The borderline syndrome in adolescents

The borderline adolescent is discussed in terms of diagnostic perspectives, characteristic features based on disturbed object relations, and treatment. The disorder is not fully manifest in adolescence but gradually emerges into a definable personality type, the various features of which express the unsatisfactory outcome of a complex psychodynamic struggle related to developmental arrests in psychic structure. Based on clinical observations, the diagnosis of borderline personality, like the schizoid personality, is considered to be compatible with a past, present or future schizophrenic disorder. Finally, therapeutic approaches in a day-treatment program, and individual therapy is considered from a developmental object relations viewpoint.     

Identity, sexuality and the self in late adolescence

This paper explores the concepts of identity, sexuality and the self within the context of adolescent development. The development of the identity concept in adolescence is traced in Jung's theoretical, clinical and autobiographical writings. Jung's adolescent development is viewed as the matrix out of which the identity concept emerged within analytical psychology. This was later elaborated theoretically by Jung in Symbols of Transformation (1912/1956). One of Jung's clinical cases of a late adolescent is discussed in which themes related to the development of identity and sexuality emerged. An adolescent case from the author's analytic practice is presented where similar themes of identity, homosexuality and self emerged. The developmental and symbolic themes which emerged in the analysis are viewed within the context of the transference/countertransference relationship.     

The overstimulation of everyday life: I. New aspects of male homosexuality.

Western heterosexual culture surrounds the homosexually inclined boy in a climate of erotic overstimulation that powerfully affects his development and adult sexual adaptation. This assertion is illustrated through a case presentation of a homosexual man who shared a bed with his brother from childhood into adolescence. Analysis of the patient's transference enactment--repeatedly falling asleep on the couch--gradually revealed the psychic impact of this everyday overstimulation: the creation of a tantalized inner world of longing. The regular occurrence and developmental understanding of adolescent homosexual boys' unrequited love affairs with adolescent heterosexual boys are described and explored. Finally, the overstimulation of everyday life is proposed as a new model for understanding certain behavioral aspects of male homosexuality, such as the avoidance of rough-and-tumble play in childhood and homosexual cruising.     

Borderline Personality Disorder in Adolescence Through the Lens of the Interview of Personality Organization Processes in Adolescence (IPOP-A): Clinical Use and Implications

Borderline personality disorder can be assessed in adolescence mainly through a dimensional approach that takes into account strengths and weaknesses of emerging personality patterns. Clinical interviews could help clinicians to gather information about adolescent’s functioning, fostering therapeutic alliance and promoting a mentalizing stance during the assessment of borderline adolescents. In this article, the Interview of Personality Organization Processes in Adolescence (IPOP-A) is presented through clinical case material to show its usefulness in clinical and research settings. The IPOP-A assesses an adolescent’s emerging personality along three dimensions: identity, quality of object relations and affect regulation. These dimensions are the core of borderline personality in adolescence.     

The Relation Between Eating- and Weight-Related Disturbances and Depression in Adolescence: A Review

Depression often emerges during adolescence and persists into adulthood. Thus, it is critical to study risk factors that contribute to the development of depression in adolescence. One set of risk factors that has been recently studied in adolescent depression research is eating- and weight-related disturbances (EWRDs). EWRDs encompass negative cognitions related to one’s body or physical appearance, negative attitudes toward eating, and unhealthy weight control behaviors. However, there have been no comprehensive reviews of EWRDs and depression research that are contextualized within developmental frameworks of adolescent depression. Thus, this review will summarize research findings on the relation between EWRDs and depression in adolescence using a cognitive vulnerability developmental framework. First, a brief overview of epidemiological findings on depression is provided in order to highlight the importance of examining depression in adolescence. Second, a cognitive vulnerability developmental framework that can be used to conceptualize depression in adolescence is described. Next, theories and findings on EWRDs and depression in adolescence are summarized within this framework. Research limitations and suggestions for future research are provided. Finally, implications of this review related to the assessment, intervention, and prevention of depression in adolescence are provided.     

Superego formation, adolescent transformation, and the adult neurosis

The superego is heir to the Oedipus complex but has a much larger developmental legacy which includes preoedipal precursors and the influence of latency and adolescence. The superego continues to change in function and content throughout life, and radical transformation in adolescence may result in developmental discontinuity as well as core developmental continuity. A case is discussed in which adolescence was overlooked in previous analysis and in which adolescent superego modification had a major impact on the patient's character and his adult neurosis. The developmental significance of adolescence experienced under conditions of social isolation and rejection with forebodings of the Holocaust was unrecognized in sanctioned silence and shared analytic denial. These repeated earlier experiences of silent submission and stifled protest, and the silent suffering of the patient and his family, were an integral part of his humiliating and emasculating adolescent experiences. The intimidated adolescent, threatened from within and without, identified with the aggressor as well as with the victim. Identification with the aggressor and glorified victor contributed to a final adolescent structuralization of a punitive, sadistic superego and a rigidly perfectionistic ego ideal. As an adult, he tended to passive masochistic compliance with diminished self-esteem and unconscious self-denigration. He was prone to shame and guilt, self-criticism, and hidden hypercritical attitudes toward others. The adolescent internalization of aggression, intense castration anxiety, and pervasive narcissistic mortification led to retreat from resolution of revived oedipal conflict and to concomitant detrimental superego alteration. These issues were of major importance for analytic understanding and therapeutic progress.     

