Personality disorders are complex and often misunderstood conditions that can significantly impact an individual’s life. Diagnosing these disorders in children is particularly challenging due to the dynamic nature of childhood and adolescence, and the potential for misinterpretation of symptoms.
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Diagnosing Personality Disorders in Children
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a personality disorder can technically be diagnosed in individuals under 18 if the features have been present for at least one year. However, it is incredibly unusual and almost unheard of to diagnose a personality disorder in children under 13.
In practice, clinicians often use placeholder diagnoses until the individual reaches adulthood. This approach allows for treatment and intervention without the potential stigma and permanence of a personality disorder diagnosis. For instance, a child displaying symptoms of borderline personality disorder might be diagnosed with Oppositional Defiant Disorder or ADHD until they reach adulthood.
Challenges in Diagnosis
Diagnosing personality disorders in children is challenging due to several reasons. Adolescence is a period of change and turmoil, making it difficult for clinicians to distinguish between normal identity questioning and the symptoms of a personality disorder. Many clinicians are reluctant to diagnose personality disorders during youth, viewing pediatric personality deviations as reflective of given developmental stages. Lastly, the symptoms of personality disorders can be similar to those of other childhood disorders like ADHD and Oppositional Defiant Disorder, leading to potential confusion in diagnosis.
Common Personality Disorders in Children
The most commonly diagnosed personality disorders in children and adolescents are borderline personality disorder and antisocial personality disorder. Other personality disorders that can occur in children include paranoid personality disorder, schizotypal personality disorder, schizoid personality disorder, histrionic personality disorder, and narcissistic personality disorder.
Signs of Personality Disorders in Children
Signs that a child may have a personality disorder can include intense emotional reactions that seem disproportionate to the situation, severe mood swings, difficulty calming down once upset, impulsivity, recklessness, risky behaviors, sudden changes in plans and goals, and unstable relationships. Children potentially displaying early signs of a personality disorder may fluctuate between idealizing and devaluing their friends, have intense and short-lived friendships, and fear of real or imagined abandonment. These signs are similar to those seen in adults with personality disorders, but they may be interpreted differently in children due to their developmental stage.
While personality disorders can technically be diagnosed in children, it’s more common for clinicians to use placeholder diagnoses until the individual reaches adulthood. This approach allows for treatment and intervention without the potential stigma and permanence of a personality disorder diagnosis.
Avedian Counseling Center is on a mission to empower individuals, couples, and families to achieve balance, healing, and fulfillment by providing counseling in a safe environment. Contact us today at (818) 383-1399 to learn more.
Sipan Nazaryan is an Associate Marriage and Family Therapist and a Certified Anger Management Counselor with offices in Sherman Oaks and Glendale. He works with adults and teens providing a comfortable and confidential environment for in-person sessions and telehealth appointments. Sipan has helped numerous people manage their aggressive behavior and their mental health journey. He facilitates numerous weekly anger management classes. Fluent in both English and Armenian, Sipan brings a culturally sensitive approach to his practice, making him accessible to a broad range of individuals seeking mental health support.
