Skip to main content Accessibility help

Heritability of borderline personality disorder features is similar across three countries

  • M. A. Distel (a1), T. J. Trull (a2), C. A. Derom (a3), E. W. Thiery (a4), M. A. Grimmer (a5), N. G. Martin (a5), G. Willemsen (a1) and D. I. Boomsma (a1)...



Most of our knowledge about borderline personality disorder features has been obtained through the study of clinical samples. Although these studies are important in their own right, they are limited in their ability to address certain important epidemiological and aetiological questions such as the degree to which there is a genetic influence on the manifestation of borderline personality disorder features. Though family history studies of borderline personality disorder indicate genetic influences, there have been very few twin studies and the degree of genetic influence on borderline personality disorder remains unclear.


Data were drawn from twin samples from The Netherlands (n=3918), Belgium (n=904) and Australia (n=674). In total, data were available on 5496 twins between the ages of 18 and 86 years from 3644 families who participated in the study by completion of a mailed self-report questionnaire on borderline personality disorder features.


In all countries, females scored higher than males and there was a general tendency for younger adults to endorse more borderline personality disorder features than older adults. Model-fitting results showed that additive genetic influences explain 42% of the variation in borderline personality disorder features in both men and women and that this heritability estimate is similar across The Netherlands, Belgium and Australia. Unique environmental influences explain the remaining 58% of the variance.


Genetic factors play a role in individual differences in borderline personality disorder features in Western society.


Corresponding author

*Address for correspondence: M. A. Distel, M.Sc., VU University Amsterdam, Department of Biological Psychology, van der Boechorststraat 1, 1081 BTAmsterdam, The Netherlands. (Email:


