The study found that teens who are prone to hypermentalizing are more likely to have a diagnosis of BPD. Hypermentalizing is defined as excessive, inaccurate mentalizing. Mentalizing is the ability to infer and attribute thoughts and feelings to understand and predict another person’s behavior.
“Teens do not wake up at 19 and have a personality disorder on the first day of their 19th year, so there must be some precursors to the disorder,” said lead researcher Carla Sharp, associate professor in clinical psychology and director of the Developmental Psychopathology Lab at the University of Houston.
Study on Adolescent BPD
Researchers spent two years investigating the relationship between BPD symptoms and hypermentalizing in more than 100 teenagers ages 12 to 17. The teens were assessed on their social cognition processes by watching and responding to film clips and participating in clinical interviews.
About 25 percent of the teenagers who participated in the study were diagnosed with Borderline Personality Disorder. Those teens had a higher frequency of hypermentalizing responses when asked to describe what the characters in the film clips were feeling and thinking. They were also more likely to misread people’s thoughts.
The study looked at how teens think and whether their thoughts might indicate a personality disorder.
“I am trying to understand the development of the disorder and what happens in the brain, and what happens in the minds of these children as they develop to put them on a different trajectory compared to their peers,” Sharp said.
Importance of Assessing BPD in Teens
Finding a way to assess the presence of Borderline Personality Disorder in teenagers can help with early intervention, BPD treatment, and identification of the disorder.
“The danger of not recognizing the precursors of Borderline Personality Disorder in adolescents is that it can lead to years of confusion and pain for family members and the individual with misdiagnosis, and lack of appropriate treatment,” Sharp said. “These families often go through years of assessment, and people might think it’s Bipolar Disorder, depression, conduct disorder, or comorbidity.”
BPD is not typically diagnosed in adolescence, and many people don’t become aware that they have the disorder until their mid-20s or later.
“Clinicians have been reluctant to diagnose Borderline Personality Disorder in adolescence because there is the notion that personality is not fully developed in childhood and adolescence,” Sharp said. “We know that the brain is only fully developed by age 25, so how can we diagnose a personality disorder in someone if they don’t have a fully developed brain yet?”
This is the question Sharp hopes to answer with her project, “Theory of Mind and Emotion Regulation Difficulties in Adolescents with Borderline Traits,” which was featured in the Journal of the American Academy of Child & Adolescent Psychiatry.
“There’s been a group of people, including myself, advocating that we not necessarily diagnose Borderline Personality Disorder in adolescence, but that we assess for it to make sure that we don’t miss these children.”