CAUSE: Borderline Personality Disorder?

[BPDFamily.com]

This was a very big concern of mine because I have two young sons with my BPD ex husband.  I think it's the age old question of "nature vs. nurture".  And I think right now because they are so young (2 and 1), even if they are prone to BPD in terms of genetics, there is a possibility that with the right form of parenting, they could lead somewhat normal lives.  I noticed that my mother in law always catered to my husband's BPD nature (maybe even if she wasn't quite aware of it).  When he threw a fit, everyone would cave in to his needs.  She did this more so when he was a child.  She started to do that with my oldest son when he started the whole terrible two temper tantrum thing.  I think impulse control is learned behavior.  In my opinion most BPD's lack this.  So I think it's a mixture of genetics, environment and "learned behavior"...  

[gypsy_darkeyes]

This was a very big concern of mine because I have two young sons with my BPD ex husband.  I think it's the age old question of "nature vs. nurture".  And I think right now because they are so young (2 and 1), even if they are prone to BPD in terms of genetics, there is a possibility that with the right form of parenting, they could lead somewhat normal lives.  I noticed that my mother in law always catered to my husband's BPD nature (maybe even if she wasn't quite aware of it).  When he threw a fit, everyone would cave in to his needs.  She did this more so when he was a child.  She started to do that with my oldest son when he started the whole terrible two temper tantrum thing.  I think impulse control is learned behavior.  In my opinion most BPD's lack this.  So I think it's a mixture of genetics, environment and "learned behavior"...  

[Abigail]

I believe it is a mixture of genetics and trauma or abuse.  Other risk factors that have been noted are being adopted, early parental loss (or inadequate infant bonding),head injuries and untreated ADHD.  ( 50% of those with "untreated" ADHD develop the borderline disorder and also, 50% of borderlines also have ADHD)

Our doctor, who specializes in treating those with the borderline disorder, has also treated a high number of Amish with the disorder.  This seems to indicate that there is a genetic disposition to the disorder since the Amish do not intermarry with outsiders. And therefore, any genetic disorders would be passed on more frequently among themselves.

 

BPD doesn't always develop in someone who has the predisposition.  Being raised in a mentally healthy environment without abuse and good self esteem have been recommended (and treating any mental disorders of the parents) to greatly reduce the chance of developing BPD.

My husband was diagnosed with BPD and ADHD a year and a half ago.  Our 24 year old daughter and 14 year old son show no signs of having the disorder.  They are however, both being treated for ADD.  My husband was adopted so I don't know anything about his biological family background.

One comment I would like to add to something gypsy darkeyes said.  Although I do agree that in many instances impulse control is a learned behavior, for someone with ADHD the impulse problems are not something that can be controlled (outside of medication greatly reducing or eliminating the impulsiveness).  Many children who are ADHD are blamed for something that they can not control.  There are even several psychiatrists and psychologists that I know of who have ADHD and are also knowledgeable and experienced in treating ADHD who can attest to this both from knowledge and personal experience.

 

Abigail

[StressedinCleveland]

Borderline psychopathology in the first-degree relatives of borderline and axis II comparison probands.

The purpose of this study was to assess the prevalence of each of the nine DSM criteria for borderline personality disorder and the prevalence of the disorder itself in the first-degree relatives of borderline probands and Axis II comparison subjects. Four hundred and forty-five inpatients were interviewed about familial borderline psychopathology using the Revised Family History Questionnaire--a semistructured interview of demonstrated reliability. Of these 445 subjects, 341 met both DIB-R and DSM-III-R criteria for BPD and 104 met DSM-III-R criteria for another type of personality disorder (and neither criteria set for BPD). The psychopathology of 1,580 first-degree relatives of borderline probands and 472 relatives of Axis II comparison subjects was assessed. Both DSM-III-R and DSM-IV BPD were found to be more common among the relatives of borderline than Axis II comparison probands. However, five of the criteria for BPD (inappropriate anger, affective instability, paranoia/dissociation, general impulsivity, and intense, unstable relationships) and all four sectors of borderline psychopathology (affect, cognition, impulsivity, and interpersonal relationships) were found to be both more common and discriminating than the BPD diagnosis itself. Taken together, the results of this study suggest that the subsyndromal phenomenology of BPD may be more common than the borderline diagnosis itself.