Hide All
Akaike, H (1987). Factor analysis and AIC. Psychometrika 52, 317332.
APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, revised. American Psychiatric Press: Arlington, VA.
Bagge, CL, Trull, TJ (2003). DAPP-BQ: factor structure and relations to personality disorder symptoms in a non-clinical sample. Journal of Personality Disorders 17, 1932.
Baron, M, Gruen, R, Asnis, L, Lord, S (1985). Familial transmission of schizotypal and borderline personality disorders. American Journal of Psychiatry 142, 927934.
Becker, DF, Grilo, CM, Edell, WS, McGlashan, TH (2000). Comorbidity of borderline personality disorder with other personality disorders in hospitalized adolescents and adults. American Journal of Psychiatry 157, 20112016.
BellPringle, VJ, Pate, JL, Brown, RC (1997). Assessment of borderline personality disorder using the MMPI-2 and the personality assessment inventory. Assessment 4, 131139.
Bernstein, DP, Cohen, P, Skodol, A, Bezirganian, S, Brook, JS (1996). Childhood antecedents of adolescent personality disorders. American Journal of Psychiatry 153, 907913.
Boomsma, DI, Busjahn, A, Peltonen, L (2002 a). Classical twin studies and beyond. Nature Reviews Genetics 3, 872882.
Boomsma, DI, de Geus, EJC, Vink, JM, Stubbe, JH, Distel, MA, Hottenga, JJ, Posthuma, D, van Beijsterveld, CEM, Hudziak, JJ, Bartels, M, Willemsen, G (2006). Netherlands Twin Register: from twins to twin families. Twin Research and Human Genetics 9, 849857.
Boomsma, DI, Vink, JM, van Beijsterveldt, TC, de Geus, EJC, Beem, AL, Mulder, EJ, Derks, EM, Riese, H, Willemsen, GA, Bartels, M, van den Berg, M, Kupper, NH, Polderman, TJ, Posthuma, D, Rietveld, MJ, Stubbe, JH, Knol, LI, Stroet, T, van Baal, GC (2002 b). Netherlands Twin Register: a focus on longitudinal research. Twin Research 5, 401406.
Carter, JD, Joyce, PR, Mulder, RT, Sullivan, PF, Luty, SE (1999). Gender differences in the frequency of personality disorders in depressed outpatients. Journal of Personality Disorders 13, 6774.
Cloninger, CR, Svrakic, DM, Przybeck, TR (1993). A psychobiological model of temperament and character. Archives of General Psychiatry 50, 975990.
Coid, J, Yang, M, Tyrer, P, Roberts, A, Ullrich, S (2006). Prevalence and correlates of personality disorder in Great Britain. British Journal of Psychiatry 188, 423431.
Costa, PT, McCrae, RR (1992). Professional Manual: Revised NEO Personality Inventory (NEO-PI-R) and NEO Five-Factor Inventory (NEO-FFI). Psychological Assessment Resources: Odessa, FL.
Derom, C, Derom, R (2005). The East Flanders prospective twin survey. In Multiple Pregnancy: Epidemiology, Gestation and Perinatal Outcome, 2nd edn (ed. Blickstein, I. K. L. G.), pp. 3947. Taylor and Francis: Oxford.
Derom, CA, Vlietinck, RF, Thiery, EW, Leroy, FOG, Fryns, JP, Derom, RM (2006). The East Flanders Prospective Twin Survey (EFPTS). Twin Research and Human Genetics 9, 733738.
Distel, MA, Ligthart, L, Willemsen, G, Nyholt, DR, Trull, TJ, Boomsma, DI (2007). Personality, health and lifestyle in a questionnaire family study: a comparison between highly cooperative and less cooperative families. Twin Research and Human Genetics 10, 348353.
Golomb, M, Fava, M, Abraham, M, Rosenbaum, JF (1995). Gender differences in personality disorders. American Journal of Psychiatry 152, 579582.
Grilo, CM (2002). Are there gender differences in DSM-IV personality disorders? Comprehensive Psychiatry 43, 427430.
Grilo, CM, Anez, LM, McGlashan, TH (2002). DSM-IV axis II comorbidity with borderline personality disorder in monolingual Hispanic psychiatric outpatients. Journal of Nervous and Mental Disease 190, 324330.
Grilo, CM, Becker, DF, Walker, ML, Edell, WS, McGlashan, TH (1996). Gender differences in personality disorders in psychiatrically hospitalized young adults. Journal of Nervous and Mental Disease 184, 754757.
Gunderson, JG, Zanarini, MC (1987). Current overview of the borderline diagnosis. Journal of Clinical Psychiatry 48, 511.
Jackson, HJ, Whiteside, HL, Bates, GW, Bell, R, Rudd, RP, Edwards, J (1991). Diagnosing personality disorders in psychiatric inpatients. Acta Psychiatrica Scandinavica 83, 206213.
Jacobo, MC, Blais, MA, Baity, MR, Harley, R (2007). Concurrent validity of personality assessment inventory scales in patients seeking dialectical behaviour therapy. Journal of Personality Assessment 88, 7480.
