Borderline Personality Disorder Research

Borderline Personality Disorder Etiology

December 2003

    Temperament, childhood environment and psychopathology as risk
factors for avoidant and borderline personality disorders.

Aust N Z J Psychiatry. 2003 Dec;37(6):756-64.
Joyce PR, McKenzie JM, Luty SE, Mulder RT, Carter JD, Sullivan PF,
Cloninger CR.

"OBJECTIVE: To evaluate childhood experiences (neglect and abuse), temperament and childhood and adolescent psychopathology as risk factors for avoidant and borderline personality disorders in depressed outpatients... RESULTS: Avoidant personality disorder can be conceptualized as arising from a combination of high harm avoidance (shy, anxious), childhood and adolescent anxiety disorders and parental neglect. Borderline personality disorder can be formulated as arising from a combination of childhood abuse and/or neglect, a borderline temperament (high novelty seeking and high harm avoidance), and childhood and adolescent depression, hypomania, conduct disorder and alcohol and drug dependence. CONCLUSIONS: Combinations of risk factors from the three domains of temperament, childhood experiences and childhood and adolescent psychopathology make major contributions to the development of avoidant and borderline personality disorders."

January - February 2003

  Family studies of borderline personality disorder: a review.

Harv Rev Psychiatry. 2003 Jan-Feb;11(1):8-19.
White CN, Gunderson JG, Zanarini MC, Hudson JI.
McLean Hospital, Belmont, Mass. 02478, USA.

"This paper reviews the literature examining the psychopathology found in relatives of individuals with borderline personality disorder (BPD). Reflecting changes in how BPD has been conceptualized, researchers have investigated the prevalence of schizophrenia, then mood disorders, and more recently, impulse spectrum disorders in these relatives. This literature does not support a link between BPD and schizophrenia, is ambiguous about a link between BPD and major depressive disorder, and suggests a familial aggregation of impulse spectrum disorders and BPD, as well as of BPD itself. Because of significant methodological problems, most notably indirect assessments and inadequate sample size, major questions persist about the familial aggregation of this disorder that require more definitive methods.

June 2002

  The borderline diagnosis III: identifying endophenotypes for genetic studies.

Biol Psychiatry. 2002 Jun 15;51(12):964-8
Siever LJ, Torgersen S, Gunderson JG, Livesley WJ, Kendler KS.
Department of Psychiatry, Mount Sinai School of Medicine, New York, New York, USA.

"Although it is generally acknowledged that borderline personality disorder (BPD) has a complex, multifactorial etiology with interacting genetic and environmental substrates, the specific genetic underpinnings of this disorder have not been extensively investigated. Family aggregation studies suggest the heritability for BPD as a diagnosis, but the genetic basis for this disorder may be stronger for dimensions such as impulsivity/aggression and affective instability than for the diagnostic criteria itself. Family, adoptive, and twin studies also converge to support an underlying genetic component to the disorder. An endophenotypic approach to defining the genetics of this complex disorder may be called for. Twin studies in an epidemiologic, non-clinically ascertained sample using both diagnostic measures and laboratory measures that can be operationalized, including neuropsychologic, psychophysiologic, and operationalized behavioral tests, may be useful. Large-scale family studies of clinically ascertained samples with careful diagnostic demarcation and measurement of endophenotypes in probands and relatives may also prove to be a promising approach. The use of laboratory paradigms for measures of aggression and affective instability are discussed in the context of such endophenotypic approaches."

June 2002

  The borderline diagnosis II: biology, genetics, and clinical course.

Biol Psychiatry. 2002 Jun 15;51(12):951-63.
Skodol AE, Siever LJ, Livesley WJ, Gunderson JG, Pfohl B, Widiger TA.
Department of Psychiatry, Columbia University College of Physicians and Surgeons, and the New York State Psychiatric Institute, New York, New York, USA.

