Multifinality in the development of personality disorders: a Biology x Sex x Environment interaction model of antisocial and borderline traits.
Multifinality in the development of personality disorders: a Biology x Sex x Environment interaction model of antisocial and borderline traits.
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DOI：
10.1017/s0954579409000418
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发表时间：
2009
影响因子：
3.3
通讯作者：
Gatzke-Kopp L
中科院分区：
文献类型：
--
作者：
Beauchaine TP;Klein DN;Crowell SE;Derbidge C;Gatzke-Kopp L
尽管反社会人格障碍（ASPD）在男性中更常见，而边缘型人格障碍（BPD）在女性中更常见，但一些人（例如）认为这两种疾病反映了单一病因的多种最终结果。这一论断是基于几个重叠的症状和特征，包括特质性冲动、情绪不稳定、高抑郁率和自杀率，以及童年虐待和/或忽视的高可能性。此外，在BPD患者的一级亲属中，反社会人格障碍的发生率升高，并且这两种疾病的并发合并症发生率很高。在这篇文章中，我们提出了一个反社会和边缘人格发展的共同模型。我们首先回顾诊断和研究儿童和青少年人格障碍的问题和问题。接下来，我们将讨论特质冲动性的多巴胺能和血清素能机制作为反社会人格障碍和BPD的易感性。最后，我们扩展了反社会人格障碍和边缘型人格障碍的共同风险模型，明确了可能导致男性对冲动攻击和情绪失调以及女性对冲动自伤和情绪失调的不同易感性的基因位点。尽管这些性别调节的遗传脆弱性的确切机制尚不清楚，但它们似乎与环境风险因素（包括不利的养育环境）相互作用，从而增强了反社会人格障碍和BPD的发展。
Although antisocial personality disorder (ASPD) is more common among males and borderline personality disorder (BPD) is more common among females, some (e.g.,) 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.