Jang, KL, Livesley, WJ, Vernon, PA (1996 a). Heritability of the big five personality dimensions and their facets: a twin study. Journal of Personality 64, 577591.
Jang, KL, Livesley, WJ, Vernon, PA (1996 b). The genetic basis of personality at different ages: a cross-sectional twin study. Personality and Individual Differences 21, 299301.
Jang, KL, Livesley, WJ, Vernon, PA, Jackson, DN (1996 c). Heritability of personality disorder traits: a twin study. Acta Psychiatrica Scandinavica 94, 438444.
Jardine, R, Martin, NG, Henderson, AS (1984). Genetic covariation between neuroticism and the symptoms of anxiety and depression. Genetic Epidemiology 1, 89107.
Johnson, AM, Vernon, PA, Harris, JA, Jang, KL (2004). A behavior genetic investigation of the relationship between leadership and personality. Twin Research 7, 2732.
Johnson, BA, Brent, DA, Connolly, J, Bridge, J, Matta, J, Constantine, D, Rather, C, White, T (1995). Familial aggregation of adolescent personality disorders. Journal of the American Academy of Child and Adolescent Psychiatry 34, 798804.
Johnson, JG, Cohen, P, Kasen, S, Skodol, AE, Hamagami, F, Brook, JS (2000). Age-related change in personality disorder trait levels between early adolescence and adulthood: a community-based longitudinal investigation. Acta Psychiatrica Scandinavica 102, 265275.
Keller, MC, Coventry, WL, Heath, AC, Martin, NG (2005). Widespread evidence for non-additive genetic variation in Cloninger's and Eysenck's personality dimensions using a twin plus sibling design. Behavior Genetics 35, 707721.
Korner, A, Gerull, F, Stevenson, J, Meares, R (2007). Harm avoidance, self-harm, psychic pain, and the borderline personality: life in a ‘haunted house’. Comprehensive Psychiatry 48, 303308.
Kurtz, JE, Morey, LC (2001). Use of structured self-report assessment to diagnose borderline personality disorder during major depressive episodes. Assessment 8, 291300.
Kurtz, JE, Morey, LC, Tomarken, AJ (1993). The concurrent validity of three self-report measures of borderline personality. Journal of Psychopathology and Behavioral Assessment 15, 255266.
Livesley, WJ (1986). Trait and behavioral prototypes of personality disorder. American Journal of Psychiatry 143, 728732.
Livesley, WJ (1987). A systematic approach to the delineation of personality disorders. American Journal of Psychiatry 144, 772777.
Livesley, WJ (2006). The dimensional assessment of personality pathology (DAPP) approach to personality disorder. In Differentiating Normal and Abnormal Personality, 2nd edn (ed. Strack, S.), pp. 401425. Springer Publishing Company: New York.
Livesley, WJ (2007). A framework for integrating dimensional and categorical classifications of personality disorder. Journal of Personality Disorders 21, 199224.
Livesley, WJ, Jang, KL, Jackson, DN, Vernon, PA (1993). Genetic and environmental contributions to dimensions of personality disorder. American Journal of Psychiatry 150, 18261831.
Livesley, WJ, Jang, KL, Vernon, PA (1998). Phenotypic and genetic structure of traits delineating personality disorder. Archives of General Psychiatry 55, 941948.
Loos, R, Derom, C, Vlietinck, R, Derom, R (1998). The East Flanders prospective twin survey (Belgium): a population-based register. Twin Research 1, 167175.
Loranger, AW, Oldham, JM, Tulis, EH (1982). Familial transmission of DSM-III borderline personality disorder. Archives of General Psychiatry 39, 795799.
McGlashan, TH, Grilo, CM, Skodol, AE, Gunderson, JG, Shea, MT, Morey, LC, Zanarini, MC, Stout, RL (2000). The collaborative longitudinal personality disorders study: baseline axis I/II and II/II diagnostic co-occurrence. Acta Psychiatrica Scandinavica 102, 256264.
Morey, LC (1988). The categorical representation of personality disorder: a cluster analysis of DSM-III-R personality features. Journal of Abnormal Psychology 97, 314321.
Morey, LC (1991). The Personality Assessment Inventory: Professional Manual. Psychological Assessment Resources: Odessa, FL.
Neale, MC, Boker, SM, Xie, G, Maes, HH (2003). Mx: Statistical Modeling, 6th edn.Virginia Commonwealth University: Richmond, VA.
Neale, MC, Cardon, L (1992). Methodology for Genetic Studies of Twins and Families. Kluwer Academic Publishers: Dordrecht.
Nigg, JT, Goldsmith, HH (1994). Genetics of personality disorders: perspectives from personality and psychopathology research. Psychological Bulletin 115, 346380.
