Borderline personality disorder symptoms and criminal justice system involvement: The roles of emotion-driven difficulties controlling impulsive behaviors and physical Aggression

Impulsive and compulsive reading comprehension in the prison population

BACKGROUND

Developmental dyslexia is characterized by reading and writing deficits that persist into adulthood. Dyslexia is strongly associated with academic underachievement, as well as impulsive, compulsive, and criminal behaviors. The aims of this study were to investigate impulsive or compulsive reading comprehension, analyzing the differences in reading errors between two distinct groups -one with Antisocial Personality Disorder (ASPD) and another with Obsessive-Compulsive Personality Disorder (OCPD) and examine their correlation with criminal behavior within a prison population.

METHODS

We gathered data from 194 participants: 81 with ASPD and 113 with OCPD from a prison center. Participants took part in interviews to gather data on demographic, criminal, and behavioral data. Additionally, the participants underwent various assessments, including the International Examination for Personality Disorders; Symptom Inventory, and Battery for the Assessment of Reading Processes in Secondary and High School - Revised.

RESULTS

Our analysis revealed differences in reading skills between the ASPD and OCPD groups. Specifically, the OCPD group showed poorer performance on lexical selection, semantic categorization, grammar structures, grammatical judgements, and expository comprehension when compared with the ASPD group. Conversely, the OCPD group obtained higher scores on narrative comprehension relative to the ASPD group.

CONCLUSIONS

The OCPD group showed slow lexical-phonological coding and phonological activation.

Examining the Presence, Frequency, and Associated Characteristics of Nonsuicidal Self-Injury by Proxy: Initial Validation of the Nonsuicidal Self-Injury by Proxy Questionnaire (NSSIBPQ)

Nonsuicidal self-injury (NSSI) by proxy is the intentional destruction of one's own body tissue through the elicitation of another being's actions. Despite its clinical relevance, research on NSSI by proxy is limited and there are no available measures of this behavior. This research aimed to characterize NSSI by proxy among young adults and provide preliminary data on the validity of a new self-report measure, the NSSI by Proxy Questionnaire (NSSIBPQ). Two nationwide community samples of young adults (one general community sample and one with a history of traditional NSSI and suicidality) completed online studies. NSSI by proxy was reported by 18% of the general community sample and 45% of the self-injuring sample. Findings support the clinical relevance of NSSI by proxy and its potential to meet criteria for an NSSI disorder diagnosis. Results also provide preliminary support for the internal consistency and convergent, discriminant, and concurrent validity of the NSSIBPQ.

The Effectiveness of Interpersonal Psychotherapy on Alexithymia, Emotion Regulation, and Psychological Capital of Male Substance Abusers Treated by Addiction Treatment Centers in Kerman

Background

Addiction is a psychiatric disorder with biological, psychological, and social aspects. Literatures indicated that alexithymia, emotional dysregulation, and low psychological capital affect substance abuse. This study investigated the effectiveness of interpersonal psychotherapy on alexithymia, emotional regulation, and psychological capital of male substance abusers.

Methods

This quasi-experimental study was conducted in 2021 in Kerman, Iran using a pretest, post-test design with a control group. A single therapy center was randomly selected via the multi-stage cluster method from several substance abuse treatment centers. 50 people were randomly selected and allocated to experimental and control groups. The research instruments were questionnaires for alexithymia, emotional regulation, and psychological capital. After the pretest phase, the experimental group underwent 12 sessions of interpersonal psychotherapy. In the next step, the post-test was conducted and after 6 weeks the follow-up test was performed on the groups. The control group did not receive the treatment. Finally, the data obtained from 40 participants were analyzed using the MANCOVA test by SPSS25 statistical software.

Findings

Our findings indicated significant MANCOVA results for alexithymia (F=65.14 and P<0.05), emotion regulation (F=44.72 and P<0.05) and psychological capital (F=12.05 and P<0.05) showing a significant difference between the scores of dependent variables in the experimental group and control group.

Conclusion

The results showed that interpersonal psychotherapy improves the state of alexithymia, emotional regulation, and psychological capital in substance abusers. It can also be used as an effective intervention in addiction treatment centers.

