Symposia
ADHD - Child
Rosanna Breaux, Ph.D.
Assistant Professor
Virginia Tech
Blacksburg, Virginia
Annah R. Cash, BS
Clinical Psychology Doctoral Student
Virginia Tech
Blacksburg, Virginia
Elizabeth A. DeLucia, MS
Graduate Student
Virginia Polytechnic Institute and State University
Virginia Polytechnic Institute and State University
Blacksburg, Virginia
Katelyn Garcia, PhD
Graduate Student
Virginia Tech
Blacksburg, VA
Delshad Shroff, MA
Graduate Student
Virginia Polytechnic Institute and State University
Blacksburg, VA
Courtney Swanson, M.S.
Graduate Student
Virginia Polytechnic Institute and State University
Blacksburg, Virginia
Background. There has been growing recognition of the overlap in symptomatology and impairment (e.g., impulsivity, emotion dysregulation) between borderline personality disorder (BPD) and attention-deficit/hyperactivity disorder (ADHD), and that ADHD may serve as a pre-cursor to BPD (e.g., Akça et al., 2020; Storebø & Simonsen, 2014). However, the first line treatment for BPD, Dialectical Behavioral Therapy, is often not available for adolescents without a formal BPD diagnosis. As such, it is important to explore whether existing psychosocial treatment options for adolescents with ADHD may improve BPD features (BPF). One promising intervention is the RELAX (Regulating Emotions Like An eXpert) intervention (Breaux & Langberg, 2020; Breaux et al., 2021), which targets emotion dysregulation and interpersonal conflict among families of adolescents with ADHD. Methods. Participants included 20 adolescents who were comprehensively diagnosed with ADHD (ages 11-14 years; 14 males) and a caregiver (14 mothers, 6 fathers). Adolescents displayed a range of comorbid diagnoses: 10 comorbid anxiety disorder, 3 comorbid autism spectrum disorder, 3 comorbid language and/or processing disorder, 2 comorbid oppositional defiant disorder, and 1 comorbid post-traumatic stress disorder. Families participated in the 8-session RELAX intervention via telehealth across four therapy groups spanning October 2020 – August 2021. BPF were measured using adolescent self-report on the Borderline Personality Features Scale for Children (BPFS-C; Crick et al., 2005). BPF means were consistent with inpatient adolescent non-BPD samples, but significantly lower than inpatient adolescent BPD samples (Chang et al., 2011). Results. RELAX resulted in a significant decrease in BPF from pre (M=60.25, SD=9.10) to post-intervention (M=56.75, SD=9.58), d=0.37. BPF symptoms further decreased from post-intervention to the 6-month follow-up (M=53.60, SD=10.72), d=0.31. This improvement in BPF was driven by significant decreases in the Negative Relationships and Self-Harm subscales of the BPFS-C, with non-significant change on the Affective Instability and Identity Problems subscales. Conclusions. Results suggest that a brief, low-cost, group-based telehealth intervention can result in significantly reduced BPF among adolescents with ADHD. Future research should seek to examine mediators of treatment response for BPF in this at-risk clinical population, and whether treatment for ADHD during adolescence can reduce risk for development of BPD in adulthood.