Academic journal article International Public Health Journal

Childhood and Adolescence: Perspectives on Personality Disorders

Academic journal article International Public Health Journal

Childhood and Adolescence: Perspectives on Personality Disorders

Article excerpt

Introduction

Youth who exhibit symptoms associated with personality disorders (PD) can result in that person being diagnosed with a personality disorder (1). This is problematic because these youth have not reached full maturity. Most symptoms they exhibit can often be better explained by other incidents, factors or reactions that they experience throughout stages of development (cognitive, emotional, and mental); such as: a) trauma; b) abuse (emotional, physical, verbal); c) violence (domestic between care-providers, abuse from care providers or siblings; d) multiple trauma exposures; e) parents who have a history of uncontrolled mental disorders; and f) a strong familial genetic history of serious psychopathology (such as, depression, personality disorders. Not all youth who are exposed to the above conditions develop personality disorders (1). Some children who are exposed to factors identified in the above list as a neonate, during infancy, childhood, adolescence, or young adulthood can often receive appropriate psychotherapy to alleviate distress and teach effective coping strategies.

Other youth diagnosed with comorbid disorders and exposed multiple traumatic events are at risk for developing deviant or maladaptive behavior patterns that significantly impairs their growth and development. A personality disorder can develop in youth who do not developmental flexibility, resilience, consistent supportive relationships with others, strong connections to their school or community, future orientation, and a sense of hope; they may develop personality traits that are inflexible and maladaptive and cause significant functional impairment or subjective distress (2-5).

Definition

A personality disorder is defined by the "Diagnostic and statistical manual of mental disorders," fifth edition, as being characterized by enduring patterns of internal experiences and behaviors that markedly deviates from the individual's culture (3). These stable patterns are pervasive, enduring, inflexible deviant and maladaptive cognitions, perceptions, impulse control, interpersonal relationships, and behaviors that usually begin in adolescence or early adulthood; the outcome for affected youth results in disruptive and impaired function. Their behaviors are exhibited in a wide range of social and personal contexts. There are 10 classifications of personality disorders, divided into three clusters; Cluster A: Odd and eccentric, Cluster B: Dramatic, emotional, and erratic and Cluster C: Anxious and fearful. The reader is referred to the DSM-V or the National Institute of Mental Health (NIMH) website for further information (3, 6-12).

Prevalence rates

The estimated prevalence rate for any personality disorder in the general adult population in the United States is 10-15%; 5.7% in Cluster A disorders; 1.5% for Cluster B and 6% for Cluster C disorders (3,5,710,13). Research on prevalence rates of personality disorders in youth is lacking. Research from community samples in primary care estimated that adolescents with at least one personality disorder range from 6%-17%. Prevalence rates tend to peak in early adolescence and then decline steadily during adolescence and early adulthood. Such data is sparse for specific personality disorders. Prevalence of childonset bipolar is not well established due to debate about the appropriate definition of caseness (or boundaries of diagnosis) among preadolescents (9).

Clinical features

In order to be diagnosed with a personality disorder, an individual must meet certain criteria as established by the DSM-V which include; 1) an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture in two or more areas: a) cognition, b) affectivity, c) interpersonal relationships and d) impulse control; 2) The enduring pattern is inflexible, pervasive and stable occurs across a broad range of personal and social situations; 3) the enduring pattern leads to clinically significant distress or impairment in social, occupational or other important areas of functioning (3). …

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