Borderline Personality Disorder and Attention Deficit/hyperactivity Disorder in Adolescence: Overlap and Differences in a Clinical Setting

Overview

Journal Borderline Personal Disord Emot Dysregul

Publisher Biomed Central

Date 2020 Apr 22

PMID 32313658

Citations 1

Authors

Omer Faruk Akca

Kiana Wall

Carla Sharp

Affiliations

Soon will be listed here.

Abstract

Background: With increased consensus regarding the validity and reliability of diagnosing Borderline Personality Disorder (BPD) in adolescents, clinicians express concern over the distinction between BPD and Attention-Deficit/Hyperactivity Disorder (ADHD), and its co-morbidity in clinical settings. The goal of this study was to evaluate differences between BPD, ADHD and BPD + ADHD in terms of co-morbid psychiatric disorders and a range of self-reported behavioral problems in adolescents.

Methods: Our sample consisted of = 550 inpatient adolescents with behavioral and emotional disorders that have not responded to prior intervention. We took a person-centered approach (for increase clinical relevance) and compared adolescents with ADHD, BPD and ADHD+BPD in terms of co-occurring psychiatric disorders and behavioral problems. We performed a regression analysis to test whether BPD symptoms make an incremental contribution to the prediction of psychiatric symptoms over ADHD symptoms.

Results: The severity of almost all co-occurring disorders, aggression, self-harm, suicidal thoughts, and substance use, were higher in the ADHD+BPD group. Borderline symptoms made an incremental contribution to the prediction of psychiatric symptoms beyond the contribution of ADHD.

Conclusion: Severity and co-morbidity may be helpful factors in distinguishing between ADHD and BPD in clinical practice and the co-morbidity of these two disorders may indicate a worse clinical outcome.

Citing Articles

Discrimination of Borderline Personality Disorder (BPD) and Attention-Deficit/Hyperactivity Disorder (ADHD) in adolescents: Spanish version of the Borderline Personality Features Scale for Children-11 Self-Report (BPFSC-11) Preliminary results.

Calvo N, Marin J, Vidal R, Sharp C, Duque J, Ramos-Quiroga J Borderline Personal Disord Emot Dysregul. 2023; 10(1):15.

PMID: 37189168 PMC: 10185374. DOI: 10.1186/s40479-023-00223-2.

References

Miller C, Flory J, Miller S, Harty S, Newcorn J, Halperin J . Childhood attention-deficit/hyperactivity disorder and the emergence of personality disorders in adolescence: a prospective follow-up study. J Clin Psychiatry. 2009; 69(9):1477-84. PMC: 2637402. DOI: 10.4088/jcp.v69n0916. View

Sebastian A, Jacob G, Lieb K, Tuscher O . Impulsivity in borderline personality disorder: a matter of disturbed impulse control or a facet of emotional dysregulation?. Curr Psychiatry Rep. 2013; 15(2):339. DOI: 10.1007/s11920-012-0339-y. View

Shaffer D, Fisher P, Lucas C, Dulcan M . NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses. J Am Acad Child Adolesc Psychiatry. 2000; 39(1):28-38. DOI: 10.1097/00004583-200001000-00014. View

Dowson J, McLean A, Bazanis E, Toone B, Young S, Robbins T . The specificity of clinical characteristics in adults with attention-deficit/hyperactivity disorder: a comparison with patients with borderline personality disorder. Eur Psychiatry. 2004; 19(2):72-8. DOI: 10.1016/j.eurpsy.2003.07.010. View

Storebo O, Simonsen E . The Association Between ADHD and Antisocial Personality Disorder (ASPD): A Review. J Atten Disord. 2013; 20(10):815-24. DOI: 10.1177/1087054713512150. View

Cackowski S, Krause-Utz A, Van Eijk J, Klohr K, Daffner S, Sobanski E . Anger and aggression in borderline personality disorder and attention deficit hyperactivity disorder - does stress matter?. Borderline Personal Disord Emot Dysregul. 2017; 4:6. PMC: 5356413. DOI: 10.1186/s40479-017-0057-5. View

