Personality Disorders and Violence Potential

Abstract

Violence associated with personality disorders is usually best viewed separately from psychiatric diagnosis, as a syndrome of violence rather than a syndrome of diagnosis. The authors describe eight categories of violence associated with personality disorders that may help clinicians choose treatment or management techniques: purposeful, instrumental violence; purposeful, non-instrumental violence; purposeful, targeted, defensive violence; targeted, impulsive violence; nontargeted, impulsive violence incidental to emotional escape; random but purposeful violence; violence related to perceived or feared loss or abandonment; and violence related to chronic paranoia or related misconceptions. The categories are not completely mutually exclusive, nor do they represent a "decision tree." We also point out three important principles about the relationship between personality disorders and violence: 1) Personality disorders are rarely ego dystonic; 2) Most patients and violent situations that come to clinical attention involve comorbid conditions. 3) Violence and violence risk are often associated with intoxication.

Aggression in Borderline Personality Disorder: Evidence for Increased Risk and Clinical Predictors

“…Clinical lore holds that patients with BPD are at risk of committing violence, especially in the context of perceived or feared loss or abandonment in interpersonal relationships [7], and cogent theories have been developed over the past two decades that explain the risk of aggression in terms of an impulsive-aggression trait at the core of BPD pathology [8,9]. This would imply that there may be factors specific to BPD that could predict an increased risk of aggression in certain patients.…”

Subtypes of aggression in patients with schizophrenia: The role of personality disorders

“…Several studies have underscored the importance of personality features in general (e.g. Hart et al, ; Reid and Thorne, ) and personality disorders (PDs) in particular when predicting risk of violence in civil and forensic populations (Coid, ; Fountoulakis et al, ). A common problem arises, however, when attempting to categorise PD.…”

Subtypes of aggression in patients with schizophrenia: the role of psychopathy

“…Several studies have underscored the importance of personality features in general (e.g. Hart et al, 1988;Reid and Thorne, 2007) and personality disorders (PDs) in particular when predicting risk of violence in civil and forensic populations (Coid, 1998;Fountoulakis et al, 2008). A common problem arises, however, when attempting to categorise PD.…”