Introduction to the Special Issue

It gives me great pleasure to introduce this special issue dedicated to Advances in Understanding and Treating Borderline Personality Disorders in Adolescents. During the past decade there has been an exciting “awakening” among clinicians and researchers regarding the importance of making services available for adolescents with borderline personality disorder. We owe this in part to pioneers and tireless advocates like Paulina Kernberg, who demonstrated that personality disorders were evident and recognizable in children and adolescents. She stressed the importance of intervening as early as possible to decrease the risk of maladaptive patterns becoming entrenched and to re-establish a more normal developmental path so that the child or adolescent could benefit from educational and social opportunities. Today the vision of these pioneers is becoming a reality, and clinicians in hospitals, clinics, and private practice recognize the need to provide and develop treatments specifically geared to this population.

The contribution by Powers and Casey provides an overview from a world expert on neurobiological changes specific to adolescence that explains why adolescence is a particular risk period for the manifestation of psychopathology. There have been important advances in neurobiological research, and while it is not always easy to link these developments to our clinical models, we must continue attempts at integration until we can bridge the gaps meaningfully.

In the next article, Steele, Bate, Nikitiades and Buhl-Nielsen provide an excellent critical overview and nuanced reflection on why attachment is important for understanding adolescents with borderline personality disorder. This is complemented by a fascinating article in which Sharp and Vanwoerden present their important findings clarifying that adolescents with borderline personality do not show global deficits in the capacity to think about social interactions in mental state terms, but instead have problems