ASSESSING BORDERLINE PERSONALITY DISORDER IN ADOLESCENCE ACCORDING TO THE PSYCHODYNAMIC DIAGNOSTIC MANUAL-2 (PDM-2) CLINICAL FRAMEWORK

Assessing borderline personality disorder (BPD) in adolescence is very difficult due to its high symptom heterogeneity and severity. This study aimed to provide an empirically valid and clinically rich portrait of BPD identifying specific subtypes in borderline adolescent patients according to the PDM-2 framework. Fifty clinicians completed the Psychodiagnostic Chart-Adolescents of the PDM and the Therapist Response Questionnaire-Adolescents. Patients filled in the Defense Mechanisms Rating Scales-Self-Report-30. Three emerging personality profiles were identified. The emotionally dysregulated subtype, characterized by the strong use of splitting, projective identification, acting, was positively related to angry/criticized and disorganized therapist responses. The impulsive–histrionic subtype, characterized by disavowal and minor image-distorting defenses, acting, was positively related to angry/criticized and sexualized therapist responses. The dependent–victimized subtype, characterized by depressive defenses, was negatively related to overinvolved/ worried therapist response. A more differentiated view of BPD may have relevant treatment implications and may help plan individualized and effective interventions in adolescence.