Zanarini MC, Frankenburg FR, Yong L, Raviola G, Bradford Reich D, Hennen J, Hudson JI, Gunderson JG.

J Personal Disord. 2004 Oct;18(5):439-47. Related Articles, Links  

The Laboratory for the Study for Adult Development, McLean Hospital, and the Department of Psychiatry, Harvard Medical School, Belmont, MA 02478, USA. zanarini@mclean.harvard.edu

[lost_ethel]

Taken together, the results of this study suggest that the subsyndromal phenomenology of BPD may be more common than the borderline diagnosis itself.

 

I don't understand.  What point are you making?  Looks like about one-third of close relatives turn out to be BPD themselves.  Is that what we need to know?

[mommadee]

Wow. I find a minimum of 18 family members with symptoms of BPD or other PD.  It is not that I want to be diagnosing everyone, I just could not believe the abuse that exists within our family and I wanted to take a closer look at the symptoms I have been seeing for years.  

I only included relatives of blood and never counted the married into which would really bring the count up.

[StressedinCleveland]

Taken together, the results of this study suggest that the subsyndromal phenomenology of BPD may be more common than the borderline diagnosis itself.  

I don't understand.  What point are you making?  Looks like about one-third of close relatives turn out to be BPD themselves.  Is that what we need to know?

A point of the study which I think is important is that a lot of relatives have features of BPD even if they don't meet the full diagnostic criteria.

[Abigail]

A child is six times more likely to develop BPD if a parent has the disorder.

You also need to consider that your children are at risk for developing the disorder if their mother has it.  

There are some things you can do to lessen the risk that they will develop it.  Build up their self-esteem, make sure that you are mentally healthy and treat any mental health problems that they may develop, in particular, ADHD.  Untreated ADHD is one of the risk factors for developing BPD.  

 Abigail

 

[makeitstop]

I was wondering about the 6x more likely to develop BPD if the child had a BPD parent.  Knowing that the thinking is that it is 50% genetic and 50% environmental, is that 6x for a child who is genetically predisposed to BPD to develop BPD vs. another child who is predisposed (i.e. not including children not genetically predisposed)?

[Abigail]

I'm not sure.  

[Up Out of It]

I just found a great article on borderlinepersonalitydisorder.com called "Etiology of BPD by John G. Gunderson, MD".  It helps explain how both genetics and environment contribute to BPD.

It is not easy to develop BPD. I expect that only a small fraction of the people who have the genetic disposition go on to develop it. Parenting is sometimes dysfunctional, but villains are truly rare. We need far more research to understand the contributions of both genes and environment.

the etiology of the borderline personality disorder (BPD) involves both genes and environment. The genetic component, which has been underappreciated, is substantial. It is not, however, the disorder itself which is inherited. Rather, what is inherited are forms of temperament that predispose a child to develop this disorder. The predisposing temperaments (aka phenotypes) for BPD are Affective Instability, Impulsivity, and Needy/Fearful Relationships.

Each of these temperaments predisposes to other disorders as well as BPD; Affective Instability also predisposes to mood disorders, Impulsivity also predisposes to substance / alcohol abuse, bulimia, and conduct disorder, and Needy/Fearful Relationships also predispose to histrionic, dependent, and avoidant personality disorders. The presence of these inherited temperaments helps explain why patients with BPD are often co-morbid with these other disorders.

Early caretaking relationships are significantly shaped by the child. This contrasts with the more widely recognized belief that parental interactions significantly shape the child. Thus, the easily upset, needy/fearful, hyperactive child who possesses the predisposing temperaments for BPD will pose special problems for parents. Such a child will benefit from forms of parenting that may not come natural to their parents.

