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The causes of BPD are unclear and complex, implicating genetic, neurological, and psychosocial conditions in its development. A genetic predisposition is evident, with the disorder significantly more common in people with a family history of BPD, particularly immediate relatives. Psychosocial factors, particularly adverse childhood experiences, have been proposed. Neurologically, the underlying mechanism appears to involve the frontolimbic neuronal network of the limbic system. The American Diagnostic and Statistical Manual of Mental Disorders (DSM) classifies BPD as a cluster B personality disorder, alongside antisocial, histrionic, and narcissistic personality disorders. There is a small risk of misdiagnosis, with BPD most commonly confused with a mood disorder, substance use disorder, or other mental health disorders.