Q. As the mother of a 28 year old daughter who has BPD, I would like to know whether the fact that she was born 3 months premature (at 26 weeks and weighing 820 grams) could be the reason for her BPD? There is no history of BPD in our family and she had a very loving, non-abusive or violent upbringing. Could the trauma of her birth and the fact that she spent her first 3 months in hospital have caused her BPD, or could it be that her brain was not developed sufficiently and also not 'stimulated' by mother bonding in those early weeks of life?

A. I guess anything is possible, but I am not aware of any studies nor even single case reports showing premature birth leading to BPD. Even though BPD does not run in the family, she may have a family chemistry. Perhaps someone has migraines, or anxiety, or obsessionality, or irritable bowel or a host of other related chemistries. The presence of BPD has nothing to do with how 
someone is raised. If you doubt how little the environment really plays in how our kids develop, read Strangers in the Nest: Do Parents Really Shape Their Child's Personality, Intelligence, or Character? by David B. Cohen (John Wiley and Sons, 1999).

The illness is not you or your husband's fault in any way, any more than your daughter's hair color or skin color is your fault. It is just part of the genetics. There are a number of letters discussing treatment with medications, which is a must. If you get her on the right one, she will improve. It is a bit of a haul, but Phil Cowen's group at Oxford could probably help her out if you can get there.