Distal Risk Factor Symptoms And Treatments

A behavioral or environmental factor that has a remote or indirect causal influence on a specific disease outcome. Many etiological factors in chronic diseases fall into this category. In this article, we shall discuss distal risk factor symptoms and treatments. This does not mean a relationship that is remote in time or one that has a long latency period, but one that acts indirectly by way of its influence on the chain of causation.  An example is the presence in the atmosphere of ozone-destroying substances, such as freon gas from air conditioning equipment leading to attenuation of the ozone layer, higher levels of biologically active ultraviolet solar radiation, and consequently greater risk of skin cancer and cataract. Thus, the use of ozone-destroying substances is a distal risk factor for skin cancer and cataract.

A distal risk factor is a risk factor that represents an underlying vulnerability for a particular condition, such as borderline personality disorder (BPD). Having a distal risk factor does not mean you will get BPD. It simply means that you may be at risk of developing it at some time in the future.

Some examples of distal risk factors include:

  • Childhood trauma and adversities: Any sort of significant childhood stress can increase the risk of developing BPD. Trauma includes parental loss, parental alcohol or substance abuse, emotional and physical abuse and neglect, and sexual abuse.
  • Family history and genetics: If you have a first-degree relative (a parent or sibling) with BPD or a similar disorder, you are more vulnerable to developing BPD.
  • Temperament: If you were “wired” for traits such as emotionality and shyness, this could increase your risk for BPD.

For instance, childhood trauma puts a person at a higher risk of later being diagnosed with BPD. However, not everyone who has BPD had a traumatic childhood. Similarly, not everyone who experienced trauma develops BPD.

Proximal vs. Distal Risk Factors

In contrast to distal risk factors, proximal risk factors represent an immediate vulnerability for a particular condition or event.

Some examples of proximal risk factors are ongoing abuse, having difficulties because of a physical impairment or injury, poor academic or work performance, and stressful life events.

All of these risk factors, particularly when combined with distal risk factors, can lead to the development of a condition such as BPD.

Distal factors indirectly influence health by acting on the more proximal factors.


Symptoms and patterns of BPD typically begin in the teenage years, and sometimes in young adulthood. Symptoms may be different for different people but can include:

  • Dissociative states
  • Emotional instability
  • Fear of abandonment
  • Feelings of emptiness
  • Impairment in identity
  • Impulsivity
  • Intense anger and aggressive behavior
  • Self-harm or suicide
  • Unstable relationships

In order to be diagnosed with BPD, you must show at least five of these symptoms. If you or a loved one experiences any of these symptoms, make an appointment with your physician for an evaluation.


If you’re diagnosed with BPD, the most helpful tool in your treatment plan will be psychotherapy. Specific types that have been shown to be particularly helpful for BPD include:

  • Dialectical behavior therapy
  • Mentalization-based therapy
  • Schema-focused therapy
  • Transference-focused psychotherapy

Though the Food and Drug Administration (FDA) has not approved any particular medications for the treatment of BPD, your doctor may prescribe you medication to help treat your symptoms or other disorders you may have along with BPD, such as depression.


Current research shows that if you have been diagnosed with BPD, the outlook for your future tends to be positive. A lot of the symptoms that can be so debilitating go away within the first few years of treatment, and most patients improve with time. Also, the sooner your BPD is diagnosed and treated, the more favorable your outcome, so early detection is vital.

I hope you find this article helpful.

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