White et al: 
Results from a twin study based on structural interviews in a clinical sample suggest that heritability is estimated to be 69% Borderline, 63% Histrionic, and 77% Narcissistic personality disorder. 

In a more recent study by Torgersen et al:
- Conducted a population-based twin study. Heritability was estimated to be 38% for anti-social personality disorder, 31% for histrionic personality disorder, 24% for narcissistic personality disorder, and 35% for borderline personality disorder. There were no shared environmental influences or sex differences were found. 

Genetic Link 

Reichborn-Kjennerud, T. (2010). The genetic epidemiology of personality disorders. Dialogues in clinical neuroscience. Retrieved July 31, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181941/ 

Boston University

- Being rewarded for attention-seeking behaviors as a child 
- A family history of personality disorders, anxiety, or depression 
- Learning behaviors from a parent or caregiver with HPD 
- A lack of criticism or punishment as a child 
- Unpredictable attention from your parents 
- Experienced depression or anxiety in the past 
- Genetic susceptibility 

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