Stepson With Personality Disorder

Question:

My youngest stepson will be 9 years old next month. My husband and I have been married for 5 years and he has had custody for 6 six years. The separated when the youngest was a year old. The birth mother is very unstable and exhibits many signs of several personality disorders. She has never been a positive influence in my stepson’s lives and she has not seen or spoken to them in over two years. He is starting to show signs of a personality disorder. Is that possible at his age? Are there resources I can research to find out more. I would like to identify this as a problem early on and help him adapt if possible. I am so worried about him.

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Answer:

A good starting place resource to look at when wanting to learn more about personality and child disorders is the Diagnostic and Statistical Manual of Mental Disorders, currently in its fourth (revised) edition. A copy is probably available at your local library. The DSM (the book containing definitions of mental illnesses and syndromes) is a political document as much as it is anything else. The book’s aim is to classify disorders based on their scientific distinctiveness rather than on theoretical considerations. While it does a good job meeting this goal with some families of diagnoses, it does rather poorly in other areas, one of which is the personality disorders which are as a group a typology of inflexible social and emotional adaptations. Personality disorders were originally organized into their present form for political and theoretical reasons – they are a remnant from a time when psychoanalysis ruled the medical establishment and evidenced based science was not considered as important. This isn’t to say that there is nothing to the idea of personality disorders; quite the contrary there is a lot of evidence supporting the validity of some of these diagnoses. It is the case however, that some of the classifications of personality disorder have held up better than others to the light of scientific scrutiny.

Personality disorder diagnoses proper are not generally applied to children. However, there are several childhood disorders, such as Oppositional Defiant Disorder, that are related to adult personality disorders (e.g., Antisocial Personality Disorder) and children can certainly show a range of personality-disorder-like behaviors too. Some of the children that display personality disorder symptoms and behaviors will grow up to merit a personality disorder diagnosis.

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All of this is background. If your son (step or not) is having difficulty adjusting socially, it is time for your family to visit with a child psychologist. Through play therapy and hopefully also parent training, a child psychologist can help your son to learn new more flexible and effective ways of coping with his environment and can additionally help you to learn how to interact with your son so as to best help him get past his problem behavior.

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