Structure of genetic and environmental risk factors for symptoms of DSM-IV borderline personality disorder

JAMA Psychiatry. 2013 Nov;70(11):1206-14. doi: 10.1001/jamapsychiatry.2013.1944.


Importance: Previous studies have indicated that the psychopathological dimensions of borderline personality disorder (BPD) are influenced by a unitary liability factor. However, to our knowledge, the underlying etiological nature of the individual criteria for BPD as defined by the DSM-IV has not been explored.

Objective: To determine the structure of genetic and environmental risk factors for the symptoms of BPD.

Design, setting, and participants: Multivariate twin study with BPD criteria assessed by personal interview within a general community setting. Participants included 2794 young adults from the Norwegian Institute of Public Health Twin Panel.

Main outcomes and measures: The 9 criteria for BPD assessed by the Structured Interview for DSM-IV Personality.

Results: A common pathway model dominated by 1 highly heritable (55%) general BPD factor that strongly influenced all 9 BPD criteria (standardized path coefficients, 0.53-0.79) fit the data best. The model also included 2 additional common liability factors, mainly influencing criteria reflecting the affective and interpersonal dimensions. Both of these were mostly influenced by environmental liability factors (heritability, 29.3% and 2.2%). With 1 exception (criterion 2, unstable and intense relationships), the specific criteria were strongly influenced by environmental factors. Five of the 9 criterion-specific genetic effects were either 0 or negligible.

Conclusions and relevance: These results indicate that most of the genetic effects on the individual BPD criteria derive from 1 highly heritable general BPD factor, whereas the environmental influences were mostly criterion specific.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Borderline Personality Disorder / diagnosis*
  • Borderline Personality Disorder / genetics*
  • Borderline Personality Disorder / psychology
  • Diagnostic and Statistical Manual of Mental Disorders*
  • Diseases in Twins / diagnosis*
  • Diseases in Twins / psychology*
  • Female
  • Humans
  • Interview, Psychological
  • Male
  • Models, Psychological
  • Risk Factors
  • Twins / psychology*