Nyholt, DR (2006). On the probability of dizygotic twins being concordant for two alleles at multiple polymorphic loci. Twin Research and Human Genetics 9, 194197.
Paris, J, Brown, R, Nowlis, D (1987). Long-term follow-up of borderline patients in a general hospital. Comprehensive Psychiatry 28, 530535.
Pukrop, R, Gentil, I, Steinbring, I, Steinmeyer, E (2001). Factorial structure of the German version of the dimensional assessment of personality pathology – basic questionnaire in clinical and nonclinical samples. Journal of Personality Disorders 15, 450456.
Samuels, J, Eaton, WW, Bienvenu, OJ, Brown, CH, Costa, PT, Nestadt, G (2002). Prevalence and correlates of personality disorders in a community sample. British Journal of Psychiatry 180, 536542.
Saulsman, LM, Page, AC (2004). The five-factor model and personality disorder empirical literature: a meta-analytic review. Clinical Psychology Review 23, 10551085.
Skodol, AE, Gunderson, JG, Pfohl, B, Widiger, TA, Livesley, WJ, Siever, LJ (2002). The borderline diagnosis I: Psychopathology, comorbidity, and personality structure. Biological Psychiatry 51, 936950.
Stein, MB, Pinkster-Aspen, JH, Hilsenroth, MJ (2007). Borderline pathology and the personality assessment inventory (PAI): an evaluation of criterion and concurrent validity. Journal of Personality Assessment 88, 8189.
Stone, MH (1990). The Fate of Borderline Patients: Successful Outcome and Psychiatric Practice. Guilford Press: New York, NY.
Stubbe, JH, Posthuma, D, Boomsma, DI, de Geus, EJC (2005). Heritability of life satisfaction in adults: a twin-family study. Psychological Medicine 35, 15811588.
Torgersen, S (1984). Genetic and nosological aspects of schizotypal and borderline personality disorders. A twin study. Archives of General Psychiatry 41, 546554.
Torgersen, S, Kringlen, E, Cramer, V (2001). The prevalence of personality disorders in a community sample. Archives of General Psychiatry 58, 590596.
Torgersen, S, Lygren, S, Oien, PA, Skre, I, Onstad, S, Edvardsen, J, Tambs, K, Kringlen, E (2000). A twin study of personality disorders. Comprehensive Psychiatry 41, 416425.
Trull, TJ (1995). Borderline personality disorder features in nonclinical young adults: 1. Identification and validation. Psychological Assessment 7, 3341.
Trull, TJ (2001). Structural relations between borderline personality disorder features and putative etiological correlates. Journal of Abnormal Psychology 110, 471481.
Trull, TJ, Tragesser, SL, Solhan, M, Schwartz-Mette, R (2007). Dimensional models of personality disorder: Diagnostic and Statistical Manual of Mental Disorders Fifth Edition and beyond. Current Opinion in Psychiatry 20, 5256.
Trull, TJ, Widiger, TA, Guthrie, P (1990). Categorical versus dimensional status of borderline personality disorder. Journal of Abnormal Psychology 99, 4048.
Vink, JM, Willemsen, G, Stubbe, JH, Middeldorp, CM, Ligthart, RS, Baas, KD, Dirkzwager, HJ, de Geus, EJ, Boomsma, DI (2004). Estimating non-response bias in family studies: application to mental health and lifestyle. European Journal of Epidemiology 19, 623630.
Widiger, TA, Trull, TJ (2007). Plate tectonics in the classification of personality disorder: shifting to a dimensional model. American Psychologist 62, 7183.
Widiger, TA, Weissman, MM (1991). Epidemiology of borderline personality disorder. Hospital and Community Psychiatry (Washington, DC) 42, 10151021.
Willemsen, G, Posthuma, D, Boomsma, DI (2005). Environmental factors determine where the Dutch live: results from the Netherlands Twin Register. Twin Research and Human Genetics 8, 312317.
Zanarini, MC, Frankenburg, FR, Dubo, ED, Sickel, AE, Trikha, A, Levin, A, Reynolds, V (1998). Axis I comorbidity of borderline personality disorder. American Journal of Psychiatry 155, 17331739.
Zanarini, MC, Frankenburg, FR, Yong, L, Raviola, G, Reich, DB, Hennen, J, Hudson, JI, Gunderson, JG (2004). Borderline psychopathology in the first-degree relatives of borderline and axis II comparison probands. Journal of Personality Disorders 18, 439447.
Zimmerman, M, Coryell, W (1989). DSM-III personality disorder diagnoses in a nonpatient sample. Demographic correlates and comorbidity. Archives of General Psychiatry 46, 682689.
Zimmerman, M, Mattia, JI (1999). Axis I diagnostic comorbidity and borderline personality disorder. Comprehensive Psychiatry 40, 245252.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed