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I've been doing a lot of research and have come across some articles that speculate a link between RAD and borderline personality disorder. I've only ever worked with one or two kids who were officially diagnosed as having RAD, but I have worked with a LOT of patients who had borderline personality disorder (adults) or borderline traits (adolescents). One serious concern with people who have borderline personality disorder is suicide risk. They often make many, many suicide attempts without succeeding, but some of these attempts are nonetheless very serious, and some do succeed in killing themselves.
I know that kids with RAD sometimes self-harm and have high pain tolerance (also common with borderline personality disorder), but do they tend to be at risk for suicide attempts (overdosing, tying something around their neck, cutting their wrists or neck, etc.)? I haven't found anything relating to that with regard to RAD in all the reading I've done, so I'm really getting the feeling that the two are completely different disorders that just happen to have a lot of similarities. I know the two girls I worked with who had diagnosed RAD were very different from the girls who had borderline traits.
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Our son has been diagnosed with RAD (as well as ADD, bipolar disorder, PTSD, and borderline traits). He has attempted suicide several times as well as exhibiting some cutting behaviors. I see both symptoms of the RAD and borderline personality disorder. Our daughter was diagnosed with attachment issues (but not full-blown RAD), oppositional defiant disorder, ADHD, PTSD and borderline traits. She has threatened to jump off bridges and out of second story windows, but has never actually made the jump, I believe she did jump out of a moving car once, but that may have been her brother. I see symptoms of borderline personality disorder in her too. As we address the children's diagnoses their suicide risk lessens. In the last 6 months they have only threatened a handful of times and that was more in the heat of "battle." Since diagnosis and treatment of our son's bipolar disorder he has stopped cutting and aggression to himself and others - although he did attempt to obtain drugs a couple of months ago - which could be self-injurious behavior, but was more likely his reaction to our lightening up on his supervision (he is back under almost line of sight supervision again). I've also heard of the link between RAD and BPD, and can definitely see it in my teens.
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We had a 3 year old with RAD who would stick her finger up her nose and dig until she bled. She was facinated with blood. If she had the smallest little boo-boo she'd pick and pick until it got infected. She fell off the curb one time and hit her face on the asphault. Her chin was cut open and not one peep out of her. There was blood gushing and she just sort of dissociated out. Totally blank stare in her eyes! I had never seen someone with such a high pain tolerance.
I know quite a few aged out foster kids who were dx'd with RAD as kids and are definately BPD as adults!
Several of mine hurt themselves when they have any emotion, good or bad. They have extreme tolerances for pain and test that limit almost daily by punching themselves, trying to break their own arms, pulling out chunks of hair, scratching the skin off their arms, and biting their nails way pat the bleeding point. Their more serious attacks on themselves such as trying to hang from the ceiling fan by their neck, cutting themselves with a knife or razor, and running into oncoming traffic have faded away after 2 years.
My daughter has an incredible tolerance for pain. When she was 7, she fell off her swing. We saw her fall and she just got back up and continued playing. A few hours later we found her in her room wrapping her arm up with duct tape. It was broken pretty badly. She said it didn't hurt. However, if she gets a hang nail, the world stops.She threatens suicide on a regular basis. I believe it is an attention getting attempt, but she has some rather bizarre ways that she plans to do it. She says that she will pick at her skin til it gets infected and kills her. She said that she wanted to bang her head on the fireplace hearth til she cracked her head open. She wants to shoot me and then shoot herself. I have found her in her room with a belt around her neck (the other end wasn't attached to anything - I think she missed the concept). Anyway, you get the idea.She picks her nose til it bleeds and then plays with the blood. Really gross.
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Thanks to everyone for sharing your experiences. All these stories definitely remind me of some of the patients with BPD/Borderline Traits with whom I have worked. Indeed, I bet a lot of the kids, especially the ones who had an unusually early onset of severe symptoms, had undiagnosed RAD. I don't think all cases of BPD are from RAD -- most don't have onset of symptoms until adolescence, and often were not abused until long after age 3 -- but there definitely seems to be parallels. I'm beginning to think that BPD, like so many other mental illnessed, has multiple possible causes, though it wouldn't suprise me if the most severe cases have a high correlation with having a history of RAD.