Does childhood sexual abuse cause borderline personality disorder?

Several studies have found that women with borderline personality disorder are more likely than controls to report a history of childhood sexual abuse. Researchers have generally assumed that childhood sexual abuse causes borderline personality disorder, but there are other possible interpretations of the association. We surveyed psychologists about the likelihood that patients with various personality disorders would engage in behaviors relevant to several alternative interpretations. Relative to patients with other personality disorders and to the "typical outpatient," patients with borderline personality disorder were rated as especially likely to misinterpret or misremember social interactions, to lie manipulatively and convincingly, and to have voluntarily entered destructive sexual relationships, possibly even at young ages. We discuss the plausibility of relevant alternative interpretations of the association between childhood sexual abuse and borderline personality disorder.