According to Paris (1999, 2007), a key causal factor in borderline personality disorder seems to be

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Paris (1999, 2007) proposes that a key causal factor in borderline personality disorder is a combination of impulsivity and affective instability interacting with such factors as trauma or loss. Childhood experiences may contribute to the development of impulsivity and affective instability, but it is the interaction with later life events that seems to be the key factor. Inconsistent or highly punitive discipline in childhood (A) may be a contributing factor, but it is not the primary causal factor. Negative attributional style (C) and inability to empathize with other people (D) may also be characteristic of individuals with borderline personality disorder, but they are not regarded as causal factors by Paris.

According to Paris (1999, 2007), a Key Causal Factor in Borderline