"In Part I of this three-part article, consideration of the core features of BPD psychopathology, of comorbidity with Axis I disorders, and of underlying personality trait structure suggested that the borderline diagnosis might be productively studied from the perspective of dimensions of trait expression, in addition to that of the category itself. In Part II, we review the biology, genetics, and clinical course of borderline personality disorder (BPD), continuing to attend to the utility of a focus on fundamental dimensions of psychopathology. Biological approaches to the study of personality can identify individual differences with both genetic and environmental influences. The aspects of personality disorder that are likely to have biologic correlates are those involving regulation of affects, impulse/action patterns, cognitive organization and anxiety/inhibition. For BPD, key psychobiological domains include impulsive aggression, associated with reduced serotonergic activity in the brain, and affective instability, associated with increased responsivity of cholinergic systems. There may be a strong genetic component for the development of BPD, but it seems clear, at least, that there are strong genetic influences on traits that underlie it, such as neuroticism, impulsivity, anxiousness, affective lability, and insecure attachment. The course of BPD suggests a heterogeneous disorder. Predictors of poor prognosis include history of childhood sexual abuse, early age at first psychiatric contact, chronicity of symptoms, affective instability, aggression, substance abuse, and increased comorbidity. For research purposes, at least, biological, genetic, and prognostic studies all continue to suggest the need to supplement categorical diagnoses of BPD with assessments of key underlying personality trait dimensions and with historical and clinical observations apart from those needed to make the borderline diagnosis itself."

August 2001

  Women in special hospitals: understanding the presenting behaviour of women diagnosed with borderline personality disorder.

Wilkins TM Warner S., 
J Psychiatr Ment Health Nurs 2001 Aug; 8:289-97

Women who have the BPD's case notes were studied in a High Secure Psychiatric Hospital and there was a correlation in their childhood history and their behavior today.

March 2000

  Genetics of patients with borderline personality disorder.

Psychiatr Clin North Am 2000 Mar;23(1):1-9
Torgersen S.
Center for Research in Clinical Psychology, University of Oslo, Norway.

"An overview of the existing literature suggests that traits similar to BPD are influenced by genes. It is too early to say to what extent BPD is also influenced by genes, but because personality traits generally show a strong genetic influence, this should also be true for BPD. Nonetheless, if the equal-environment assumption were to be violated for MZ and DZ pairs, twin studies may be overestimating genetic effects and hiding the effect of common family environment. The less than-ideal reliability of measurements used in this research may also reduce the effects of genes and common environment while increasing the effects of unique or nonshared environment. The effect of genes on the development of BPD is likely substantial. The effect of common family environment may be close to zero. More studies, large and small, are needed to reach firmer conclusions about the influence of genetics on BPD."

Spring 1997

  Pathways to the development of borderline personality disorder.

J Personal Disord 1997 Spring;11(1):93-104 
Zanarini MC, Frankenburg FR.
Laboratory for the Study of Adult Development, McLean Hospital, Belmont, Massachusetts 02178, USA.

"The available empirical evidence concerning the etiology of borderline personality disorder is reviewed. A tripartite model of the development of BPD is then presented. This model has three elements: a traumatic childhood (broadly defined), a vulnerable (hyperbolic) temperament, and a triggering event or series of events. The authors conclude that each borderline patient has a unique pathway to the development of BPD that is a painful variation on an unfortunate but familiar theme."

June 1996

  Psychopathology in offspring of mothers with borderline personality disorder: a pilot study.

Can J Psychiatry 1996 Jun;41(5):285-90
Weiss M, Zelkowitz P, Feldman RB, Vogel J, Heyman M, Paris J.
Division of Child Psychiatry, University of British Columbia, Vancouver.

Are children of mothers with the BPD at higher risk for psychopathology? 21 children of BPDs were studied with 23 children of non borderline mothers. Diagnoses were obtained and global assessments were taken using tests. "Physical, sexual, and verbal abuse, as well as family violence and placements, were also assessed.

RESULTS: The children of the borderline mothers, as compared with controls, had more psychiatric diagnoses, more impulse control disorders, a higher frequency of child BPD, and lower CGAS scores. There were no differences between the groups for trauma. CONCLUSION: The offspring of borderline mothers are at high risk for psychopathology."

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