Psychobiological Correlates of Aggression in Female Adolescents with Borderline Personality Disorder

INTRODUCTION

Aggressive behavior in reaction to threats, frustration, or provocation is prevalent in borderline personality disorder (BPD). This study investigated aggressive behavior and its biological correlates in adolescents with BPD.

METHODS

Twenty-one female adolescents with a DSM-IV BPD diagnosis and 25 sex- and age-matched healthy controls participated in the Taylor Aggression Paradigm (TAP), a laboratory-based experiment measuring aggressive behavior in the interpersonal context. Heart rate was measured and saliva samples were taken throughout the experiment.

RESULTS

Multilevel mixed-effects linear regression analyses revealed no significant group difference in aggressive behavior induced by the TAP. Additionally, the two groups did not differ in cortisol, testosterone, and heart rate responses to the aggression induction. The BPD group showed a significant cortisol increase in the time preceding the start of the TAP in contrast to the healthy control group, in whom a significant heart rate increase from baseline to the first block of the TAP was observed.

DISCUSSION

There was no evidence, either at the phenomenological or the biological level, of increased task-induced aggression in adolescents with BPD. The results may indicate that adolescents with BPD experienced fearful stress in anticipation of the experimental task in contrast to healthy controls who showed an adaptive response of the autonomic nervous system necessary to deal with the upcoming demand.

Borderline Personality Disorder Diagnosis and Symptoms in Outpatient Youth as Risk Factors for Criminal Offenses and Interpersonal Violence

The aim of the current study was to examine the risk for offending among outpatient youth with borderline pathology. Demographic and diagnostic data from 492 outpatients who attended a public mental health service for 15-to 25-year-olds between January 1998 and March 2008 were linked with information regarding criminal offenses and intervention orders collected from a statewide police database between March 1993 and June 2017. BPD diagnosis and number of BPD criteria were both associated with an elevated risk for violent and nonviolent offenses and family violence intervention orders. Moderation analyses revealed that the number of BPD criteria might affect males and females differently in terms of offending. Both impulsivity and anger independently predicted the risk for violent and nonviolent offenses and family violence intervention orders. Early detection of increased risk of offending among youth with BPD features is essential to develop targeted treatments for criminal or violent behavior.

High-Frequency Heart Rate Variability and Emotion-Driven Impulse Control Difficulties During Adolescence: Examining Experienced and Expressed Negative Emotion as Moderators

Emotion-driven impulse control difficulties are associated with negative psychological outcomes. Extant research suggests that high frequency heart rate variability (HF-HRV) may be indicative of emotion-driven impulse control difficulties and potentially moderated by negative emotion. In the current study, 248 eleven- to 14-year-olds and their parent engaged in a negatively emotionally arousing conflict task at Time 1. Adolescents' HF-HRV and negative emotional expression and experience were assessed before, during, and/or after the task. Adolescents reported on their levels of emotion-driven impulse control difficulties at Time 1 and one year later. Results revealed that higher levels of HF-HRV reactivity (i.e., higher HF-HRV augmentation) predicted higher levels of emotion-driven impulse control difficulties one year later among adolescents who experienced higher negative emotion. These findings suggest that negative emotional context should be considered when examining HF-HRV reactivity as a risk factor for emotion-driven impulse control difficulties and associated outcomes.

The dual mediating roles of impulsivity and emotion regulation of the borderline personality disorder-violence relationship: A structural equation modeling approach

Although the past research has indicated that features of borderline personality disorder (BPD) increase the risk for violence, much less research has examined the mediators of this relationship. This study examined the mediating roles that impulsivity and emotion dysregulation may play in explaining the relationship between BPD and violence. The Pathways to Desistance data were used in analyses. Generalized structural equation modeling was used to estimate the direct effect of BPD features on violent offending risk and to examine the mediating roles of emotion dysregulation and impulsivity. Results indicated that the direct effect of BPD symptoms on violence was mediated to non-significance by key constructs, and the magnitude of the effect was reduced by around 40%. The total indirect effect was significant, and the mediation was attributed mainly to impulsivity. This indicates the importance of structuring treatment programming for BPD patients around impulsivity for reducing violence. Programming focused on improving impulsivity among individuals suffering from BPD may aid in reducing violent offending among this population, particularly those prior histories of involvement with the criminal justice system.

