Borderline personality traits and adult attention‐deficit hyperactivity disorder symptoms: A genetic analysis of comorbidity

Abstract

Previous research has established the comorbidity of adult Attention-Deficit Hyperactivity Disorder (ADHD) with different personality disorders including Borderline Personality Disorder (BPD). The association between adult ADHD and BPD has primarily been investigated at the phenotypic level and not yet at the genetic level. The present study investigates the genetic and environmental contributions to the association between borderline personality traits (BPT) and ADHD symptoms in a sample of 7,233 twins and siblings (aged 18–90 years) registered with the Netherlands Twin Register and the East Flanders Prospective Twin Survey (EFPTS). Participants completed the Conners’ Adult ADHD Rating Scales (CAARS-S:SV) and the Personality Assessment Inventory-Borderline Features Scale (PAI-BOR). A bivariate genetic analysis was performed to determine the extent to which genetic and environmental factors influence variation in BPT and ADHD symptoms and the covariance between them. The heritability of BPT and ADHD symptoms was estimated at 45 and 36%, respectively. The remaining variance in BPT and ADHD symptoms was explained by unique environmental influences. The phenotypic correlation between BPT and ADHD symptoms was estimated at r = 0.59, and could be explained for 49% by genetic factors and 51% by environmental factors. The genetic and environmental correlations between BPT and ADHD symptoms were 0.72 and 0.51, respectively. The shared etiology between BPT and ADHD symptoms is thus a likely cause for the comorbidity of the two disorders.

Developmental Pathways to Borderline Personality Disorder

“…Heritability estimates for BPD (or dimensional representations of BPD) range from 35% to 45% [10][11][12][13][14][15]. Multivariate modeling indicates that there is likely to be a single common genetic factor reflecting vulnerability to PD pathology and/or negative emotionality, and two other genetic factors reflecting high impulsivity/low agreeableness and introversion [13].…”

“…So-called comorbidity of BPD with other disorders might also be due to gene-environment correlation, although these data derive only from adult samples. For example, the genetic and environmental correlations between adult BPD traits and adult attention-deficit/hyperactivity disorder (ADHD) symptoms have been reported to be 0.72 and 0.51, respectively, supporting a shared etiology for the two disorders [15].…”

Clinical, neuropsychological and structural convergences and divergences between Attention Deficit/Hyperactivity Disorder and Borderline Personality Disorder: A systematic review

“…As to the comorbidity of ADHD with BPD, emphasis has been given to the reinforcement of the clinical features such as impulsivity (attentional/cognitive impulsiveness), substance abuse, affective instability, suicidal behavior (Distel et al, 2011;Ferrer et al, 2010), outwardlydirected anger and lifetime aggression (Prada et al, 2014) and the greater likelihood of disruptive disorders and cluster B personality disorders (Speranza et al, 2011), and it has been suggested that the Articles specifically examining the relation between ADHD and BPD Articles non-specifically examining the relation between ADHD and BPD Matthies and Philipsen (2014): Common ground in Attention Deficit Hyperactivity Disorder (ADHD) and Borderline Personality Disorder (BPD) -review of recent findings.…”

“…The developmental association of ADHD and BPD has also been explained through a partially shared genetic etiology (Storebø & Simonsen, 2014). Distel et al (2011) analyzed the comorbidity of ADHD and borderline personality traits and found a phenotypic correlation, 49% of which could be explained by genetic factors versus 51% by environmental factors. Thus we might say that a combination of temperamental predisposition, environmental circumstances and genetic factors all contribute to the developmental perspective in this pathway from ADHD to BPD.…”

Diagnosing Borderline Personality Disorder During Adolescence: A Review of the Published Literature

“…Studies have demonstrated an important association between ADHD and late BPD (56)(57)(58)(59)(60)(61). ADHD and BPD share some clinical features, particularly impulsivity and emotional instability (60).…”