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Bridging the gap: the assessment and treatment of adolescent personality disorder in routine clinical care
  1. Carla Sharp1,2
  1. 1Department of Psychology, University of Houston, Houston, Texas, USA
  2. 2Centre for Development Support, University of the Free State, South Africa
  1. Correspondence to Dr Carla Sharp, Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX 77204, USA; csharp2{at}


Despite a marked increase in research supporting the assessment, diagnosis and treatment of personality disorder (PD) in adolescence, clinicians continue to be reluctant to apply treatment guidelines and psychiatric nomenclature in routine clinical care. This gap arises from several beliefs: (1) psychiatric nomenclature does not allow the diagnosis of PD in adolescence; (2) certain features of PD are normative and not particularly symptomatic of personality disturbance; (3) the symptoms of PD are better explained by other psychiatric syndromes; (4) adolescents' personalities are still developing and therefore too unstable to warrant a PD diagnosis; and (5) because PD is long-lasting, treatment-resistant and unpopular to treat, it would be stigmatising to label an adolescent with borderline personality disorder (BPD). In this paper, the empirical evidence challenging each of these beliefs is evaluated in the hope of providing a balanced review of the validity of adolescent PD with a specific focus on BPD. The paper concludes with recommendations on how routine clinical care can integrate a PD focus.

  • Child Psychiatry
  • Adolescent Health

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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