Substance use disorders and criminal justice contact among those with co-occurring antisocial and borderline personality disorders: Findings from a nationally representative sample

One variant of borderline personality disorder (BPD), frequently encountered in forensic and correctional samples, is the 'dissocial' subtype that combines borderline and antisocial traits. We tested the hypothesis that this subtype, defined by the co-occurrence of antisocial personality disorder (ASPD) and BPD (ASPD + BPD), would be associated with high rates of substance use disorder and contact with the criminal justice (CJ) system in a large nationally representative sample of North American adults (N = 36 309). Results suggested that the dissocial variant of BPD was associated with a high risk for substance use disorders and CJ contact. The odds of these outcomes were significantly raised about fivefold in ASPD + BPD individuals in comparison with those who lacked either an ASPD or BPD diagnosis. ASPD + BPD, compared with BPD alone, was also associated with significantly (p < 0.0001) greater severity of borderline symptoms. Although CJ contact appears to be strongly driven by ASPD, substance use, primarily driven by severity of borderline symptoms, added to the risk of CJ contact. It is suggested that, in the 11th Revision of the International Classification of Diseases terms, the dissocial borderline variant is a severe form of personality disorder characterized by high levels of traits within domains of negative emotionality and dissociality. Further studies will be required to verify this suggestion. © 2020 The Authors Personality and Mental Health Published by John Wiley & Sons Ltd.

Men and women with borderline personality disorder resident in Dutch special psychiatric units in prisons: A descriptive and comparative study

BACKGROUND

The overall prevalence of borderline personality disorder is well known, but characteristics of offender patients with the condition are less clear, especially among men.

AIM

Describe characteristics of men and women with borderline personality disorder in special psychiatric units in Dutch prisons on three domains: prevalence of child abuse, comorbidity of borderline personality disorder with other disorders, and clinical symptoms.

METHODS

One hundred and sixty-seven people were assigned to this study based on a Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) diagnoses retrieved from records. Other DSM-5 diagnoses were also recorded. Two scales, the Dutch Historisch, Klinisch, Toekomst-Revisie and the international Brief Psychiatric Rating Scale-Expanded (BPRS-E) were used to record child abuse and clinical symptoms, respectively.

RESULTS

Prevalence rates of child abuse were high, but the men and women did not differ in this respect. The male offender patients were more likely than the women to have a comorbid substance use disorder, whereas the women were more likely to have a comorbid anxiety disorder. Intellectual disability was the most common comorbid Axis II disorder. The women were more likely than the men to have committed a fatal/nearly fatal index offence and showed higher rates of distress or behavioural disturbance on all five BPRS-E factors.

CONCLUSIONS

This study provides evidence of the importance of in-depth knowledge of presentations with borderline personality disorder specific to setting. Although we were unable to make direct comparisons with other samples, our figures suggest clinically relevant differences among offender patients from the more widely reported general samples. We also shed light on a sometimes underexposed group of men with borderline personality disorder and their clinical needs. More population-specific intervention and follow-up studies are now indicated.

Correlates of Aggression in Personality Disorders: an Update

PURPOSE OF REVIEW

This review article aims at giving an update on studies investigating correlates of aggression in personality disorders during the last 5 years.

RECENT FINDINGS

Most data refer to borderline personality disorder (BPD) and antisocial personality disorder (ASPD). In BPD, emotion dysregulation, hypersensitivity to interpersonal rejection/threat, increased rumination, increased negative urgency, aggression-related knowledge structures, and invalidation were either corroborated or emerged as psychological correlates of aggression, while reduced ambiguity sensitivity, hyposensitivity to interpersonal threat, and reduced mindfulness were associated with aggression in ASPD. Neurobiologically, alterations of the monoaminooxidase-A-, the oxytocinergic-, and the prefrontal-limbic-system as well as increases of the thyroid hormone T3, γ-aminobutyric acid and several inflammatory markers were associated with increased aggression across various personality disorders. Our understanding of correlates of aggression in personality disorders has increased over the last 5 years. More efforts in improving the conceptualization of personality disorders and aggression are needed to develop innovative treatments for those affected.