Borderline Personality Disorder

Borderline Personality Disorder - Diagnosis, Description, and Etiology (including genetics): 

Over the last 30 years, Dr. Trull has studied Borderline Personality Disorder (BPD), and has been funded by the NIMH, NIAAA, and research foundations for these projects. Early on, he was impressed by the fact that while there were many published articles on this disorder, there were relatively few methodologically sound, empirically-based studies. He became interested in (1) how best to define the disorder, given the great degree of heterogeneity within this diagnostic category; (2) how to understand the symptoms of this disorder by considering the major personality traits that underlie the symptoms; and (3) developing and testing etiological models of the disorder. 

Dr. Trull's first studies focused on the development of BPD features in young adults. Published results from these projects have demonstrated the reliability and validity of methods to identify features of BPD in young adults, evaluated several etiological models of BPD and outcomes of BPD features, examined the comorbidity (co-occurrence) of BPD and substance use disorders (e.g., alcohol or drug dependence) from both an empirical and theoretical perspective, and reviewed evidence for alternative dimensional models of BPD and other personality disorders. Other studies focused on attachment and parental bonding, relations between BPD features and negative outcome two years later, and the assessment of childhood abuse. Finally, we have investigated treatment utilization in those with BPD features, personality and psychopathology, BPD features and substance use, and the relations among BPD features over time.

Another set of projects focusing on the genetics of BPD and related phenotypes is of great relevance to this proposal. A large behavior genetic study on BPD features was funded by the Borderline Personality Disorder Research Foundation to conduct a behavior genetic study of BPD features. Specifically, with colleagues Nick Martin (Australia) and Dorret Boomsma (Netherlands), we initiated a twin study of the genetics of Borderline Personality Disorder, as well as of the personality dimensions that underlie the symptoms of this disorder. To date, we have phenotyped approximately 8,000 Australian twins, and approximately 28,000 Dutch twins and family members. Outcomes of this study to date include better estimates of the distribution of BPD features in the population, of genetic influences on BPD features, and of the extent to which the covariation between BPD features and personality traits is determined by underlying genetic factors. 

To date our publications have addressed the heritability of BPD features, the invariance of BPD feature scores across age and gender, genetic linkage of BPD features, and a genetic analysis of the comorbidity between BPD and five-factor model traits. Data collection on another cohort of Australian twins is almost complete, and we will collect BPD feature data in the next wave of data collection for the Netherlands Twin Registry. Our ultimate aim is to obtain GWAS data from a large portion of these individuals to conduct molecular genetic analyses on BPD and related phenotypes. For the research described above, Dr. Trull played critical roles in all aspects of the research (i.e., study planning, obtaining funding, framing the research question, data analytic approach, and ms. preparation).

Related Publications:

• Trull, T. J. (2001). Structural relations between borderline personality disorder features and putative etiological correlates. Journal of Abnormal Psychology, 110, 471-481. PMID: 11502090

• Bagge, C., Nickell, A., Stepp, S., Durrett, C., & Trull, T. J. (2004). Borderline personality disorder features predict negative outcome two years later. Journal of Abnormal Psychology, 113, 279-288. PMID: 15122948

• Distel, M. A., Trull, T. J., Willemsen, G., Derom, C., Thiery, E., Grimmer, M., Martin, N. G., & Boomsma, D. I. (2008). Heritability of Borderline Personality Features is similar across Three Countries. Psychological Medicine, 38, 1219-1229. PMID: 17988414

• Distel, M. A., Trull, T. J., Vink, J. M., Willemsen, G., Derom, C. A., Lynskey, M., Martin, N. G., & Boomsma, D. I. (2009). The five factor model of personality and borderline personality disorder: A genetic analysis of comorbidity. Biological Psychiatry, 66, 1131-1138. PMID: 19748081