Severe personality disorder emerging in childhood: a proposal for a new developmental disorder.
BACKGROUND
The concept of 'severe personality disorder' is currently applied to adults with a history of serious antisocial and offending behaviour. There is, however, no similar classification that can be applied to the sub-group of children and adolescents who display persistent and serious offending from an early age. This omission from diagnostic nomenclature prevents the appropriate early identification, assessment and management of these young people.


METHODS
This paper therefore proposes a new developmental disorder: 'severe personality disorder emerging in childhood'. The existing evidence base strongly supports the presence of a developmental trajectory from childhood to adult life for the small number of children who show early signs of severe personality disorder (SPD). Based on a review of the literature and the experience of working in a specialist, forensic Child and Adolescent Mental Health Service (CAMHS), a multi-factorial model is proposed that outlines the developmental trajectory of SPD. This model includes neurobiological, psychosocial, environmental and systemic factors, within a developmental framework, and contributes to a more developmentally appropriate understanding of the genesis of severe personality disorder.
Vizard
Eileen
E
The Young Abusers Project, The Peckwater Centre, London, UK. e.vizard@ucl.ac.uk
French
Lesley
L
Hickey
Nicole
N
Bladon
Emily
E
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000523:psychology*; D019955:Conduct Disorder / Q000175:diagnosis / Q000523:psychology; D006801:Humans; D007398:Interpersonal Relations; D008960:Models, Psychological; D009484:Neuropsychology; D010554:Personality Disorders / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D012742:Sex Offenses / Q000523:psychology; D006113:United Kingdom