The easily upset child may need an unusually calm and patient caretaker. In its absence their emotions may be poorly integrated and disturbing to them. The needy/fearful child may require a consistently involved reassuring caretaker. In its absence, their fears of abandonment may become unrealistic. An impulsive child may need parenting marked by predictability and non-punitive limit setting. In its absence, they may not develop self-controls.

Regardless of the early childcare, the child with predisposing temperaments for BPD will be far more easily undone by traumatic events. Most children with trauma grow up without sequelae. Those who suffer enduring consequences from trauma have both a predisposing temperament and -- perhaps due to problematic early caretaking -- will often have failed to disclose and process the event with their caretakers.



www.borderlinepersonalitydisorder.com/notes-gunderson.shtml

[Mollyd]

It's also important to remember that not all people with BPD have a history of abuse/neglect/abandonment.  

That's hard to see, because the perspective of BPD is often one of victimization (e.g. they perceive they've been victimized all the time - current and past).  Personality disorders, in general, are a condition where there isn't a clear path of "disease" like:  a + b = personality disorder.  Maybe someday, as brain research gets better.

Molly

[ian]

So, one of the new and interesting developments in recent science is the field of Epigenetics. What researchers have discovered that environment influences gene expression. This means that there are alot of genes that are more like switches, with two or more positions and that they can be switched on and off by environmental factors. This is may be why some abused people and up ok and others end up with a personality disorder.

So it appears that environment and genetics are two interdependant factors, that may even be flexible throughout life.

[Bitzee]

BPD results from the combination of a sensitive emotional nature (inborn) along with an invalidating environment.  The environment does not have to be abusive in order to be invalidating.  The parent and child may simply be a poor fit.

My niece, for instance, was diagnosed with BPD.  There was some sort of trauma at her birth... .a lack of oxygen.  She was developmentally slow, but the doctors did not really acknowledge it.  Anyway, I'm saying she was 'different' and it was difficult to be validating for her.  Just your normal, run of the mill environment was invalidating for her... .because she was different from the get go and this was never appropriately addressed and compensated for.

[JoannaK]

This has been alluded to in this thread, but I'm not sure it has been stated outright.  Environment affects physiology.  Children brought up in more stressful situations, with abuse, war, violence around them, actually produce different (or different amounts of) neurotransmitters and hormones.  Those neurotransmitters and hormones do affect their bodies physiologically and usually permanently.

[Unreal]

www.ncbi.nlm.nih.gov/pubmed/17988414

Heritability of borderline personality disorder features is similar across three countries.

Distel MA, Trull TJ, Derom CA, Thiery EW, Grimmer MA, Martin NG, Willemsen G, Boomsma DI.

Department of Biological Psychology, VU University, Amsterdam, The Netherlands. ma.distel@psy.vu.nl

BACKGROUND: Most of our knowledge about borderline personality disorder features has been obtained through the study of clinical samples. Although these studies are important in their own right, they are limited in their ability to address certain important epidemiological and aetiological questions such as the degree to which there is a genetic influence on the manifestation of borderline personality disorder features. Though family history studies of borderline personality disorder indicate genetic influences, there have been very few twin studies and the degree of genetic influence on borderline personality disorder remains unclear.

METHOD: Data were drawn from twin samples from The Netherlands (n=3918), Belgium (n=904) and Australia (n=674). In total, data were available on 5496 twins between the ages of 18 and 86 years from 3644 families who participated in the study by completion of a mailed self-report questionnaire on borderline personality disorder features.

RESULTS: In all countries, females scored higher than males and there was a general tendency for younger adults to endorse more borderline personality disorder features than older adults. Model-fitting results showed that additive genetic influences explain 42% of the variation in borderline personality disorder features in both men and women and that this heritability estimate is similar across The Netherlands, Belgium and Australia. Unique environmental influences explain the remaining 58% of the variance.

CONCLUSION: Genetic factors play a role in individual differences in borderline personality disorder features in Western society.

