scholarly journals Differential Effects of the Menstrual Cycle on Reactive and Proactive Aggression in Borderline Personality Disorder

2018 ◽  
Author(s):  
Jessica R. Peters ◽  
Sarah A. Owens ◽  
Katja M. Schmalenberger ◽  
Tory A. Eisenlohr-Moul
Keyword(s):  
Borderline Personality Disorder ◽  
Menstrual Cycle ◽  
Personality Disorder ◽  
Aggressive Behavior ◽  
Reactive Aggression ◽  
Borderline Personality ◽  
Proactive Aggression ◽  
Cycle Phase ◽  
Emotional Symptoms ◽  
Reactive And Proactive Aggression

AbstractBorderline personality disorder (BPD) is characterized by rapidly shifting symptoms, including intense anger and aggressive behavior. Understanding how fluctuations in ovarian hormones across the menstrual cycle may contribute to symptom instability is key for accurate assessment of BPD symptoms and effective interventions. Reactive and proactive aggression, as well as anger in and out, were assessed daily in 15 physically healthy, unmedicated naturally cycling female individuals without dysmenorrhea meeting criteria for BPD across 35 days. Urine LH surge and salivary progesterone were used to confirm ovulation and verify cycle phase. Cyclical worsening of symptoms was evaluated using multilevel models to evaluate symptom differences between cycle phases. Both forms of aggressive behavior demonstrated marked cycle effects, with reactive aggression highest during perimenstrual cycle phases, co-occurring with increases in anger in and out. In contrast, highest levels of proactive aggression were observed during the follicular and ovulatory phases, when emotional symptoms and anger were otherwise at lowest levels. These findings highlight the importance of identifying the function of aggression when considering potential psychological and biological influences. Naturally cycling individuals with BPD may be at elevated risk for perimenstrual worsening of a range of interpersonally reactive symptoms, including reactive aggression, whereas proactive aggression may occur more in phases characterized by less emotional and cognitive vulnerability and greater reward sensitivity. Research on aggression in this population should consider cycle effects. Cycling individuals with BPD attempting to reduce aggressive behavior may benefit from cycle-tracking to increase awareness of these effects and to develop appropriate strategies.

Respiratory Sinus Arrhythmia Mediates Links Between Borderline Personality Disorder Symptoms and Both Aggressive and Violent Behavior

2019 ◽  
Vol 33 (4) ◽  
pp. 544-559 ◽  
Author(s):  
Nicholas D. Thomson ◽  
Theodore P. Beauchaine
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Respiratory Sinus Arrhythmia ◽  
Interpersonal Violence ◽  
Emotion Dysregulation ◽  
Violent Behavior ◽  
Reactive Aggression ◽  
Borderline Personality ◽  
Proactive Aggression ◽  
Sinus Arrhythmia

Although emotion dysregulation (ED) is a core symptom of borderline personality disorder (BPD), tests of associations between ED and aggression and violence—which are common to BPD—are sparse. The authors evaluated mediating effects of an autonomic vulnerability to ED on links between BPD symptoms and (a) reactive aggression, (b) proactive aggression, and (c) histories of interpersonal violence in a sample of young adults (N = 104), ages 18–22 years. Low baseline respiratory sinus arrhythmia (RSA) mediated the association between BPD symptoms and reactive aggression. In contrast, although BPD symptoms were correlated with proactive aggression, no mediational effect was found. In addition, low RSA mediated the association between BPD symptoms and histories of interpersonal violence. Collectively, these findings add evidence that neurobiological vulnerability to ED contributes to aggressive and violent behavior among those with BPD.

scholarly journals Perimenstrual Exacerbation of Symptoms in Borderline Personality Disorder: Evidence from Multilevel Models and the Carolina Premenstrual Assessment Scoring System

2017 ◽  
Author(s):  
Tory A. Eisenlohr-Moul ◽  
Katja M. Schmalenberger ◽  
Sarah A. Owens ◽  
Jessica R. Peters ◽  
Danyelle N. Dawson ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Scoring System ◽  
Multilevel Models ◽  
Borderline Personality ◽  
Instability Criterion ◽  
Cycle Phase ◽  
Emotional Symptoms ◽  
Emotional Instability ◽  
Clinically Significant

