The Structure of Genetic and Environmental Risk Factors for DSM-IV Personality Disorders

Abstract

Context Although both genetic and environmental factors affect risk of individual personality disorders (PDs), we know little of how they contribute to the pattern of comorbidity between the PDs in the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV). Objective To clarify the structure of the genetic and environmental risk factors for the 10 DSM-IV PDs. Design Assessment of PDs at personal interview and multivariate twin modeling with the Mx program. Setting General community. Participants A total of 2794 young adult members of the Norwegian Institute of Public Health Twin Panel. Main Outcome Measure Number of endorsed criteria for the 10 DSM-IV PDs. Results The best-fit multivariate twin model required 3 genetic and 3 individual-specific environmental factors and genetic and individual-specific factors unique to each PD. The first genetic factor had high loadings on PDs from all 3 clusters including paranoid, histrionic, borderline, narcissistic, dependent, and obsessive-compulsive. The second genetic factor had substantial loadings only on borderline and antisocial PD. The third genetic factor had high loadings only on schizoid and avoidant PD. Several PDs had substantial disorder-specific genetic risk factors. The first, second, and third individual-specific environmental factors had high loadings on the cluster B, A, and C PDs, respectively, with 1 exception: obsessive-compulsive PD loaded with cluster B and not cluster C PDs. Conclusions Genetic risk factors for DSM-IV PDs do not reflect the cluster A, B, and C typology. Rather, 1 genetic factor reflects a broad vulnerability to PD pathology and/or negative emotionality. The 2 other genetic factors are more specific and reflect high impulsivity/low agreeableness and introversion. Unexpectedly, the cluster A, B, and C typology is well reflected in the structure of environmental risk factors, suggesting that environmental experiences may be responsible for the tendency of cluster A, B, and C PDs to co-occur.

Genetic and Environmental Contributions to the Co-Occurrence of Depressive Personality Disorder and DSM-IV Personality Disorders

“…The path coefficients from dependent and obsessive-compulsive PDs were small, indicating that DPD to a very limited extent shares genetic risk factors with the other Cluster C PDs that are not also shared with avoidant PD. Thus the main difference between DPD and MDD in terms of genetic liability shared with the DSM-IV PDs seems to be the close genetic relationship between DPD and avoidant PD.Our findings are also interesting in light of a previous study on the structure of genetic and environmental risk factors for all the DSM-IV PDs, based on the same sample as in our study, where three genetic factors were identified (Kendler et al, 2008). The first was a …”

“…Knowledge about common genetic and environmental risk factors can both broaden our understanding of co-occurrence of psychiatric disorders (Kendler, 2006;Krueger & Markon, 2006) and be used to inform the development of classification systems such as DSM-5 (Andrews et al, 2009 The Norwegian Institute of Public Health has recently assessed Axis I and Axis II disorders, including all the DSM-IV PDs, in a population-based sample of young adult twins. This dataset has previously been used to explore common genetic and environmental risk factors for the three PD clusters (Kendler, Czajkowski, et al, 2006; Reichborn-Kjennerud, Czajkowski, Neale, et al, 2007;Torgersen et al, 2008), the relationship between selected Axis I disorders and PDs (Reichborn-Kjennerud, Czajkowski, Torgersen, et al, 2007;Reichborn-Kjennerud et al, 2010) and, most recently, the underlying structure of risk factors for all 10 DSM-IV PDs (Kendler et al, 2008).…”

Borderline Personality Disorder in Adolescence

“…However, no specific genes have been identified yet, 27 and genetic vulnerability is more likely to be linked to certain temperamental factors such as negative emotionality, impulsivity, and introversion. 47 Indeed, a BPD-specific temperamental pattern comprising opposing temperamental traits such as high novelty seeking and high harm avoidance has recently been found among adolescents with BPD, even when compared with clinical controls. 48 Recent evidence from adults with BPD supports both gene-environment interaction and correlation in the development of BPD.…”

Borderline Personality Traits and Substance Use: Genetic Factors Underlie the Association with Smoking and Ever Use of Cannabis, but Not with High Alcohol Consumption

“…For BPD and related traits, large scale twin and twin family studies report heritability estimates around 40% for BPD and borderline personality traits (BPT; Bornovalova, Hicks, Iacono, & Mcgue, 2009;Distel et al, 2008;Distel et al, 2009;Kendler et al, 2008;Torgersen et al, 2008) and no evidence of environmental influences that are shared by family members.…”

“…Li, Cheng, Ma, and Swan (2003) conducted a meta-analysis for tobacco use and report a heritability estimate of 59%. A meta-analysis for cannabis initiation estimated the heritability to be 48% for males and 40% for females although the confidence intervals around these estimates for males and females overlapped (Verweij et al, 2010).For BPD and related traits, large scale twin and twin family studies report heritability estimates around 40% for BPD and borderline personality traits (BPT; Bornovalova, Hicks, Iacono, & Mcgue, 2009;Distel et al, 2008;Distel et al, 2009;Kendler et al, 2008;Torgersen et al, 2008) and no evidence of environmental influences that are shared by family members.First degree relatives of individuals with BPD have a significantly higher lifetime prevalence of substance use disorders (alcohol abuse/dependence, drug abuse/dependence, and any substance use disorder) than first degree relatives of individuals with other personality disorders such as histrionic, narcissistic, sadistic, and antisocial personality disorders (Zanarini, Barison, Frankenburg, Reich, & Hudson, 2009). This suggests that there are familial factors that increase the risk for BPD as well as substance use/abuse.…”