[Abigail]

Many mental disorders is based on a stress-diathesis model - a combination of risk factors involving genetic, biological factors and environmental stressors eventually reach a "tipping" point where the development of a mental disorder occurs.  

One can have a lot of biological factors and not need many environmental stressors to develop and another individual might have a lot of environmental stressors without quite as many biological factors and still develop the disorder.  

 Abigail

[Skip]

Wanted to add this recent information to the discussion:

Possible Genetic Causes Of Borderline Personality Disorder Identified

ScienceDaily (Dec. 20, 2008) — According to the National Institute of Mental Health, borderline personality disorder (BPD) is more common than schizophrenia or bipolar disorder and is estimated to affect 2 percent of the population. In a new study, a University of Missouri researcher and Dutch team of research collaborators found that genetic material on chromosome nine was linked to BPD features, a disorder characterized by pervasive instability in moods, interpersonal relationships, self-image and behavior, and can lead to suicidal behavior, substance abuse and failed relationships.

“The results of this study hopefully will bring researchers closer to determining the genetic causes of BPD and may have important implications for treatment programs in the future,” said Timothy Trull, professor of psychology in the MU College of Arts and Science. “Localizing and identifying the genes that influence the development of BPD will not only be important for scientific purposes, but will also have clinical implications.”

In an ongoing study of the health and lifestyles of families with twins in the Netherlands, Trull and colleagues examined 711 pairs of siblings and 561 parents to identify the location of genetic traits that influences the manifestation of BPD. The researchers conducted a genetic linkage analysis of the families and identified chromosomal regions that could contain genes that influence the development of BPD. Trull found the strongest evidence for a genetic influence on BPD features on chromosome nine.

In a previous study, Trull and research colleagues examined data from 5,496 twins in the Netherlands, Belgium and Australia to assess the extent of genetic influence on the manifestation of BPD features. The research team found that 42 percent of variation in BPD features was attributable to genetic influences and 58 percent was attributable to environmental influences, and this was consistent across the three countries. In addition, Trull and colleagues found that there was no significant difference in heritability rates between men and women, and that young adults displayed more BPD features then older adults.

“We were able to provide precise estimates of the genetic influence on BPD features, test for differences between the sexes, and determine if our estimates were consistent across three different countries,” Trull said. “Our results suggest that genetic factors play a major role in individual differences of borderline personality disorder features in Western society.”

Journal references:

   1. Distel et al. Chromosome 9: linkage for borderline personality disorder features. Psychiatric Genetics, 2008; 18 (6): 302 DOI: 10.1097/YPG.0b013e3283118468

   2. Distel et al. Heritability of borderline personality disorder features is similar across three countries. Psychological Medicine, 2008; 38 (9): DOI: 10.1017/S0033291707002024

[WalrusGumboot]

Great information Skip. Thanks!

[Peaceful.]

Very helpful Skip!  Is there research data that has measured the prevalance of BPD in children born to BPD mothers?

Of course there are individual cases of BPD children with BPD mothers, but I was wondering if there was national data that provides a % number.

[arjay]

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

Children of mothers with borderline personality disorder (BPD) were hypothesized to be at greater risk for psychopathology, particularly impulse spectrum disorders, than children of mothers with other personality disorders.

METHOD:Twenty-one index children were compared with 23 children of mothers with a nonborderline personality disorder. Diagnoses were obtained using the Kiddie Schedule for Affective Disorders and Schizophrenia-Episodic Version (KSADS-E) and the Child Diagnostic Interview for BPD (CDIB), and functioning was rated with the Child Global Assessment Schedule (CGAS). 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.





Weiss M1, Zelkowitz P, Feldman RB, Vogel J, Heyman M, Paris J., Can J Psychiatry. 1996 Jun;41(5):285-90.

www.ww1.cpa-apc.org:8080/Publications/Archives/PDF/1996/June/WEISS.PDF

[stpmom]

Interesting study, Skip,  I often wonder given the distortions of facts by those with BPD if the trauma that they were exposed to as children is real or imaginary.  I suppose that imaginary trauma can be damaging also.  

