Considerations in Transition of Pediatric Neurology Patients to Adult Care.

Personality disorders (PD) represent a major challenge in mental health care due to their pervasive impact on social, occupational, and daily functioning, as well as overall mental wellbeing. They are characterized by enduring patterns of maladaptive cognition, affect regulation, and interpersonal difficulties, which contribute to substantial distress and functional impairments (; ). Although evidence-based psychotherapies—such as schema therapy, dialectical behavior therapy, and mentalization-based treatment—effectively reduce symptom severity (; ), their effects on social participation, occupational functioning, and long-term mental wellbeing remain modest and heterogeneous (). These limitations underscore the need for approaches that extend beyond symptom reduction to address broader dimensions of recovery. From a developmental perspective, personality disorders (PD) can be understood as the outcome of disrupted self-development processes that emerge during adolescence. Rather than arising in adulthood, personality pathology is thought to reflect earlier disturbances in identity formation and self-functioning (). Longitudinal research suggests that impairments in identity integration and self-definition during adolescence are associated with later personality dysfunction (). These disruptions may contribute to enduring difficulties in self-regulation, interpersonal functioning, and identity stability. Emerging evidence further indicates that interventions targeting personality functioning can lead to meaningful improvements, particularly in identity-related domains (). This developmental perspective is relevant to the present study because it suggests that interventions targeting self-related capacities, such as self-compassion, may address processes central to personality pathology. Self-compassion may be particularly relevant within this framework because it reflects an adaptive form of self-relating that may counteract disruptions in identity formation and self-functioning. Self-compassion involves responding to personal suffering with kindness, non-judgment, and understanding () and has been shown to buffer the association between emotional distress and borderline features in adolescents (). In addition, self-compassion has been identified as a potential mechanism linking supportive interpersonal experiences to better mental health outcomes (). Together, these findings suggest that interventions targeting self-related processes, including self-compassion, may be relevant for addressing core features of personality dysfunction. This may be particularly relevant for individuals with PD, who often experience elevated shame and self-criticism. Positive Psychology Interventions (PPIs) delivered without sufficient attention to emotional safety may sometimes be experienced as invalidating or unattainable in individuals with severe psychopathology. Integrating compassion-based principles may therefore help create a safer context in which positive psychological resources can be explored. Individuals with severe mental illness, including PD, often experience chronic distress, long treatment histories, and impairments across multiple life domains (; ; ). This highlights the importance of interventions that promote positive mental health. Positive mental health, or mental wellbeing, comprises emotional, psychological, and social wellbeing () and can be defined as the ability to experience joy, meaning, engagement, and relatedness—even in the presence of mental health difficulties (). Lower levels of mental wellbeing and psychological wellbeing in particular, constitute a robust risk factor for the onset and recurrence of mental disorders (; ; ; ). Psychological wellbeing closely aligns with the concept of personal recovery (; ; ), which is conceptualized as an individualized, self-directed process through which individuals regain agency, identity, and purpose. Personal recovery emphasizes living a meaningful life grounded in personal strengths and values rather than focusing solely on symptom reduction (; ; ; ).