Diagnosis of Personality Disorders in Children
The time has finally come to take the diagnosis of Personality Disorders in children and adolescents more seriously. Personality Disorders, by definition, involve an ongoing pattern of inflexible or maladaptive behaviors and interactions that result in significant functional impairment and are of sufficient severity to cause dis tress. Diagnostic categories are listed in Table 17.1. Manifestations of most Personality Disorders are often recognizable by adolescence or earlier and most may be diagnosed in children or adolescents, with the exception of Antisocial Personality Disorder. Conduct Disorder, by definition, is a precursor of Antisocial Personality Disorder, which is not diagnosed under age 18. A Personality Disor der diagnosis should be made only when the characteristic features are typical of the child or adolescent's long-term functioning and when the maladaptive personality traits appear to be stable, al though there are virtually no data about their persistence into adulthood. DSM-IV has largely abandoned the parallel between Axis I childhood and adolescent disorders with Axis 0 Personality Disorders (e.g., Avoidant Disorder of Childhood or Adolescence is gone).