We don't know if she experienced trauma at her mothers house or if her mothers rejection has caused it.  We do know that she received a lot of love and support also.  It is very frustrating that we are the ones she "can't be around" now.  

She is an adult now and responsible for her choices regardless of the wounds of her childhood... .just like all of us.

[Bitzee]

Not an abusive environment, an Invalidating one.

There does not have to be abuse... . It is said that BPD develops as the result of a combination of an Inborn Sensitive Nature and an Invalidating Environment.  Not an abusive environment, an Invalidating one.

It can be fairly subtle... .perhaps the family is merely stressed during crucial stages of the child's early development (especially infancy).  Perhaps the mother has an extended illness, or one of the other children become seriously ill, or there are financial hardships.  If the family system becomes too stressed, the child's needs are not met.  BPD is especially associated with early separations.  If the mother may have had to give the infant to someone else to care for for an extended period while she was having a difficult time.  That sort of thing.

There are many scenarios.  And many are unintentional.  Sometimes it is a poor fit between the temperament of the mother and the child.

[oneflewover]

I have two theories:

Spiritual malady  Definitely yes to the idea of a spiritual malady.  No doubt in my mind that many who are afflicted with this disorder is a direct link to their shameful and sinful patterns and choices.  Because of their impulsive behaviors they are often full of regret later and are embarrassed internally.  That embarrassment is the motivation for so much of what we see in them, anger, anxiety, odd thinking, unusual perceptions, substance abuse, sexual deviance.  A masking of sorts to numb and dull the shame and guilt.      

Emotional developmental issue  I also feel that BPD is also an emotional developmental issue.  I think that a borderline suffers from a lack of growing up emotionally, hence why we see such child-like behaviors from them.  For whatever reasons (i.e. environmental, dysfunctional parents, trauma, abuse, etc.) they were never able to bridge that gap into adulthood which allows them to have healthy interpersonal skills.  My interactions with my ex feels like I am dealing with a child.  

OFO

[Neal]

In my opinion it is not a spiritual problem since personality is formed before the age of accountability.

I also don't think that genetics play as important of a role. Genetics would put more of the emphasis on neurotransmitters, development of the brain, etc.

In my experience, ASPD, NPD, and BPD have always had an environmental factor. That factor might not be the parents or anyone within their FOO. IMHO, it only takes the right circumstance at a critical moment in development and the child to continue in that pattern of response (internally) to allow it to become part of their coping mechanisms and later personality.

From my own personal life, I can identify many early developmental points at which (by happenstance, providence, or whatever) my reaction and subsequent reactions to similar lead away from PD instead of towards it. Very easily I could have reacted differently and if repeated over time it could have lead to the maladaptive behavior that we label as a personality disorder.

[boarderchic]

Confusion about the role a particular genetic fingerprint plays in the development of disease

I'm a scientist doing medical research, so my post is more in that vein.

I think there is some confusion about the role a particular genetic fingerprint plays in the development of disease.  For some diseases there is a very clear relationship between a genetic defect (mutation, lack of a gene, etc) and the disease.  And it is deterministic: if you have the mutation or lack the gene, you get the disease.    There is no middle ground.  For example, Huntington's disease is a single-gene disease.  If you have a mutation to the gene that produces the protein Huntington, you get Huntington's disease.  That's it.  :)own's syndrome is a chromosal disease (still a genetic disorder).  You have 3 copies of chromosome 21, you have Down's syndrome.    

However, for most medical problems genetics are not nearly as deterministic.  Instead, they are multi-factorial, meaning they are influenced by a variety of factors including your particular genetic fingerprint and environment.  

