A Network Approach to Understanding and Diagnosing Adolescent Borderline Personality Disorder

Abstract

Borderline personality disorder is a prevalent mental disorder characterized by instability in emotion regulation, interpersonal relationships,
impulse control, and self-image and a high mortality rate due to suicide. Adolescent borderline personality disorder is a heavily debated topic as
personality disorders are not formally diagnosed until age 18 and personality is still developing during adolescence, but borderline personality
disorder has been found to be just as reliable in adolescents as in adults, and adolescents can benefit from early intervention and targeted treatment. The DSM employs a categorical approach to psychopathology in which disorders are viewed as distinct entities that cause symptom occurrence and covariance, but this framework fails to reconcile heterogeneity within disorders, symptom overlap across multiple disorders, and high rate of comorbidity among mental disorders. I propose taking a network approach to adolescent borderline personality disorder, which postulates that mental disorders can be conceptualized and studied as systems of interconnected, mutually reinforcing symptoms. Studying patterns of symptom dynamics, such as node activity and connectivity between nodes, through a network architecture could yield vital insights into what tips the metaphorical scale from normal to maladaptive during development. These insights can inform key periods of intervention and more targeted treatment options for psychopathology, equipping patients with tools to better cope with symptoms and focusing on deactivating central nodes, which in turn downregulate the activity of connected nodes