Adjustment Problems and Emerging Personality Characteristics from Early to Late Adolescence

This 6-year longitudinal study extended earlier findings of contextual influences on adolescent adjustment problems by examining relationships between adolescent emotional and behavioral problems and late adolescent personality among more than 400 youths who were followed from 7th grade to the last year of high school. Results suggest that psychological distress and behavioral problems experienced during the adolescent years (7th–10th grades) are significantly related to personality structure during the final year of high school (12th grade). Psychological distress in adolescence was primarily related to the Multidimensional Personality Questionnaire (MPQ) superfactors of negative and positive emotionality, whereas delinquency and substance use problems were primarily related to the MPQ superfactor of constraint. These relationships remained significant even when personality characteristics in 9th grade were taken into account. That is, emotional and behavioral problems predicted change in personality traits during the adolescent years. Moreover, both initial level and change in distress and problem behaviors were predictive of late adolescent or early adult personality. This finding suggests that personality formation is a dynamic process, dependent on the growth or decline, as well as the magnitude of earlier developmental problems. Because earlier research has shown that these developmental problems are affected by both distal and proximal environmental contexts as well as by the formative nature of adolescence, intervention efforts aimed at the reduction of maladjustment and the enhancement of healthy personality development should target early adolescent social contexts. Other theoretical implications of the findings also are discussed.     

From reassurance to irrelevance: adolescent psychology and homosexuality in America

American psychology by the 1920s contained a greater capacity for viewing some homosexual experiences as normal than most current historical literature suggests. Developmental psychologists agreed with psychiatrists that adult homosexuality was pathological, but they also agreed that adolescent sexual development included a homosexual phase. Until the late 1960s, developmental texts reassured parents and teachers that homosexual behavior among adolescents was transitory and quite normal. The psychiatric view of homosexuality as pathology came under attack after the middle of the century and eventually was abandoned. The developmental concern with a transitory homosexual phase disappeared gradually. This trend in psychology suggests underlying social and cultural changes.     

"You learn and learn and learn.... and then you are an adult": parental perceptions of adolescence in contemporary Swaziland

The developmental period of adolescence is explored in Swaziland from a multidisciplinary perspective. The study compares early anthropological research with contemporary interviews of Swazi parents. While the Swazi language, siSwati, does not have a term for "adolescent," there is evidence of a definite developmental period which could be defined as adolescence. Parents view this period as being qualitatively different from childhood and adulthood, but they also have gender-related interpretations of its nature and length. While biological maturation (especially menarche for females) is viewed as a vital step in becoming an adult, behaviors must be learned during this time (i.e., "adolescence") before one is completely of adult status.     

THE ROLE OF AN IMMIGRANT MOTHER IN HER ADOLESCENT’S IDENTITY FORMATION: “WHO AM I?”

Immigration is a complex bio-psycho-social process and the immigrant mother has a truly complex task in lending her ego strength to her adolescent offspring. The normal adolescence’s decathexis of the love object and the consequent search for a new object may not happen smoothly for those adolescents whose mothers are immigrants. The immigration experience may cause the immigrant mother, who lost her motherland, deeper disturbance in self-identity as well as disequilibrium in her psychic structure, which in turn impacts adversely her adolescent’s development. The adolescent’s inadequate early experience with an immigrant mother may result in a deeper disturbance in his separation-individuation process as well as his identification process. An immigrant mother who has not mourned adequately, with a different sociocultural background has to go through a far more complex development of motherhood. The case of an adolescent boy, Jason, demonstrates the impact of immigrant motherhood on his ego development.     

Counseling Adolescent Males

This article describes the developmental tasks faced by adolescent males. Biological and psychological changes that occur during adolescence are discussed. Finally, common problems encountered by counselors working with adolescent males are reviewed.     

Development of the self-concept during adolescence

Adolescence is a period of life in which the sense of 'self' changes profoundly. Here, we review recent behavioural and neuroimaging studies on adolescent development of the self-concept. These studies have shown that adolescence is an important developmental period for the self and its supporting neural structures. Recent neuroimaging research has demonstrated that activity in brain regions associated with self-processing, including the medial prefrontal cortex, changes between early adolescence and adulthood. These studies indicate that neurocognitive development might contribute to behavioural phenomena characteristic of adolescence, such as heightened self-consciousness and susceptibility to peer influence. We attempt to integrate this recent neurocognitive research on adolescence with findings from developmental and social psychology.     

Affectivity: Regulation,Identity Formation,and Metaphorical Thought

ABSTRACT

Understanding affects, and their multiple roles in all aspects of the human condition and development, has more and more become a focus of study for contemporary psychoanalysis. Psychodynamic personality theories have always regarded affective life as pivotal to developmental experiences, the evolving structures of the personality, identity formation, and clinical processes. The centrality of emotion in development and affect regulation, as a maturational theme in the adolescent stage, are explored through the views afforded by object relations theory and ego psychology, intersubjectivity, the second separation individuation process, and unconscious metaphorical thought in the dream states of two clients and their therapist.     