OMalley G, McHugh L, Mac Giollabhui N, Bramham J . Characterizing adult attention-deficit/hyperactivity-disorder and comorbid borderline personality disorder: ADHD symptoms, psychopathology, cognitive functioning and psychosocial factors. Eur Psychiatry. 2015; 31:29-36. DOI: 10.1016/j.eurpsy.2015.09.012. View

Belsky D, Caspi A, Arseneault L, Bleidorn W, Fonagy P, Goodman M . Etiological features of borderline personality related characteristics in a birth cohort of 12-year-old children. Dev Psychopathol. 2012; 24(1):251-65. PMC: 3547630. DOI: 10.1017/S0954579411000812. View

Grilo C, Becker D, Fehon D, Walker M, Edell W, McGlashan T . Gender differences in personality disorders in psychiatrically hospitalized adolescents. Am J Psychiatry. 1996; 153(8):1089-91. DOI: 10.1176/ajp.153.8.1089. View

10.

Kuja-Halkola R, Lind Juto K, Skoglund C, Ruck C, Mataix-Cols D, Perez-Vigil A . Do borderline personality disorder and attention-deficit/hyperactivity disorder co-aggregate in families? A population-based study of 2 million Swedes. Mol Psychiatry. 2018; 26(1):341-349. PMC: 7815504. DOI: 10.1038/s41380-018-0248-5. View

11.

Kaess M, Brunner R, Chanen A . Borderline personality disorder in adolescence. Pediatrics. 2014; 134(4):782-93. DOI: 10.1542/peds.2013-3677. View

12.

Chanen A, Sharp C, Hoffman P . Prevention and early intervention for borderline personality disorder: a novel public health priority. World Psychiatry. 2017; 16(2):215-216. PMC: 5428197. DOI: 10.1002/wps.20429. View

13.

Puiu A, Wudarczyk O, S Goerlich K, Votinov M, Herpertz-Dahlmann B, Turetsky B . Impulsive aggression and response inhibition in attention-deficit/hyperactivity disorder and disruptive behavioral disorders: Findings from a systematic review. Neurosci Biobehav Rev. 2018; 90:231-246. DOI: 10.1016/j.neubiorev.2018.04.016. View

14.

Moukhtarian T, Mintah R, Moran P, Asherson P . Emotion dysregulation in attention-deficit/hyperactivity disorder and borderline personality disorder. Borderline Personal Disord Emot Dysregul. 2018; 5:9. PMC: 5960499. DOI: 10.1186/s40479-018-0086-8. View

15.

Levy K, Becker D, Grilo C, Mattanah J, Garnet K, Quinlan D . Concurrent and predictive validity of the personality disorder diagnosis in adolescent inpatients. Am J Psychiatry. 1999; 156(10):1522-8. DOI: 10.1176/ajp.156.10.1522. View

16.

Matthies S, Philipsen A . Common ground in Attention Deficit Hyperactivity Disorder (ADHD) and Borderline Personality Disorder (BPD)-review of recent findings. Borderline Personal Disord Emot Dysregul. 2016; 1:3. PMC: 4739390. DOI: 10.1186/2051-6673-1-3. View

17.

Speranza M, Revah-Levy A, Cortese S, Falissard B, Pham-Scottez A, Corcos M . ADHD in adolescents with borderline personality disorder. BMC Psychiatry. 2011; 11:158. PMC: 3202232. DOI: 10.1186/1471-244X-11-158. View

18.

Koerting J, Pukrop R, Klein P, Ritter K, Knowles M, Banzhaf A . Comparing Dimensional Models Assessing Personality Traits and Personality Pathology Among Adult ADHD and Borderline Personality Disorder. J Atten Disord. 2012; 20(8):715-24. DOI: 10.1177/1087054712464391. View

19.

Ferrer M, Andion O, Matali J, Valero S, Navarro J, Ramos-Quiroga J . Comorbid attention-deficit/hyperactivity disorder in borderline patients defines an impulsive subtype of borderline personality disorder. J Pers Disord. 2010; 24(6):812-22. DOI: 10.1521/pedi.2010.24.6.812. View

20.

Bernardi S, Faraone S, Cortese S, Kerridge B, Pallanti S, Wang S . The lifetime impact of attention deficit hyperactivity disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Psychol Med. 2011; 42(4):875-87. PMC: 3383088. DOI: 10.1017/S003329171100153X. View