Experimentally Assessed Reactive Aggression in Borderline Personality Disorder

PLoS One. 2016 Nov 16;11(11):e0166737. doi: 10.1371/journal.pone.0166737. eCollection 2016.

Abstract

Approximately 73% of patients suffering from Borderline personality disorder (BPD) exhibit aggressive behaviour, which severely hinders therapeutic work and clinical improvement. Because the underlying mechanisms of aggression in BPD are not yet completely understood, additional research in this domain has a high clinical and scientific relevance. We employed a modified version of the Taylor Aggression Paradigm (mTAP), in order to examine for the first time whether this task can be used to differentiate between BPD patients and healthy controls with regard to reactive aggression. In the mTAP, the amount of money subtracted by a virtual opponent was categorized into 'low' (10-20 cents) and 'high' (80-100 cents) provocations, enabling us to compare how much money BPD patients and healthy controls subtracted (i.e., how aggressively participants responded) following high and low provocation trials. Our results showed that, compared to healthy controls, BPD patients showed higher overall aggression, higher aggression after high provocation trials, as well as a larger difference between high and low provocation trials. This finding was corroborated by a neuropsychological assessment, demonstrating higher levels of aggression and impulsivity in BPD patients. Interestingly, reactive aggression in the mTAP was positively correlated with symptom severity and impulsivity in BPD patients. We suggest that the mTAP provides a valuable tool allowing psychiatrists to quantify reactive aggression in BPD. Therefore, clinicians and researchers might consider this task, as a short experimental measure of reactive aggression, either in future studies or to aid diagnostic assessment during clinical practice.

MeSH terms

  • Adult
  • Aggression / psychology*
  • Borderline Personality Disorder / psychology*
  • Case-Control Studies
  • Demography
  • Emotions
  • Female
  • Humans
  • Impulsive Behavior
  • Neuropsychological Tests

Grants and funding

This work was funded by the Interdisciplinary Center for Clinical Research (ICCR; N4-4) of the Faculty of Medicine, RWTH Aachen (http://www.medizin.rwth-aachen.de/cms/Medizin/Die-Fakultaet/Einrichtungen/~dgun/IZKF-Aachen/). The funding source had no role in study design, in collection, analysis, and interpretation of data, in the writing of the report, and in the decision to submit the article for publication.