Background: In recent years, an increasing interest in personality disorders in childhood and adolescence has
been observed. This is partly due to recent findings of temperament, personality and neurobiological research.
Method: This article reviews the history of the concept of borderline conditions in children and adolescents, and presents
recent evidence from developmental psychology and neurobiology to support the diagnosis in adolescents as a disorder of
development. An overview of treatment based on the decades-long experience with these patients at the Tiefenbrunn
Clinic in Germany is described.
Results: While the term personality disorder implies enduring traits, the evidence suggests that it is relatively unstable in
adults as well as adolescents. Concerns about labeling adolescents with a presumably lifelong condition have hampered
research on pathogenesis and treatment. Nevertheless, some adolescents with severe impairments in functioning do meet
adult criteria for BPD, and do respond to the tailored treatment approaches that have been developed for them.
Conclusions: The psychopathology of adolescents with BPD is probably a result of the interaction of the adolescent developmental
process and defects in attachment and mentalization similar to those in adults with BPD. The term “developmental
borderline personality disorder” is suggested to reflect the fluidity of this condition. Appropriate intervention requires
a comprehensive multimodal approach in which individual therapy takes place within a protective framework of
boundaries and limits.