Development and Psychopathology

Regular Articles

Multifinality in the development of personality disorders: A Biology × Sex × Environment interaction model of antisocial and borderline traits

Theodore P. Beauchainea1 c1, Daniel N. Kleina2, Sheila E. Crowella1, Christina Derbidgea1 and Lisa Gatzke-Koppa3

a1 University of Washington

a2 State University of New York at Stony Brook

a3 Pennsylvania State University

Abstract

Although antisocial personality disorder (ASPD) is more common among males and borderline PD (BPD) is more common among females, some authors have suggested that the two disorders reflect multifinal outcomes of a single etiology. This assertion is based on several overlapping symptoms and features, including trait impulsivity, emotional lability, high rates of depression and suicide, and a high likelihood of childhood abuse and/or neglect. Furthermore, rates of ASPD are elevated in the first degree relatives of those with BPD, and concurrent comorbidity rates for the two disorders are high. In this article, we present a common model of antisocial and borderline personality development. We begin by reviewing issues and problems with diagnosing and studying PDs in children and adolescents. Next, we discuss dopaminergic and serotonergic mechanisms of trait impulsivity as predisposing vulnerabilities to ASPD and BPD. Finally, we extend shared risk models for ASPD and BPD by specifying genetic loci that may confer differential vulnerability to impulsive aggression and mood dysregulation among males and impulsive self-injury and mood dysregulation among females. Although the precise mechanisms of these sex-moderated genetic vulnerabilities remain poorly understood, they appear to interact with environmental risk factors including adverse rearing environments to potentiate the development of ASPD and BPD.

Correspondence

c1 Address correspondence and reprint requests to: Theodore P. Beauchaine, Department of Psychology, University of Washington, Box 351525, Seattle, WA 98195-1525; E-mail: tbeaucha@u.washington.edu.

Footnotes

This paper was supported by Grant R01 MH067192 from the National Institute of Mental Health.