AbstractBackgroundIndividuals with borderline personality disorder (BPD) suffer from a constellation of rapidly shifting emotional, interpersonal, and behavioral symptoms. The menstrual cycle may contribute to symptom instability among females with this disorder.MethodsFifteen healthy, unmedicated females with BPD and without dysmenorrhea reported daily symptoms across 35 days. Urine luteinizing hormone (LH) and salivary progesterone (P4) were used to confirm ovulation and cycle phase. Cyclical worsening of symptoms was evaluated using (1) phase contrasts in multilevel models and (2) the Carolina Premenstrual Assessment Scoring System (C-PASS; Eisenlohr-Moul et al., 2017b), a protocol for evaluating clinically significant cycle effects on symptoms.ResultsMost symptoms demonstrated midluteal worsening, a perimenstrual peak, and resolution of symptoms in the follicular or ovulatory phase. Post-hoc correlations with person-centered progesterone revealed negative correlations with most symptoms. Depressive symptoms showed an unexpected delayed pattern in which baseline levels of symptoms were observed in the ovulatory and midluteal phases, and exacerbations were observed during both the perimenstrual and follicular phases. The majority of participants met C-PASS criteria for clinically significant (>=30%) symptom exacerbation. All participants met the emotional instability criterion of BPD, and no participant met DSM-5 criteria for premenstrual dysphoric disorder (PMDD).ConclusionsFemales with BPD may be at elevated risk for perimenstrual worsening of emotional symptoms. Longitudinal studies with fine-grained hormonal measurement as well as hormonal experiments are needed to determine the pathophysiology of perimenstrual exacerbation in BPD.

scholarly journals Perimenstrual exacerbation of symptoms in borderline personality disorder: evidence from multilevel models and the Carolina Premenstrual Assessment Scoring System

2018 ◽  
Vol 48 (12) ◽  
pp. 2085-2095 ◽  
Author(s):  
Tory A. Eisenlohr-Moul ◽  
Katja M. Schmalenberger ◽  
Sarah A. Owens ◽  
Jessica R. Peters ◽  
Danyelle N. Dawson ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Scoring System ◽  
Multilevel Models ◽  
Borderline Personality ◽  
Instability Criterion ◽  
Cycle Phase ◽  
Emotional Symptoms ◽  
Emotional Instability ◽  
Clinically Significant

AbstractBackgroundIndividuals with a borderline personality disorder (BPD) suffer from a constellation of rapidly shifting emotional, interpersonal, and behavioral symptoms. The menstrual cycle may contribute to symptom instability among females with this disorder.MethodsFifteen healthy, unmedicated females with BPD and without dysmenorrhea reported daily symptoms across 35 days. Urine luteinizing hormone and salivary progesterone (P4) were used to confirm ovulation and cycle phase. Cyclical worsening of symptoms was evaluated using (1) phase contrasts in multilevel models and (2) the Carolina Premenstrual Assessment Scoring System (C-PASS), a protocol for evaluating clinically significant cycle effects on symptoms.ResultsMost symptoms demonstrated midluteal worsening, a perimenstrual peak, and resolution of symptoms in the follicular or ovulatory phase. Post-hoc correlations with person-centered progesterone revealed negative correlations with most symptoms. Depressive symptoms showed an unexpected delayed pattern in which baseline levels of symptoms were observed in the ovulatory and midluteal phases, and exacerbations were observed during both the perimenstrual and follicular phases. The majority of participants met C-PASS criteria for clinically significant (⩾30%) symptom exacerbation. All participants met the emotional instability criterion of BPD, and no participant met DSM-5 criteria for premenstrual dysphoric disorder (PMDD).ConclusionsFemales with BPD may be at elevated risk for perimenstrual worsening of emotional symptoms. Longitudinal studies with fine-grained hormonal measurement as well as hormonal experiments are needed to determine the pathophysiology of perimenstrual exacerbation in BPD.

scholarly journals Impact of a Mechanism-Based Anti-Aggression Psychotherapy on Behavioral Mechanisms of Aggression in Patients With Borderline Personality Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Hannah Honecker ◽  
Katja Bertsch ◽  
Karen Spieß ◽  
Marlene Krauch ◽  
Nikolaus Kleindienst ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Aggressive Behavior ◽  
Reactive Aggression ◽  
Borderline Personality ◽  
Post Treatment ◽  
Overt Aggression ◽  
Healthy Controls ◽  
Group Setting ◽  
Response Latencies

