Download pdf
Cultural Differences, Diagnosis, and the Intervention in Adolescence in Borderline Personality Disorder
- 1 University of Ottawa
* Author to whom correspondence should be addressed.
Abstract
The previous study showed that borderline personality disorder was strongly associated with childhood trauma and developed personality traits into adolescence that could lead to borderline personality disorder. Research also indicated a cultural difference in the psychopathology and diagnosis of borderline personality disorder in both adults and adolescents. A borderline personality disorder is a type of personality disorder that has symptoms around unstable emotions, dissociation and fear of being abandoned. Although having deviant behaviour was a significant risk factor in detecting borderline personality disorder, it could be less potent in non-western cultures like China and India. Merging cultural differences and the criteria of borderline personality disorder could accurately detect borderline personality disorder in adolescence. It helped people intervene and treat it earlier to slow the progression of borderline personality disorder. This study focused on reviewing previous research on cultural differences, detection, prevention, and intervention in adolescents with borderline personality disorder. Cultural differences like different social norms or traditions influence individual identity and interpersonal relationships, which are non-negligible components of the period of adolescence that could induce borderline personality disorder if adolescents have issues with those parts. People need to be aware of the symptoms to intervene in borderline personality disorder in adolescents through multiple treatments with an appropriate plan and management, which should focus on psychotherapy, like dialectic behavioural therapy, supportive psychotherapy, and Mentalization-based therapy.
Keywords
borderline personality disorder, psychopathology, adolescence, transcultural psychiatry
[1]. American Psychiatric Association (2000). Diagnostic and Statistical Manual Of Mental Disorders, 4th Edn, Washington, DC: American Psychiatric Association.
[2]. U.S. Department of Health and Human Services. (n.d.). Borderline personality disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/borderline-personality-disorder
[3]. Chang, T., Liu, S., Korslund, K., Lin, C., Lin, Y., Huang, H., Chen, S., Chang, Y., Sun, F., & Wu, S. (2022). Adapting dialectical behavior therapy in Mandarin‐speaking Chinese patients with borderline personality disorder: An open pilot trial in Taiwan. Asia-Pacific Psychiatry, 14(1), e12451–n/a. https://doi.org/10.1111/appy.12451
[4]. Ruggero, Camilo J.; Zimmerman, Mark; Chelminski, Iwona; Young, Diane (2010). "Borderline personality disorder and the misdiagnosis of bipolar disorder". Journal of Psychiatric Research. 44 (6): 405–408. doi:10.1016/j.jpsychires.2009.09.011. ISSN 0022-3956. PMC 2849890. PMID 19889426.
[5]. Choudhary, Shalini, and Rashmi Gupta. “Culture and Borderline Personality Disorder in India.” Frontiers in Psychology, vol. 11, 2020, pp. 714–714, https://doi.org/10.3389/fpsyg.2020.00714.
[6]. Cohen, S. (1972). Folk Devils And Moral Panics: The Creation Of The Mods And Rockers. London: MacGibbon & Kee.
[7]. Yang, K. S. (1986). “Chinese personality and its change,” in The Psychology Of The Chinese People, ed. M. Bond (Hong Kong: Oxford University Press).
[8]. Keng, S. L., Lee, Y., Drabu, S., Hong, R. Y., Chee, C. Y. I., Ho, C. S. H., & Ho, R. C. M. (2019). Construct Validity of the McLean Screening Instrument for Borderline Personality Disorder in Two Singaporean Samples. Journal of personality disorders, 33(4), 450–469. https://doi.org/10.1521/pedi_2018_32_352
[9]. Miller AL, Muehlenkamp JJ, Jackson CM. Fact or fiction: diagnosing borderline personality disorder in adolescents. Clin Psychol Rev. 2008;28(6):969–81.
[10]. Guilé, J. M., Boissel, L., Alaux-Cantin, S., & de La Rivière, S. G. (2018). Borderline personality disorder in adolescents: prevalence, diagnosis, and treatment strategies. Adolescent health, medicine and therapeutics, 9, 199–210. https://doi.org/10.2147/AHMT.S156565
[11]. Bozzatello, P., Garbarini, C., Rocca, P., & Bellino, S. (2021). Borderline Personality Disorder: Risk Factors and Early Detection. Diagnostics (Basel, Switzerland), 11(11), 2142. https://doi.org/10.3390/diagnostics11112142
[12]. Zanarini, M.C., Martinho, E., Temes, C.M. et al. Dissociative experiences of adolescents with borderline personality disorder: description and prediction. bord personal disord emot dysregul 10, 9 (2023). https://doi.org/10.1186/s40479-023-00217-0
[13]. Leichsenring F, Leibing E, Kruse J, New AS, Leweke F. Borderline personality disorder. Lancet. 2011;32:371–90.