First, let's talk a bit about genes and phenotype.  Phenotype is an observable trait of an organism (green eyes for example) and it is governed by genotype (the particular genetic code of an organism).  There are variations in phenotype (we have different colored eyes) because there is variation in genotype;  there are different alleles for each gene.  So while we all have genes for eye color, my gene specifies brown eyes (the brown eye allele), while your gene specifies blue eyes (the blue eye allele).  Thus, although we have the same genes, because we have a different genotype we have a different phenotype.  (This is a simplication but will do )

We also need to understand gene expression.  What are genes, really?  They are instructions for the cell, telling it to make a particular protein that the cell needs.  This process is highly regulated both in time and cell type, i.e. both the time that the cell starts making protein from a gene and the place where it starts making protein from gene is important.  Your eyes, for example, have the genes or instructions to make new arms and legs, but we don't have arms and legs growing from our eyes because those genes are turned off.  (Again, a simplification, but go with me).  Environmental influences can affect the regulation of these processes.  It can also affect what the cell would normally do with a properly made protein, disrupting the normal protein processes.

Now we can understand the role of genes and environment in disease and why, for example, some of us can have BPD parents but not be BPDs themselves and others of us can be non-BPD parents with BPD kids.  

For many diseases, your particular genotype can influence the chances you might develop a disease (a phenotype), but not PRE-DETERMINE that you will have a disease.  This is because these are multi-factorial diseases that do not result from a single genetic mutation, such as Huntington's disease, but result from a combination of your particular genotype and the effects of your particular environment on the genotype.  Further complicating the issue is that many different combinations of these factors can result in disease.  Consider a simple case where say 10 genes influence you chance of getting a disease.  Well, what if you have 8 of the 10 alleles that influence towards disease?  7, 6, 4?  What can we say about your likelihood of getting disese?  What about environment... .so many little variables in environment.  The complexity and difficulty of understanding the role of genes and environment becomes clearer... .

Such appears to be the case with BPD.  Let's consider some examples.  You may inherit certain alleles from your BPD parent and certain alleles from your non-BPD parent.  So now you have a different genotype from your BPD parent and it is possible that your particular genotype does not make you as susceptible to BPD as theirs did, because your personality is such that you are less sensitive, for example, as a result of your particular genotype.  It may be that in fact your particular genotype makes you more able to handle a challenging environment.  Or you may have exactly the same genotype as your BPD parent (really unlikely, but for the sake of argument) but because you environment was different its affects on things like gene expression were different and therefore you don't develop BPD.  If you're the child of non-BPD parents, you may simply have inherited a combination of alleles that, given the environment you grew up in, make you more susceptiblet to BPD, even though you had non-parents. What kind of environment would that be?  An invalidating environment, certainly, but this does not necessarily mean we could look at any particular environment and say, well, surely, their environment was fine so why did they develop it?  Their parents were wonderful and they had a great childhood, and their parents don't have BPD, so where's the genetic/environmental influence?  The point is we can't make those judgement about environment as it is not always that clear-cut.  There are many variables in environment and just because it seems good doesn't mean there weren't factors that influenced the development of BPD, factors that are subtle and not obvious to us.  These diseases are extremely complicated and we have a very poor understanding of the connection between genotype and environment precisely because of this - many genes play a role and environment is so varied and uncontrolled that it is very difficult to be able to say - if you have this gene or this environment, you have BPD.  

In my opinion, a neurochemical problem falls into the bins of genetic or environemtal cause of disease.  A genetic problem can cause a neurochemical problem (neurochemicals are simply proteins created from the instructions in genes, after all) or an environmental one (some perturbation to the environment has disrupted the process of protein production or the processes in which the protein is used).  This is why drugs can treat neurochemical problems such as bi-polar disorder.  However, the multi-factorial nature of a disease like BPD may be a reason why the drugs are not too effective with a BPD.  You've treated one part of the problem but its easy to imagine that the BPD will continue if you don't treat many of the things leading to the problem.  What if the BPD is not that sensitive to the part of the problem you've treated, i.e. yes, you've identified a factor influencing BPD but it's not the MAIN factor, or one of the most SIGNIFICANT factors?  What if there are compensatory processes that counteract the treatment you've provided (the cell is highly regulated and this is certainly a realistic possibility)?  What if there is no main factor but a bunch of genes that have subtle influences on your likelihood to get BPD, that in total give you a greater likelihood?  Without considering the combinatorics it's quite difficult to treat the multi-factorial disorders.  Paradoxically, the combinators also make it extremely difficult to understand the root cause of a disorder.  This is one of the reasons why drug research in general is facing problems right now.  

