Understanding Borderline Personality Disorder and Anger

It is a fact that most people diagnosed with Borderline Personality Disorder (BPD) have angry outbursts, but a myth that they act out violently toward others. Instead, their angry behavior is often directed toward themselves.

People with Borderline Personality Disorder rarely act aggressively toward others. This is not to say that some individuals who have been diagnosed with BPD don’t become violent, but acting aggressively toward others is very rare.

“It is in fact true that persons diagnosed with BPD often have trouble regulating emotions and behavior. Thus, anger expression is often accurately associated with individuals diagnosed with BPD,” said Dr. Alec Miller, professor of clinical psychiatry and behavioral sciences and chief of child and adolescent psychology at Montefiore Medical Center and Albert Einstein College of Medicine in New York. “Individuals with BPD often direct some of their anger toward themselves, either through suicidal behavior, non-suicidal self-injury, cutting, or other problematic behaviors.”

The majority of people diagnosed with Borderline Personality Disorder have angry outbursts. However, not all people diagnosed with BPD meet the criteria of anger, and are not prone to raging or acting out.

“While anger is one of the nine DSM-IV criteria for BPD, anger is not necessarily a feature of BPD in all those that meet criteria for the disorder,” said Dr. Carla Sharp, associate professor of clinical psychology and director of the Developmental Psychopathology Lab at the University of Houston. “One needs to meet only five out of nine criteria, so there are other ways of meeting criteria for BPD.”

Research on Anger and BPD

Researchers are trying to understand why people with Borderline Personality Disorder experience anger differently. A study, “Time course of anger and other emotions in women with borderline personality disorder: a preliminary study,” looked at prolonged anger reactions in people with BPD.

Because Borderline Personality Disorder is characterized by emotional dysregulation, including strong emotional reactions to emotional stimuli and a slow return to baseline emotions, difficulties controlling anger are particularly prominent in BPD. The study’s researchers tested emotional dysregulation in women with BPD by attempting to induce anger through a short story. The researchers wanted to see if the provocative story caused stronger and prolonged anger reactions in women with BPD as compared to female healthy controls, and whether other emotions were affected by the anger induction.

“Although the anger reaction was not stronger in the BPD group, it was significantly prolonged,” wrote the researchers. “The BPD group showed also stronger negative emotions over the whole experiment.”

Studies such as this on Borderline Personality Disorder and anger help to raise public awareness. As more people learn about the nature of BPD, the myth of aggression and violence toward others will diminish.

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