Borderline patients unfairly labelled violent
Most people with borderline personality disorder (BPD) are not violent, contrary to the overwhelming body of research, which has unduly focused on those already in the justice system, a systematic review has found.
Borderline patients unfairly labelled violent
January 20, 2012 By Mary Anne Kenny
Most people with borderline personality disorder (BPD) are not violent, contrary to the overwhelming body of research, which has unduly focused on those already in the justice system, a systematic review has found.
“Although this may be the case in some patients, they are likely the minority of individuals with BPD,” the researchers from the University of Toronto wrote in Current Psychiatry Reports. “The diagnosis of BPD may be less useful in predicting violence than one might suspect, and violence in BPD may not be as strongly determined by impulsivity as is commonly held.”
Most research had been conducted in unrepresentative samples including prisoners, people undergoing mandated psychiatric treatment, psychiatric patients, substance abusers and delinquent youths, the report noted.
“Clinical lore holds that patients are at risk of committing violence, especially in the context of perceived or feared loss or abandonment in interpersonal relationships,” the researchers said. However, this and other contextual factors needed to be examined more closely.
It was important to look beyond the diagnosis of BPD and individually assess the issue in light of interpersonal relationships and other risk factors for violence, the researchers said.
The diagnostic criteria for the condition included unstable and intense interpersonal relationships, impulsivity, affective instability, and difficulties with controlling intense or inappropriate anger.
These features suggested that aggression might be a common result, but it was important to avoid over-generalising and adding to the heavy burden of stigma that BPD patients already faced, the authors wrote.
Current Psychiatry Reports 2011 doi 10.1007/s11920-011-0244-9
2 Comments
Haven
People with BPD are more likely to be dangerous to themselves then to others. All of these symptoms clearly are common, but they’re interpretting them as if we have ASPD. ASPD is more likely to turn anger outwards. BPD ofted turns it inwards.
Bon Dobbs
Haven,
I would agree with you. In my polls, I have found that about 75% of self-identified people with BPD have attempted suicide, had substance abuse issues and engaged in self-injury. I think this represents that vast majority of people with BPD, despite all the talk of high-functioning (which I believe is a myth, because it depends on the context) violent borderlines. The ICD provides a pretty clear view on the “types” with IMO the vast majority failing in the second type who can be a danger to themselves more than other people. Thanks for the comment!
Bon