Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Borderline personality disorder: a study in adolescence


The study of the presentation, symptomatology and family characteristics of an exclusively adolescent sample of patients with borderline personality disorder (BPD) was undertaken. Twenty-four cases of borderline personality disorder, 20 females, 4 males, identified using chart review and meeting the criteria of the Diagnostic Interview for Borderlines (DIB) and DSM III-R, were matched with psychiatric controls. Adolescents with borderline personality disorder were found to have high rates of affective symptomatology with Axis I diagnosis of major depressive disorder - MDD (DSM-III-R), and high rates of interpersonal psychopathology, i.e., manipulation, devaluation, and a pervasive sense of boredom. The latter seem to be characteristic as for adults with borderline personality disorder. The families were particularly angry and volatile.

This is a preview of subscription content, log in to check access.


  1. 1.

    Anderson N, Endicott J, Spitzer R, Winokur G (1987) The family history method using diagnostic criteria. Archives of General Psychiatry 34: 1229–1235

  2. 2.

    American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders (DSM-III-R) (3rd ed. revised). Washington DC

  3. 3.

    Apter A, Bleich A, Tyano S (1988) Affective and psychotic psychopathology in hospitalised adolescents. Journal of American Academy of Child & Adolescent Psychiatry 27:116–120

  4. 4.

    Armelius B, Kullgren G, Renberg E (1985) Borderline diagnosis from hospital records: reliability and validity of Gunderson's. Diagnostic Interview for Borderlines (DIB). Journal of Nervous Mental Diseases 173:32–34

  5. 5.

    Bateman AW (1989) Borderline personality in Britain. A preliminary study. Comprehensive Psychiatry 30:385–390

  6. 6.

    Block JM, Westen W, Ludolph P, Wixom J, Jackson A (1991) Distinguishing female adolescents from normal and other disturbed adolescents. Psychiatry 54:89–103

  7. 7.

    Bradley SJ (1979) The relationship of early maternal separation to borderline personality in children and adolescents: a pilot study. American Journal of Psychiatry 136:424–426

  8. 8.

    Brown SL (1987) Family therapy and the borderline patient. In: Grotstein JS, Solomon MF, Lang JA (eds) The borderline patient: emerging concepts in diagnosis, psychodynamics and treatment, vol 2. The Analytic Press, Hillsdale, New York, pp 201–206

  9. 9.

    Campbell D, Draper R, Huffington C (1989) Second thoughts on the theory and practice of the Milan approach to family therapy. DC Associates, London

  10. 10.

    Cohen J (1968) Weighted kappa: nominal scale agreement: provision for scaled disagreement of partial credit. Psychiatric Bulletin 70:213–220

  11. 11.

    Endicott J, Spitzer RL, Fleiss JL (1976) The global assessment scale: a procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry 33:766–771

  12. 12.

    Fleiss JL (1981) Statistical methods for rates and proportions. John Wiley & Sons, New York

  13. 13.

    Goldacre M, Simmons H, Henderson J, Gill LE (1988) Trends in episode based and person based rates of admission to hospital in Oxford Record Linkeage Study area. British Medical Journal 296:583–587

  14. 14.

    Gunderson JG (1984) Borderline personality disorder. American Psychiatric Press, Washington DC

  15. 15.

    Gunderson JG, Kerr J, England DW (1980) The families of borderlines. Archives of General Psychiatry 37:27–33

  16. 16.

    Gunderson JG, Kolb JE, Austin V (1981) Diagnostic interview for borderline patients. American Journal of Psychiatry 138:896–903

  17. 17.

    Gunderson JG, Phillips KA (1991) A current view of the interface between borderline personality disorder and depression. American Journal of Psychiatry 148:967–975

  18. 18.

    Herman JL, Perry JC, Van der Kolk BA (1989) Childhood trauma in borderline personality disorder. American Journal of Psychiatry 146:490–495

  19. 19.

    19.Higgit A, Fonagy P (1992) Psychotherapy in borderline and narcissistic personality disorder. British Journal of Psychiatry 161:23–43

  20. 20.

    Kernberg OF (1967) Borderline personality organisation. Journal of the American Psychoanalytic Association 15:641–685

  21. 21.

    Kernberg OF (1975) Borderline conditions and pathological narcissism. Jason Aronson, New York

  22. 22.

