Violence and aggressiveness in borderline disorder: A systematic review
Abstract
INTRODUCTION
Borderline Personality Disorder (BPD) affects 1 to 3% of the general population and up to 20% of psychiatric inpatients. It is characterized by emotional dysregulation, impaired interpersonal relationships, and impulsive behaviors. This systematic review aims to identify psychopathological mechanisms, comorbidities, and gender differences associated with violence in BPD.
METHODS
This review followed PRISMA guidelines and included studies published in English or French with no time restriction. Literature searches were conducted in PubMed and Ovid using the search equation: ((violence [MeSH Terms]) or (aggression [MeSH Terms])) and (borderline personality disorder [MeSH Terms]) and (psychiatry). Of 502 initial publications, 28 were included in the final analysis.
RESULTS
Aggressiveness in BPD was found to be associated with emotional dysregulation and impulsivity, influencing violent behaviors (β=0.25 to 0.52). Comorbidities such as bipolar disorder, substance use, or co-occurring personality disorders exacerbated aggression (OR=2.1 to 3.2). Suicidal and self-harming behaviors affected 78% of adolescents and 73% of adults with BPD. Women accounted for 75% of BPD diagnoses and presented more self-directed aggression (suicide, self-harm), whereas men more frequently exhibited outwardly directed aggression. Finally, childhood trauma and dysfunctional family environments were seen as major predictors of aggressive and suicidal behaviors in adulthood (OR=3.9 to 5.8).…
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Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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