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

Abstract

Although antisocial personality disorder (ASPD) is more common among males and borderline personality disorder (BPD) is more common among females, some (e.g., Paris, 1997) 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 personality disorders 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. Keywordsantisocial; borderline; multifinality; genetics; environment Antisocial personality disorder (ASPD) and borderline personality disorder (BPD) are among the most costly public health concerns confronting the US criminal justice and healthcare systems. Although ASPD affects only 3-6% of adult males and 1% of adult females (American

Long-term programming of enhanced aggression by peripuberty stress in female rats

“…In humans, perpetration of intimate partner violence has been related to personality disorders in men (Edwards et al, 2003), and more recently in women (Walsh et al, 2010). Furthermore, exposure to childhood trauma increases the risk to develop both, personality disorders and intimate partner violence (Beauchaine et al, 2009).…”

Race and Sexually Transmitted Diseases in Women With and Without Borderline Personality Disorder

“…18,[44][45][46] Participants from the no BPD=SUD groups reported more STD risk factors than women in the BPD=no SUD group, and women from the BPD=SUD group appeared to be at greatest risk for STDs. Even though the results of one study suggest that comorbid SUD may be more important for HIV risk in individuals with mood disorders than in individuals with BPD, 12 our findings suggest that comorbid SUD might be considered a red flag for STD risk among female patients with BPD.…”

Future Directions in Emotion Dysregulation and Youth Psychopathology

“…Later in development, children on this trajectory are vulnerable to adverse influences of deviant peer groups, and neighborhoods high in violence and criminality. In contrast, children who are reared in protective family environments that are characterized by effective parenting, including de-escalation of affective lability, clear consequences for aggression, and positive reinforcement of prosocial behaviors (right panel), are unlikely to progress to serious conduct problems given well developed emotion regulation skills Beauchaine et al, 2010;Beauchaine et al, 2009;Beauchaine et al, in press). Nevertheless, they remain impulsive given the high heritability of this trait.…”

“…As we have reviewed elsewhere (Zisner & Beauchaine, in press-b), externalizing behaviors are associated with excessive RSA withdrawal specifically during emotion evocation-not necessarily during other types of tasks. This reflects the emotion dysregulation aspect of externalizing behavior (see Beauchaine et al, 2007;Beauchaine et al, 2009;Beauchaine & Gatzke-Kopp, 2012). In contrast, less RSA withdrawal is found among externalizing samples than controls during attention demanding, executive function, and problem-solving tasks (e.g., Dietrich et al, 2007;Hinnant & El-Sheikh, 2009;Obradović et al, 2010).…”

“…With these caveats aside, even though socialization plays an important role in the acquisition of emotion regulation (see earlier; Beauchaine et al, 2007;Beauchaine et al, 2009), the construct is also partly heritable (see Goldsmith et al, 2008). One logical strategy for identifying heritable substrates of emotion regulation is to identify neurobiological correlates of resilience among maltreated children.…”