    Kernberg P (1983) Borderline conditions: childhood and adolescent aspects. In: Robson (ed) The borderline child: approaches to etiology, diagnosis and treatment. McGraw-Hill, New York, pp 101–119

  23. 23.

    Kolb JE, Gunderson JG (1980) Diagnosing borderline patients with a semistructured interview. Archives of General Psychiatr 37:37–41

  24. 24.

    Kroll J, Sines L, Roth M (1982) Are there borderlines in Britain? Archives of General Psychiatry 39:60–63

  25. 25.

    Links PS, Boiago I, Huxley G, Steiner M, Mitton JE (1990) Sexual abuse and biparental failure as etiologic models in borderline personality disorder. In: Links P (ed) The family environment and borderline personality disorder. American Psychiatry Press, Washington DC

  26. 26.

    Ludolph P, Westen D, Misle B, Jackson A, Wixom J, Wiss C (1990) The borderline diagnosis in adolescents: symptoms and developmental history. American Journal of Psychiatry 147:470–476

  27. 27.

    Masterson JF (1972) Treatment of the borderline adolescent: a development approach. Wiley, New York

  28. 28.

    Masterson JF (1985) Treatment of the borderline adult. Brunner/Mazel, New York

  29. 29.

    Meissner WW (1984) The borderline spectrum. Jason Aronson, New York

  30. 30.

    McManus M, Lerner H, Robbins D, Barbour C (1984) Assessment of borderline symptomatology in hospitalized adolescents. Journal of American Academy of Child Psychiatry 23:685–694

  31. 31.

    McManus M, Alessi NE, Grapetine WL, Brickman A (1984) Psychiatric disturbance in serious delinquents. Journal of American Academy of Child Psychiatry 23:602–615

  32. 32.

    Ogata SN, Silk KR, Goodrich S, Lohr NE, Westen D, Hill EM (1990) Childhood sexual and physical abuse in adult patients with borderline personality disorder. American Journal of Psychiatry 147:1008–1013

  33. 33.

    Pretzer J (1990) Borderline personality disorder. In: Beck AT, Freeman A et al (eds) Cognitive therapy of personality disorders. Guildford Press, New York

  34. 34.

    Rinsley D (1980) Diagnosis and treatment of borderline and narcissistic children and adolescents. Bulletin of Menninger Clinic 44:147–170

  35. 35.

    Spitzer RL, Endicott J, Gibbon M (1979) Crossing the border into borderline personality and borderline schizophrenia. The development of criteria. Archives of General Psychiatry 36: 17–24

  36. 36.

    SPSS-X (1988) McGraw-Hill, New York

  37. 37.

    Solomon MF (1987) Therapeutic treatment of borderline patients by nonanalytic practitioners. In: Grotstein JS, Solomon MF, Lang JA (eds) The borderline patient: emerging concepts in diagnosis, psychodynamics and treatment,vol 2. The Analytic Press, Hillsdale, NJ, pp 243–260

  38. 38.

    Stein G (1992) Drug treatment of the personality disorders. The British Journal of Psychiatry 161:167–184

  39. 39.

    Stone MH, Hurt SW, Stone DK (1987) The PI 500, Long term follow-up of borderline in-patients meeting DSM-III criteria. I Global outcome. Journal of Personality Disorders 1:291–298

  40. 40.

    Westen D, Ludolph P, Lerner H, Ruffins S, Wiss FC (1990a) Object relations in borderline adolescents. Journal of American Academy of Child and Adolescent Psychiatry 29:338–348

  41. 41.

    Westen D, Ludolph P, Misle B, Ruffins S, Block J (1990b) Physical and sexual abuse in adolescent girls with borderline personality disorder. American Journal of Orthopsychiatry 60:55–66

  42. 42.

    Yanchyshyn G, Kutcher S, Cohen C (1986) The diagnostic interview for borderlines: reliability and validity in adolescents. Journal of American Academy of Child Psychiatry 25:427–429

  43. 43.

    Zanarini MC, Gunderson JG, Marino MF, Schwartz EO, Frankenburg FR (1989) Childhood experiences of borderline patients. Comprehensive Psychiatr 30:18–25

Download references

Author information

Correspondence to A. James.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

James, A., Berelowitz, M. & Vereker, M. Borderline personality disorder: a study in adolescence. European Child & Adolescent Psychiatry 5, 11–17 (1996).

Download citation

Key words

  • Adolescence
  • borderline personality disorder