Borderline Personality Disorder in Childhood

While with adults there is a clear structure in terms of symptoms required to reach a positive diagnosis of borderline personality disorder (BPD) in children there are also several different early warning signs which may indicate a problem including:

• Self-harm behaviour
• Unstable relationships
• Defensiveness
• Emotional overreactions

Self-Harm in Children

Cutting is an increasingly common form of self-harm and if one sees any open wounds or evidence of cutting, it is important to seek advice from the family doctor or mental health professional.
Self-cutters often target the arms, upper legs and torso. Further symptoms of self-harm include burn marks, pin marks or frequent bruising without any logical explanation.

Parents challenging a child's possible self-harming behaviour must do so very sensitively as it is likely that the child will already feel significant guilt and shame associated with this behaviour.

Unstable Relationships in Children

While the majority of adults may look back at their childhood memories or photographs and remember one or two firm school-friends, this is not usually the case with those affected by BPD. Children suffering from BPD will typically struggle to maintain close friendships as a direct result of their condition.
In a child with BPD, the youth is frequently making new friends and initially, he/she may be very obsessive or intense about the relationship. Then, within a short period of time, the child will no longer desire contact with the friend. This pattern of behavior can be indicative of a problem.

Defensiveness in Children

This relates to when a child responds with inappropriate rage or even total despondency as a result to everyday situations. Examples include when a child fails to be invited to a classmate's birthday party or in a situation where the youth does not get the part they wanted in the school play. As a result, the child may get extremely angry, to the point where the emotions are extreme or out of control.

Another example involves a child who believes that a teacher is being overly critical or, if the child gets a question wrong in class or on an exam, the child may experience feelings of utter hopelessness and rejection.

Emotional Overreaction in Children

Although it may of course be argued that as with the latter two symptoms or warning signs, all children may overreact frequent to everyday situations, it is the intensity and severity of such reactions that may be a cause for concern.
Behaviour identified as an intense emotional overreaction may be when a child is told they cannot stay out later than 9:00 p.m. and, in response, the child throws a fit that involves rocking, lashing out a others or punching walls or continually screaming and swearing.
As highlighted above, there are several borderline personality disorder behaviours, particularly in terms of self-harm, that require the parent to be both vigilant and willing to seek medical advice. In order to best manage situations when such symptoms surface, it is important to regularly make time for healthy communication. It can be extremely helpful for parents to establish a daily routine that provides the child with reassurance that he/she will have an opportunity to have his/her emotions and feelings acknowledged.

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