Cause
The causes of the borderline syndrome in children are seen as an interaction between environmental influences that are applied and those that come from outside. For example, a certain personality structure or the occurrence of psychiatric illnesses in the family can favour the development of a borderline syndrome. However, environmental influences such as upbringing, the relationship with parents and similar caregivers, traumatic experiences and abuse in childhood can also have a favourable effect.
Emotional coldness in the parent-child relationship, as well as neglect and abuse, can have a negative effect on the child’s development, particularly in terms of social skills, and can favour the development of a borderline personality disorder in children. Sexual abuse in particular plays a role in the borderline syndrome, but other traumatic experiences such as fear of death or extreme helplessness can also occur if they are not processed properly. Although family circumstances play an important role in childhood, relationships with peers are just as important during puberty.
Difficulties in dealing with peers in children can therefore also be important risk factors for the development or course of a borderline syndrome. Some temperamental characteristics in childhood also allow conclusions to be drawn about the later development of a borderline syndrome. For example, shy children who also show neurotic personality traits, i.e. a tendency to have a negative world view and overestimate stress factors, are more susceptible.
However, these factors only play a role in children to the extent that these factors are not prevented in their pathological manifestation by loving family contact and by learned social skills and stress management strategies. Traumatic events in childhood and self-esteem or self-perception problems are often mentioned as the causative or at least influencing factors of a borderline disorder. Thus, a neglectful upbringing can promote a borderline disorder, while a loving and encouraging upbringing reduces the probability of symptoms occurring. Due to the many other influencing factors, however, this connection cannot be clearly found in every patient.
Therapy of a borderline syndrome in children
There are no drugs that would influence the basic causes of borderline syndrome. Appropriate medication can be used to treat borderline symptoms such as depression or mood swings. These would be, for example, antidepressants or the mood stabilizer lithium.
Since traumatic experiences are often the cause of borderline syndrome in children, it is advisable to choose a psychological therapy method that helps those affected to process their inner problems and experiences. A frequently used method is DBT (dialectical-behavioural therapy), which has a favourable influence especially with regard to changing harmful behaviour. In the case of borderline syndrome, this would include, among other things, self-harming and self-damaging behaviour, suicidal intentions and destructive behaviour on a partnership, family or social level.
One focus is on trusting and encouraging interaction within the therapy, the aim of which is a constructive and clearly defined work alliance with clear objectives regarding the desired change in behaviour. The patient is not only taken into responsibility, but is also to be made aware that his point of view is heard and understood. The therapeutic interventions are carried out especially on the level of inner and outer mindfulness.
Skills of appropriate stress management and better control and regulation of emotions are to be taught. The therapeutic methods applied can include skill training, group behaviour therapy, mindfulness group, behaviour testing, self-help oriented practice groups and social counselling. Other forms of therapy such as art or occupational therapy or movement therapy can also be used.
