RT Journal
A1 Gunderson JG, Zanarini MC, Choi-Kain LW, Mitchell KS, Jang KL, Hudson JI
T1 FAmily study of borderline personality disorder and its sectors of psychopathology
JF Archives of General Psychiatry
JO Archives of General Psychiatry
YR 2011
FD July 1
VO 68
IS 7
SP 753
OP 762
DO 10.1001/archgenpsychiatry.2011.65
UL http://dx.doi.org/10.1001/archgenpsychiatry.2011.65
AB Context 
                  The familiality of borderline personality disorder (BPD) and its sectors of psychopathology are incompletely understood.Objectives 
                  To assess the familial aggregation of BPD and its 4 major sectors (affective, interpersonal, behavioral, and cognitive) and test whether the relationship of the familial and nonfamilial associations among these sectors can be accounted for by a latent BPD construct.Design 
                  Family study, with direct interviews of probands and relatives.Setting 
                  A psychiatric hospital (McLean Hospital) and the Boston-area community.Participants 
                  A total of 368 probands (132 with BPD, 134 without BPD, and 102 with major depressive disorder) and 885 siblings and parents of probands.Main Assessments 
                  The Diagnostic Interview for DSM-IV Personality Disorders and the Revised Diagnostic Interview for Borderlines (DIB-R) were used to assess borderline psychopathology, and the Structured Clinical Interview for DSM-IV was used to assess major depressive disorder.Results 
                  Borderline personality disorder meeting both DSM-IV and DIB-R criteria showed substantial familial aggregation for BPD in individuals with a family member with BPD vs those without a family member with BPD, using proband-relative pairs (risk ratio, 2.9; 95% confidence interval, 1.5-5.5) as well as using all pairs of family members (3.9; 1.7-9.0). All 4 sectors of BPD psychopathology aggregated significantly in families, using both DSM-IV and DIB-R definitions (correlation of traits among all pairs of family members ranged from 0.07 to 0.27), with the affective and interpersonal sectors showing the highest levels; however, the level of familial aggregation of BPD was higher than that of the individual sectors. The relationship among the sectors was best explained by a common pathway model in which the sectors represent manifestations of a latent BPD construct.Conclusions 
                  Familial factors contribute to BPD and its sectors of psychopathology. Borderline personality disorder may arise from a unitary liability that finds expression in its sectors of psychopathology.