Divergent mentalization types in adolescent borderline personality disorder and attention deficit/hyperactivity disorder

Abstract

Background

Attention deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD) have several similarities and it is difficult to distinguish these disorders in adolescents. We aimed to identify the unique correlates of mentalization abilities that may distinguish these two disorders, and to investigate the mentalization abilities of adolescents with ADHD, BPD and ADHD + BPD in an inpatient sample to determine the effect of co-morbidity on mentalization abilities.

Methods

We have explored the relationship between Child Eye Test (CET) scores, Movie for the Assessment of Social Cognition (MASC) subscales, and ADHD and BPD symptoms in adolescent inpatients. In addition, we compared ADHD, BPD and ADHD + BPD groups in terms of their mentalization abilities.

Results

Correct MASC scores were negatively associated with both ADHD and BPD symptoms in girls, and negatively associated with ADHD symptoms in boys. In addition, hypermentalization scores were associated with BPD symptoms in girls, and hypomentalization and no mentalization scores were associated with ADHD symptoms in girls. CET scores were negatively associated with ADHD symptoms in girls, but no relations with BPD were found. Group comparisons revealed no significant difference among groups.

Limitations

We included only inpatient sample without considering their medication condition, we did not compare the mentalization scores of the patient groups with healthy controls and we used self-report measures for several assessments.

Conclusion

Mentalization patterns in ADHD and BPD are distinct. ADHD may be related to hypomentalization, instead, BPD may be related to hypermentalization.

Keywords:

• Attention deficit/hyperactivity disorder
• borderline personality disorder
• mentalization
• social cognition
• adolescent

Disclosure statement

No potential competing interest was reported by the authors.

Notes on contributors

Ömer Faruk Akça (MD) is an Associate Professor in the Child and Adolescent Psychiatry Department of Necmettin Erbakan University, Meram School of Medicine. He is also the director of the outpatient clinic of the department.

Kiana Wall is a graduate student in the University of Houston’s Clinical Psychology doctoral program, under the mentorship of Dr. Carla Sharp.

Carla Sharp is a Professor in University of Houston Department of Psychology. She is also director of Developmental Psychopathology lab of the department.

Additional information

Funding

Dr. Akça’s work was supported by the Scientific and Technological Research Council of Turkey (TUBITAK) under Grant 1059B191700955. Dr. Sharp’s research was supported by the McNair Family Foundation.