Scientific studies show that there are likely genetic components to BPD.  But that's all it is - a component.  All it means is that genes can influence the likelihood that you get the disease.  They don't pre-determine whether you get the disease.  No one could look at your genotype and say, ah, this is the BPD genotype.  They could say (theoretically) that you might have a higher likelihood of getting it if the environment were "favorable" for developing BPD (not that it's a good thing to develop BPD), but they cannot predict that you will or won't get it.  And environment is such a complicated thing to define that it is unlikely we could ever predict who would get BPD or not.  We can say that an invalidating environment leads to BPD, but we can't precisely define every environment that everone lives in.  Yes, sometimes it's obvious.  I can point to my own childhood and pretty definitively say it was invalidating, as can many members here.  But what about more subtle cases?  There is a range, right?  How do we define an environment making a person susceptiblet to BPD?  It's not clear-cut.  And these complications are the reason why kids can have BPD but their parents don't and vice versa.  But the science seems relatively clear - there are genetic components.  But they are not DETERMINISTIC components.    

Does this help at all or is it just confusing?

[Neal]

Scientific studies show that there are likely genetic components to BPD.  But that's all it is - a component.  All it means is that genes can influence the likelihood that you get the disease.  They don't pre-determine whether you get the disease.

 

And environment is such a complicated thing to define that it is unlikely we could ever predict who would get BPD or not.  We can say that an invalidating environment leads to BPD, but we can't precisely define every environment that everone lives in.  Yes, sometimes it's obvious.  I can point to my own childhood and pretty definitively say it was invalidating, as can many members here.  But what about more subtle cases?  There is a range, right?  How do we define an environment making a person susceptiblet to BPD?  It's not clear-cut.  And these complications are the reason why kids can have BPD but their parents don't and vice versa.  But the science seems relatively clear - there are genetic components.  But they are not DETERMINISTIC components.

Exactly. Excellent post!   

Does this help at all or is it just confusing?

Very clear and to the point.

[waybird]

oneflewover:  I think there is something going on spiritually, too.  

boarderchic: Thank you for such an intelligent and comprehensive reply!  My goodness.  

[Neal]

A genetic (nature) predisposition (predisposition only, not predeterminer) that hones into one of a myriad/spectrum of psychological (mal)adaptations dependent upon complex environmental factors (nurture) during critical psychosocial developmental stages.

Genetic predisposition -> invalidating/traumatic/inconsistent environments around critical developmental stages -> reinforced behavior (stimulii <-> reward) -> personality somewhere on a spectrum (including Cluster B and disorders such as PTSD, ADHD, etc)

Genetic predisposition might be focused around adrenal medulla which arises from neural crest cells (IIRC).

What is considered psychological resilience might actually be, in part, a reflection of adrenal efficiency, adaptability, or overall adrenal health.


At least that's been my best guess so far... . 

[Randi Kreger]

In a previous study, Trull and research colleagues examined data from 5,496 twins in the Netherlands, Belgium and Australia to assess the extent of genetic influence on the manifestation of BPD features. The research team found that 42 percent of variation in BPD features was attributable to genetic influences and 58 percent was attributable to environmental influences, and this was consistent across the three countries. In addition, Trull and colleagues found that there was no significant difference in heritability rates between men and women, and that young adults displayed more BPD features then older adults.

In short, both nature and nurture (yes to the genetics) and in each person the combo is a bit different. As far as the nuture goes, it's not just parenting, but the total environment.

[Althea]

Please God in heaven, do not let BPD have a genetic component   .  I have two beautiful, perfect, light of my fun life, little baby boys with uBPDh.  Please let his BPD stem from the abuse and fighting he witnessed as a child and being abandoned by his nut job mother, as a young boy.  I am serously scared about this and staying in prayer.