Introduction
Borderline syndrome is a personality disorder and as such is not diagnosed as such according to common diagnostic criteria until the beginning of adulthood. However, there are children who show similar symptoms and who are diagnosed with a borderline personality disorder, even if this is only partially reflected in the official criteria for diagnosis. These children who suffer from borderline personality disorder have often experienced severe stress in interpersonal and family relationships or traumatic events.
The children suffer from an unsteady, delayed or disturbed development, a self-esteem disorder as well as aggressiveness and impulsiveness. They are characterized by fearful and clinging relationships with caregivers and contact problems with peers. The borderline syndrome in children, like in adults, is characterized by unstable human relationships, which alternately go hand in hand with the idealization of the partner or the devaluation of the own person.
This includes a disturbed self-esteem as well as persistent states of emptiness and boredom and the inability to be alone. Self-harming behaviour up to attempted suicide is also one of the significant symptoms. Impulsive and sometimes aggressive behaviour and severe mood swings can also occur in the borderline syndrome.
In addition to the listed criteria of the borderline personality disorder, it must be ensured that this disorder is persistent and pervasive and it is considered unlikely that it is limited to only one developmental stage. Mood swings, for example, can occur more frequently during puberty, but in this context they are a natural and life-essential phenomenon. They must be clearly distinguished from pathological mood swings in order to enable correct therapy.
This is made more difficult by the fact that the transition between normal and pathological behaviour is often fluid. Therefore, in the case of borderline personality disorder, careful attention must be paid to how severe and how often the symptoms described above occur. As with many psychiatric diseases, borderline personality disorder combines a wide range of symptoms of various degrees of severity.
A difference between the sexes has also been demonstrated. Girls are more susceptible to self-harming behaviour, emotional instability and long-lasting feelings of loneliness and emptiness. Boys on the other hand often suffer from weak impulse control.
Aggression and tantrums are among the typical symptoms of a borderline disorder. However, this also occurs regularly in healthy children, especially when they are tired or denied something. Aggression due to the child’s selfishness is therefore normal.
However, particularly frequent unprovoked aggressions or unprovoked tantrums without a trigger indicate an inner conflict of the child and are more often found in borderline patients. Self-injurious behaviour is very common in borderline disorders, especially in adolescent patients. Such behaviour such as scratching (self-harm with a blade or similar, usually on the arms or legs) is rather rare in children. But kicking against oneself or banging one’s head against a wall are also considered self-injury and can be observed in childhood. These symptoms indicate a serious disorder and clearly distinguish borderline syndrome from natural mood swings and the like at this age.
