Predicting borderline and antisocial personality disorder features in nonclinical subjects using measures of impulsivity and aggressiveness
Introduction
Although impulsivity and aggressiveness are personality characteristics relevant to various aspects of psychopathology (Lish et al., 1996, Moeller et al., 2001), it is noted in DSM-IV (American Psychiatric Association, 1994) as well as in recent studies that these personality dimensions are key features of borderline (BPD) and antisocial (ASPD) personality disorders.
It has been shown that impulsivity measures significantly predict the temporal stability of BPD diagnosis (Links et al., 1999) and discriminate BPD subjects from controls (Dougherty et al., 1999). Moreover, studies on sociality in BPD subjects showed that impulsive aggression is an important factor in suicide attempts in subjects with a BPD diagnosis (Soloff et al., 1994, Mann et al., 1999, Soloff et al., 2000). Other studies reported significant associations between measures of impulsivity and ASPD (Eysenck, 1993, Barratt et al., 1997), suggesting that impulsivity could link ASPD to BPD; however, the degree of impulsivity showed some variability among ASPD subjects (Moeller et al., 2001). Interestingly, even though impulsivity is currently considered a multidimensional construct (Eysenck, 1993, Patton et al., 1994, Moeller et al., 2001), few if any data are currently available on the relative relationships between specific impulsivity components and BPD and ASPD.
There are empirical data showing that subjects with ASPD manifest increased anger and aggression (Angst and Clayton, 1986, Bland and Orn, 1986, Haertzen et al., 1990, Dinwiddie, 1992, Hart et al., 1993, Dinwiddie and Bucholz, 1993). Research data indicating an association between BPD and aggressiveness are sparser than those for ASPD (Lish et al., 1996). Although an association between BPD and actual violent acts has been reported (Raine, 1993), other studies showed that BPD is associated with the emotional component of aggressiveness (i.e. irritability) rather than with physical aggression (Gardner et al., 1991). As a whole, the results of these studies show a general link of both BPD and ASPD to impulsivity and aggressiveness, but give no definitive answer to whether BPD and ASPD subjects share the same or different impulsive and aggressive features.
Starting from the above observations, the aim of this study was to evaluate the predictive role of different components of impulsivity and aggressiveness on BPD and ASPD features in a large sample of nonclinical subjects. The existing literature indicates that many of the thresholds for categorical personality disorder diagnoses are fairly arbitrary (Widiger, 1992), and that meaningful individual differences can be observed beyond the simple presence or absence of a categorical personality disorder diagnosis (Klein, 1993, Widiger and Frances, 1985). Hence, in this study dimensional (i.e. number of symptoms) BPD and ASPD diagnoses were retained for further analyses. Since depressive symptoms frequently co-occur with BPD features (Elliott and Gunderson, 1988) and are reported to influence personality disorder measures, particularly self-report questionnaires (Loranger et al., 1991, Zimmerman, 1994), the confounding role of depressive symptoms in the relationships of impulsivity and aggressiveness components to BPD and ASPD features was also analyzed in this study.
Section snippets
Subjects
The sample was composed of 747 undergraduate university students, studying at the University of Urbino and living on the university campus. There were 482 female subjects (64.5%) and 265 male subjects (35.5%). The mean age was 22.96 years (S.D.=2.63) and the average level of university education was 3.89 years (S.D.=1.97). All subjects signed written informed consent forms in order to participate in the study.
Measures
The Personality Diagnostic Questionnaire-4+ (PDQ-4+; Hyler, 1994) was used to assess
Descriptive statistics
As would be expected in a non-clinical sample, the average number of PDQ-4+BPD (mean=3.08, S.D.=1.95) and ASPD (mean=1.32, S.D.=1.45) symptoms observed in this sample of Italian university students was relatively small. The K-R 20 coefficient values of the PDQ-4+BPD and ASPD scales were 0.61 and 0.57, respectively. Female subjects scored significantly higher than males on the PDQ-4+BPD scale (t745=3.20, P<0.005). In contrast, the scores of female subjects on the ASPD scale were significantly
Discussion
The results of this study confirm that both BPD and ASPD are substantially linked to impulsivity and aggressiveness, consistent with suggestions from previous studies (Angst and Clayton, 1986, Bland and Orn, 1986, Haertzen et al., 1990, Dinwiddie, 1992, Dinwiddie and Bucholz, 1993, Eysenck, 1993, Raine, 1993, Barratt et al., 1997, Dougherty et al., 1999, Links et al., 1999). Futher, these links are not an artifact of the severity of the acute depressive symptoms.
Beyond this general finding,
Acknowledgements
The authors thank Elena Acquarini for her invaluable help in gathering and handling data and two anonymous reviewers whose comments were of invaluable help in improving the quality of this manuscript.
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