Genetics of Borderline Personality Disorder

Many clinicians believe that borderline personality disorder (BPD) is solely or mainly the product of aversive childhood experiences, organic traumas, or other environmental experiences. However, leading psychotherapists have another opinion. Otto Kernberg (1), for instance, has proposed that the core element in the development of borderline personality organization may be an inherited, particularly strong aggressive drive plus an inborn deficiency in the ability to tolerate anxiety. Linehan and Koerner (2) maintain that the basis for borderline personality disorder is an inherited biological predisposition to emotional dysregulation. This dysregulation implies an accentuated sensitivity to emotional stimuli, intense reactions to such stimuli, and a slow, delayed return to a more quiet emotional level. In addition, dysregulation refers to a lack of the ability to refrain from inappropriate behavior related to strong positive and negative effects, and a lack of the ability to comfort oneself when strong effects give intense physiological outcomes. These patients often have trouble diverting their attention away from their effects, and encounter difficulties in organizing and coordinating activities to reach important aims. The authors did not, however, mean that biology is the only determinant. Linehan and Kramer suggested that a disconforming childhood environment is necessary for the development of borderline personality disorder as well.