Externalized aggressive behaviors in patients with borderline personality symptomatology

Borderline personality disorder (BPD) is commonly characterized by self-directed aggressive behavior, although the literature indicates that externalized aggressive behavior may be present. The simultaneous examination of multiple types of externalized aggressive behavior in individuals with BPD and the exploration of such relationships in a primary care population have not, to our knowledge, been undertaken; this is the focus of the present study.

Using a cross-sectional approach in a consecutive sample of 335 internal medicine outpatients, we explored through a self-report survey the relation between 21 externalized aggressive behaviors and BPD symptomatology, using two self-report measures for assessment: the borderline personality disorder scale of the Personality Diagnostic Questionnaire-4 (PDQ-4) and the Self-Harm Inventory (SHI).

Scores on the measure for externalized aggressive behavior correlated strongly with scores on the PDQ-4 (r = 0.60; P < 0.001) and the SHI (r = 0.67; P < 0.001) and were statistically significantly greater among respondents who exceeded the cutoff scores for BPD symptomatology on both the PDQ-4 and the SHI as compared with respondents who did not exceed these scores.

In addition to self-directed aggressive behavior, individuals with BPD symptomatology also exhibit various externalized aggressive behaviors.