[14]. Zhong, J., & Leung, F. (2009). Diagnosis of borderline personality disorder in China: Current status and future directions. Current Psychiatry Reports, 11(1), 69–73. https://doi.org/10.1007/s11920-009-0011-3
[15]. Arens E, Stopsack M, Spitzer C, et al. Borderline personality disorder in four different age groups: a cross-sectional study of community residents in Germany. J Pers Disord 2013; 27:196–207.
[16]. Knafo A, Guile JM, Breton JJ, et al. Coping strategies associated with suicidal behaviour in adolescent inpatients with borderline personality disorder. Can J Psychiatry. 2015;60(2 Suppl 1):S46-S54.
[17]. Wall K, Kerr S, Sharp C. Barriers to care for adolescents with borderline personality disorder. Curr Opin Psychol. 2021;37:1–7.
[18]. Spiegel D, Loewenstein RJ, Lewis-Fernández R, Sar V, Simeon D, Vermetten E, et al. Dissociative disorders in DSM-5. Depress Anxiety. 2011;28(12):E17–45.
[19]. Berhe, O., Moessnang, C., Reichert, M. et al. Dose-dependent changes in real-life affective well-being in healthy community-based individuals with mild to moderate childhood trauma exposure. bord personal disord emot dysregul 10, 14 (2023). https://doi.org/10.1186/s40479-023-00220-5
[20]. Newnham, E. A., & Janca, A. (2014). Childhood adversity and borderline personality disorder: a focus on adolescence. Current Opinion in Psychiatry, 27(1), 68–72. https://doi.org/10.1097/YCO.0000000000000028
[21]. Erazo, M., & Vaillancourt, T. (2021). The Cumulative Effects of Bullying Victimization in Childhood and Adolescence on Borderline Personality Disorder Symptoms and Post-Traumatic Stress Disorder in Emerging Adulthood. Université d’Ottawa / University of Ottawa. https://doi.org/10.1007/s42380-022-00122-0
[22]. Stepp SD, Burke JD, Hipwell AE, Loeber R. Trajectories of attention deficit hyperactivity disorder and oppositional defiant disorder symptoms as precursors of borderline personality disorder symptoms in adolescent girls. J Abnorm Child Psychol. 2012;40(1):7-20.
[23]. Bo S, Sharp C, Beck E, Pedersen J, Gondan M, Simonsen E. First empirical evaluation of outcomes for mentalization-based group therapy for adolescents with BPD. Personal Disord. 2017;8(4): 396-401.
[24]. Haltigan JD, Vaillancourt T. Identifying trajectories of borderline personality features in adolescence: antecedent and interactive risk factors. Can J Psychiatry. 2016;61(3):166-175.
[25]. Wu, Y., Zheng, Y., Wang, J., & Zhang, T. (2022). Specific type of childhood trauma and borderline personality disorder in Chinese patients. Frontiers in Psychiatry, 13, 936739–936739. https://doi.org/10.3389/fpsyt.2022.936739
[26]. Wu, Z., Liu, Z., Jiang, Z., Fu, X., Deng, Q., Palaniyappan, L., Xiang, Z., Huang, D., & Long, Y. (2022). Overprotection and overcontrol in childhood: An evaluation on reliability and validity of 33-item expanded Childhood Trauma Questionnaire (CTQ-33), Chinese version. Asian Journal of Psychiatry, 68, 102962–102962. https://doi.org/10.1016/j.ajp.2021.102962
[27]. Luo, M., Huang, X., & Su, D. (2010). Influence of Confucian culture on current practice of mental health Services in China. Advances in Psychological Science, 18(09), 1481– 1488.
[28]. Antic, A. (2021). Transcultural Psychiatry: Cultural Difference, Universalism and Social Psychiatry in the Age of Decolonisation. Culture, Medicine and Psychiatry, 45(3), 359–384. https://doi.org/10.1007/s11013-021-09719-4
Cite this article
Zhao,D. (2023). Cultural Differences, Diagnosis, and the Intervention in Adolescence in Borderline Personality Disorder. Lecture Notes in Education Psychology and Public Media,19,65-73.
Data availability
The datasets used and/or analyzed during the current study will be available from the authors upon reasonable request.
Disclaimer/Publisher's Note
The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of EWA Publishing and/or the editor(s). EWA Publishing and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.
About volume
Volume title: Proceedings of the 4th International Conference on Educational Innovation and Philosophical Inquiries
© 2024 by the author(s). Licensee EWA Publishing, Oxford, UK. This article is an open access article distributed under the terms and
conditions of the Creative Commons Attribution (CC BY) license. Authors who
publish this series agree to the following terms:
1. Authors retain copyright and grant the series right of first publication with the work simultaneously licensed under a Creative Commons
Attribution License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this
series.
2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the series's published
version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial
publication in this series.
3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and
during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See
Open access policy for details).