorder) and inappropriate treatment. Such oversights also lead to a lot of pain for those affected as well as their families.

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