Archival ReportBrain Mechanisms Underlying Reactive Aggression in Borderline Personality Disorder—Sex Matters
Section snippets
Participants
Groups comprised 33 women and 23 unmedicated men with a current diagnosis of BPD (18 to 45 years of age) and 30 age-matched healthy women and 26 healthy men who had never received a psychiatric diagnosis or undergone any psychological and/or psychopharmacological treatment (Table 1). Recruitment was done by the central project of the KFO 256 (24), a clinical research unit funded by the German Research Foundation dedicated to investigating mechanisms of disturbed emotion processing in BPD (24).
Self-Reported Data
Female and male BPD patients, compared with sex-matched HC subjects, reported significantly higher levels of aggression (per BPAQ), emotion dysregulation (per Difficulties in Emotion Regulation Scale), trait anger (STAXI), dissociation (per the Dissociative Experiences Scale) and impulsivity (per Barratt Impulsiveness Scale 11), but lower levels of anger control (STAXI) (all p < .05). Male patients reported higher levels of aggression (BPAQ; p < .001) and tended to report higher levels of trait
Discussion
To the best of our knowledge, this is the first study to investigate brain circuits, which mediate the emotion of anger and anger-based reactive aggression in female and male BPD patients. According to self-report, male BPD patients turned out to be more aggressive that female BPD patients. Consistent with self-report, male, compared with female, patients revealed higher activity of the left amygdala in both the anger induction and aggression phases with the amygdala playing a central role in
Acknowledgments and Disclosures
This study was part of the Clinical Research Unit KFO 256 supported by the German Research Foundation [(24); www.kfo256.de, Grant No. HE 2660/12-1 to SCH and CS].
Dr. Herpertz and Dr. Schmahl report having received funding for this project from the German Research Foundation (Grant No. HE 2660/12-1) with this project being part of the German Research Foundation Clinical Research Unit (KFO 256, spokesperson: Dr. Schmahl) on the “Mechanisms of Disturbed Emotion Processing in Borderline Personality
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2022, Progress in Neuro-Psychopharmacology and Biological PsychiatryCitation Excerpt :In BPD patients, the OFC volume was positively related with aggression (Soloff et al., 2014b). Under provocation or during imagination of aggressive acts, OFC showed significantly stronger metabolic and functional activation in BPD compared with HCs (Herpertz et al., 2017; New et al., 2009). The relative metabolic activity in OFC was also positively correlated with improvement in aggression after patients taking fluoxetine (New et al., 2004).
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2022, Current Opinion in Behavioral SciencesCitation Excerpt :In particular, abnormalities in emotion regulation and behavioral inhibition are likely to play an important role in aggression. BPD and ADHD, linked to low inhibitory control of aggressive responses [51], are associated with structural and functional abnormalities of fronto-limbic circuits involved in emotion regulation [52–54]. When having to inhibit fast amygdala-driven emotional action tendencies in approach-avoidance tasks, aggression-prone patients with BPD [55,56] as well as violent offenders [57] show lower recruitment of the ventrolateral and dorsolateral prefrontal cortex, which in turn have been related to the tendency to act out anger.
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SCH and KN contributed equally to this work.