title: Family study of borderline personality disorder and its sectors of psychopathology.
abstract: BACKGROUND
  The familiality of borderline personality disorder (BPD) and its sectors of psychopathology are incompletely understood.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  Family study, with direct interviews of probands and relatives.
  
  
  METHODS
  A psychiatric hospital (McLean Hospital) and the Boston-area community.
  
  
  METHODS
  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.
authors: The Borderline Center, McLean Hospital, Belmont, MA 02478. jgunderson@mclean.harvard.edu
authors: John G
authors: JG
authors: Gunderson
authors: Mary C
authors: MC
authors: Zanarini
authors: Lois W
authors: LW
authors: Choi-Kain
authors: Karen S
authors: KS
authors: Mitchell
authors: Kerry L
authors: KL
authors: Jang
authors: James I
authors: JI
authors: Hudson
mesh_terms: D000328:Adult; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology; D016009:Chi-Square Distribution; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D011569:Psychiatric Status Rating Scales; D055815:Young Adult