Introduction: Aggressive behavior is highly prevalent in patients with borderline personality disorder (BPD) and represents a major burden for patients and their environment. Previous studies have hypothesized threat hypersensitivity, among other mechanisms, as a biobehavioral mechanism underlying aggressive behavior in patients with BPD. The effects of a 6-week mechanism-based anti-aggression psychotherapy (MAAP) for the group setting were tested in comparison to the effects of a non-specific supportive psychotherapy (NSSP) on this hypothesized mechanism and their relation to the effects on aggressive behavior.Methods: To assess mechanisms of reactive aggression, 38 patients with BPD (20 in MAAP and 18 in NSSP) and 24 healthy controls participated in an emotion classification task before and after therapy or at a similar interval of 7 weeks for controls, respectively. In addition, current reactive aggressive behavior was assessed by the externally directed overt aggression score of the Overt Aggression Scale Modified (OAS-M) at both time points. Mixed linear models were used to test for group differences and differential treatment effects.Results: Consistent with previous findings, patients showed longer response latencies and misclassified faces as angry more often than healthy controls. Comparing pre- and post-treatment measurements, the MAAP group showed an increase in response latency in classifying angry faces, whereas the NSSP group showed a decrease in latency. Furthermore, the difference between pre- and post-treatment response latencies in classifying emotional faces correlated with the reductions in reactive aggression in the MAAP group, but not in the NSSP group or healthy controls.Conclusion: The results suggest an impact of MAAP on threat sensitivity as well as cognitive control, which has also been previously hypothesized as a biobehavioral mechanism underlying reactive aggression in patients with BPD. In addition, our findings shed light on the importance of these two biobehavioral mechanisms underlying reactive aggression as mechanisms of change addressed by MAAP. Further studies are needed to determine whether the behavioral change is stable over time and to what extent this change is related to a stable reduction in reactive aggression in a larger group of patients with BPD.

Menstrual Cycle Influences On Mood and Behavior in Women With Borderline Personality Disorder

1995 ◽  
Vol 9 (1) ◽  
pp. 68-75 ◽  
Author(s):  
Barbara Ziv ◽  
Mark J. Russ ◽  
Margaret Moline ◽  
Stephen Hurt ◽  
Steven Zendell
Keyword(s):  
Borderline Personality Disorder ◽  
Menstrual Cycle ◽  
Personality Disorder ◽  
Borderline Personality ◽  
And Behavior

Aggressive behavior and self-harm in Borderline Personality Disorder: The role of impulsivity and emotion dysregulation in a sample of outpatients

2017 ◽  
Vol 249 ◽  
pp. 321-326 ◽  
Author(s):  
Laura Terzi ◽  
Francesca Martino ◽  
Domenico Berardi ◽  
Biancamaria Bortolotti ◽  
Anna Sasdelli ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Aggressive Behavior ◽  
Emotion Dysregulation ◽  
Borderline Personality ◽  
Self Harm

Brain Mechanisms Underlying Reactive Aggression in Borderline Personality Disorder—Sex Matters

2017 ◽  
Vol 82 (4) ◽  
pp. 257-266 ◽  
Author(s):  
Sabine C. Herpertz ◽  
Krisztina Nagy ◽  
Kai Ueltzhöffer ◽  
Ruth Schmitt ◽  
Falk Mancke ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Reactive Aggression ◽  
Borderline Personality

Aggressive Behavior and Interpersonal Difficulties in Borderline Personality Disorder

2017 ◽  
Author(s):  
Lori N. Scott ◽  
Paul A. Pilkonis
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Aggressive Behavior ◽  
Emotion Dysregulation ◽  
Interpersonal Problems ◽  
Borderline Personality ◽  
Case Formulation ◽  
Interpersonal Difficulties ◽  
Monitoring Progress

Interpersonal problems are among the most severely impairing, difficult-to-manage, and intransigent of borderline personality disorder (BPD) features and therefore require special attention in treatment. Emotion dysregulation and related mood-dependent behaviors among individuals with BPD typically occur in the context of interpersonally relevant events or stressors, signifying the central role of interpersonal and attachment-related concerns for these patients. Two prominent interpersonal themes in those with BPD are discussed: interpersonal hypersensitivity and angry or aggressive behavior. The chapter provides a brief case illustration of how these themes might emerge in psychotherapy and recommends explicit assessment of interpersonal problems and aggression to enhance risk evaluation, case formulation, treatment planning, and monitoring progress in treatment.

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