The diagnosis that should speak its name: why it is ethically right to diagnose and treat personality disorder during adolescence
Although national guidelines explicitly state that personality disorder can be diagnosed and treated in young people aged 12 to 18 years (adolescents), most clinicians remain hesitant. This creates a gap between science and practice, which we argue is largely motivated by moral reasons and, therefor...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Psychiatry |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1130417/full |
| _version_ | 1797831043730898944 |
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| author | Joost Hutsebaut Joost Hutsebaut Sharon L. Clarke Sharon L. Clarke Andrew M. Chanen Andrew M. Chanen |
| author_facet | Joost Hutsebaut Joost Hutsebaut Sharon L. Clarke Sharon L. Clarke Andrew M. Chanen Andrew M. Chanen |
| author_sort | Joost Hutsebaut |
| collection | DOAJ |
| description | Although national guidelines explicitly state that personality disorder can be diagnosed and treated in young people aged 12 to 18 years (adolescents), most clinicians remain hesitant. This creates a gap between science and practice, which we argue is largely motivated by moral reasons and, therefore, is best challenged by ethical arguments. We provide seven arguments in support of the notion that it is ethically right to diagnose and treat personality disorder when it occurs in adolescents. Central to these arguments is the scientific evidence that features of personality disorder are among the best predictors of a complex cluster of psychopathology leading to impairments in many areas of current and future mental, social and vocational functioning. We argue that intervention during adolescence and young adulthood is not only humane, but also critical for efforts to avert the longstanding psychosocial and health problems that seem refractory to treatment in adults with personality disorder. Moreover, we argue that regular services are often inadequately equipped to meet the needs of young people with personality disorder and that the common ‘stepped-care’ approach should be replaced by a ‘staged-care’ approach. Finally, we argue that early detection and intervention might have anti-stigmatizing effects, similar to other areas of healthcare in which stigmatizing labels have changed meaning when the conditions to which they refer have become more amenable to treatment. |
| first_indexed | 2024-04-09T13:45:45Z |
| format | Article |
| id | doaj.art-369a053f9bac4e7fbdde05511676ad05 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-09T13:45:45Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-369a053f9bac4e7fbdde05511676ad052023-05-09T04:31:29ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402023-05-011410.3389/fpsyt.2023.11304171130417The diagnosis that should speak its name: why it is ethically right to diagnose and treat personality disorder during adolescenceJoost Hutsebaut0Joost Hutsebaut1Sharon L. Clarke2Sharon L. Clarke3Andrew M. Chanen4Andrew M. Chanen5Department of Medical and Clinical Psychology, Tilburg University, Tilburg, NetherlandsViersprong Institute for the Study on Personality Disorders, Halsteren, NetherlandsDepartment of Medical and Clinical Psychology, Tilburg University, Tilburg, NetherlandsViersprong Institute for the Study on Personality Disorders, Halsteren, NetherlandsOrygen, Melbourne, VIC, AustraliaCentre for Youth Mental Health, The University of Melbourne, Parkville, VIC, AustraliaAlthough national guidelines explicitly state that personality disorder can be diagnosed and treated in young people aged 12 to 18 years (adolescents), most clinicians remain hesitant. This creates a gap between science and practice, which we argue is largely motivated by moral reasons and, therefore, is best challenged by ethical arguments. We provide seven arguments in support of the notion that it is ethically right to diagnose and treat personality disorder when it occurs in adolescents. Central to these arguments is the scientific evidence that features of personality disorder are among the best predictors of a complex cluster of psychopathology leading to impairments in many areas of current and future mental, social and vocational functioning. We argue that intervention during adolescence and young adulthood is not only humane, but also critical for efforts to avert the longstanding psychosocial and health problems that seem refractory to treatment in adults with personality disorder. Moreover, we argue that regular services are often inadequately equipped to meet the needs of young people with personality disorder and that the common ‘stepped-care’ approach should be replaced by a ‘staged-care’ approach. Finally, we argue that early detection and intervention might have anti-stigmatizing effects, similar to other areas of healthcare in which stigmatizing labels have changed meaning when the conditions to which they refer have become more amenable to treatment.https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1130417/fullpersonality disorderpsychopathologyadolescentspreventionearly detectionearly intervention |
| spellingShingle | Joost Hutsebaut Joost Hutsebaut Sharon L. Clarke Sharon L. Clarke Andrew M. Chanen Andrew M. Chanen The diagnosis that should speak its name: why it is ethically right to diagnose and treat personality disorder during adolescence Frontiers in Psychiatry personality disorder psychopathology adolescents prevention early detection early intervention |
| title | The diagnosis that should speak its name: why it is ethically right to diagnose and treat personality disorder during adolescence |
| title_full | The diagnosis that should speak its name: why it is ethically right to diagnose and treat personality disorder during adolescence |
| title_fullStr | The diagnosis that should speak its name: why it is ethically right to diagnose and treat personality disorder during adolescence |
| title_full_unstemmed | The diagnosis that should speak its name: why it is ethically right to diagnose and treat personality disorder during adolescence |
| title_short | The diagnosis that should speak its name: why it is ethically right to diagnose and treat personality disorder during adolescence |
| title_sort | diagnosis that should speak its name why it is ethically right to diagnose and treat personality disorder during adolescence |
| topic | personality disorder psychopathology adolescents prevention early detection early intervention |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1130417/full |
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