Borderline Pathology of Childhood: Implications of Early Axis II Diagnoses.

INTRODUCTION A personality pathology framework may be useful in the diagnosis and treatment of children with chronic psychopathology and impairment in many domains of functioning. This paper presents the utility of such an approach through a description of research investigating borderline pathology of childhood (BPC). METHODS Literature regarding the phenomenology, risk factors, and outcomes of BPC and similar disorders is reviewed. RESULTS Research conducted at the SMBD-Jewish General Hospital in Montreal has shown that children with BPC can be reliably identified via chart review, and that they exhibit a pattern of risk factors similar to that of adults with borderline personality disorder, such as psychological trauma and deficits in executive function. Preliminary results of a follow-up study in adolescence suggests that these children remain more functionally impaired than a comparison group. Our current research investigates neuropsychological deficits and their relationship to trauma in children with BPC. We are also exploring whether a similar pattern can be observed in their parents. CONCLUSION We conclude that BPC symptom patterns may diagnostically define a group of high risk children and may eventually guide our approach to early intervention.