Parent–Adolescent Collaboration: An Interpersonal Model for Understanding Optimal Interactions

Current parent–adolescent behavioral interaction research highlights the importance of three elements of behavior in defining adaptive interactions: autonomy, control, and warmth vs. hostility. However, this research has largely addressed the developmental needs and psychosocial outcomes of adolescents, as opposed to parents, with a focus on how parent and adolescent behaviors influence adolescent adaptation. This paper utilizes both adolescent and mid-life developmental research, as well as parent–adolescent interaction research, to introduce a model for conceptualizing parent–adolescent interactions as a transactional process in which both parental and adolescent development are considered. Further, ideas are presented describing how adaptive parent–adolescent interactions may change across adolescence. The concept of collaboration is proposed as a conceptual tool for assessing one form of adaptive parent–adolescent interactions. The structural analysis of social behavior (SASB) is presented as a model for studying the complex reciprocal processes that occur in parent–adolescent interpersonal processes.     

Parallel Group Treatment of Pre-School Children and Their Mothers

Object relations concepts are applicable in children's group psychoanalytic psychotherapy. The author attempts to explore and delineate areas in which developmental conflicts in object relations, emotional deprivations, traumas, and family pathologies are recapitulated in the group, and how the manifestations of pathologies can be rectified by the process and formation of the group and the role of the therapist as a “new object” in the management of individual and group transferences. Clinical examples are presented.     

“Sinking Into the Ground”: The Development and Consequences of Shame in Adolescence

Although in recent years the developmental antecedents and clinical consequences of shame have received increased theoretical and research attention, little is yet known about shame's development after early childhood or its role in developmental psychopathology. This article reviews the literature on shame and on adolescence and suggests that attention to the role of shame in adolescent development is warranted for several reasons. Social-cognitive, physical, and interpersonal changes associated with adolescence may each be associated with normative increases in shame during adolescence. In addition, several lines of evidence converge to suggest that shame may be implicated in some of the important gender-related shifts in self-esteem and developmental psychopathology that occur over the adolescent years.     

Convergence and Non-convergence in the Quality of Adolescent Relationships and its Association with Adolescent Adjustment and Young Adult Relationship Quality

With the aim of identifying and examining both converging (matched relationship quality across one's set of relationships) and non-converging (mixed relationship quality across one's set of relationships), the present study used a pattern-centered approach to examine the different ways adolescent relationships pattern together among a large, national sample of U.S adolescents (aged 13-19). The study also examined how adolescent adjustment and young adult relationship quality varied across the different relationship patterns or constellations. The current study used latent class analysis and data from Add Health (n = 4,233), a national U.S. longitudinal study that spans adolescence and young adulthood, to uncover heterogeneity in adolescent relations with parents, friends, romantic partners, peers, and teachers. As predicted, patterns of both convergence and non-convergence were found, though patterns of non-convergence were more common than expected. Some patterns of non-convergence appear more stable (i.e., similar pattern found during both adolescence and young adulthood) than others. Also, no "high" converging pattern was found, indicating that few adolescents have "first-rate" relations in every relational domain.     

Cognitive development and adolescent contraception: integrating theory and practice

The cognitive skills that develop during adolescence are crucial to successful contraceptive practice because most birth control methods require at least a minimal ability to plan for, acquire, and utilize them at the appropriate time. Consequently, we must understand the special developmental setting in which adolescent sexual growth and experimentation occurs in order to have an impact on their contraceptive use. To provide optimal service to adolescents, the developmental and medical aspects should be taken into account in order to determine the best choice for each patient. This article demonstrates how mental health and medical providers can work together to better serve the adolescent population.     

Development of relational reasoning during adolescence

Non-linear changes in behaviour and in brain activity during adolescent development have been reported in a variety of cognitive tasks. These developmental changes are often interpreted as being a consequence of changes in brain structure, including non-linear changes in grey matter volumes, which occur during adolescence. However, very few studies have attempted to combine behavioural, functional and structural data. This multi-method approach is the one we took in the current study, which was designed to investigate developmental changes in behaviour and brain activity during relational reasoning, the simultaneous integration of multiple relations. We used a relational reasoning task known to recruit rostrolateral prefrontal cortex (RLPFC), a region that undergoes substantial structural changes during adolescence. The task was administered to female participants in a behavioural (N = 178, 7-27 years) and an fMRI study (N = 37, 11-30 years). Non-linear changes in accuracy were observed, with poorer performance during mid-adolescence. fMRI and VBM results revealed a complex picture of linear and possibly non-linear changes with age. Performance and structural changes partly accounted for changes with age in RLPFC and medial superior frontal gyrus activity but not for a decrease in activation in the anterior insula/frontal operculum between mid-adolescence and adulthood. These functional changes might instead reflect the maturation of neurocognitive strategies.