Neukel Corinne, Bullenkamp Robin, Moessner Markus, Spiess Karen, Schmahl Christian, Bertsch Katja, Herpertz Sabine C
Department of General Psychiatry, Medical Faculty, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany.
Center for Psychotherapy Research, Heidelberg University, Heidelberg, Germany.
Borderline Personal Disord Emot Dysregul. 2022 Oct 17;9(1):29. doi: 10.1186/s40479-022-00199-5.
Anger and aggression are core features of Borderline Personality Disorder (BPD), contributing strongly to the individual as well as the societal burden caused by the disorder. Across studies, patients with BPD have shown increased, more frequent and prolonged episodes of anger and reported an increased prevalence of reactive aggression. However, only a few studies have investigated anger and aggression in the patients' everyday lives and did not consider anger instability. In order to contribute knowledge about aggression and its association with anger intensity and anger instability in real-life in BPD the aim of the present study was to better characterize days with and without aggressive behaviors with regard to the patients' experienced anger.
Patients with BPD and high aggression as well as healthy participants took part in an ecological momentary assessment (EMA) study assessing state anger and aggression three times per day over two weeks. Multilevel modeling was conducted and anger instability was operationalized by squared successive differences.
As expected, patients with BPD reported greater instability in their experienced anger compared to healthy participants. Most interestingly, in the BPD group the occurrence of aggressive behavior was significantly associated with anger intensity as well as anger instability. More precisely, on days when patients with BPD acted out aggressively, they reported higher anger intensity as well as greater anger instability than on days when they did not act out aggressively.
Knowledge about what characterizes days with aggressive behaviors may help to improve interventions to reduce aggressive behavior and thus relieve the burden aggression causes for patients with BPD, their surroundings and society.
愤怒和攻击行为是边缘型人格障碍（BPD）的核心特征，对该障碍给个体及社会造成的负担有很大影响。在各项研究中，BPD患者表现出愤怒发作增加、更频繁且持续时间更长，并且报告反应性攻击行为的患病率有所上升。然而，只有少数研究调查了患者日常生活中的愤怒和攻击行为，且未考虑愤怒的不稳定性。为了增进对BPD患者现实生活中攻击行为及其与愤怒强度和愤怒不稳定性之间关联的认识，本研究的目的是更好地根据患者所体验到的愤怒来描述有攻击行为和无攻击行为的日子。
BPD且攻击行为严重的患者以及健康参与者参加了一项生态瞬时评估（EMA）研究，该研究在两周内每天三次评估状态愤怒和攻击行为。进行了多层次建模，愤怒不稳定性通过连续差值的平方来衡量。
正如预期的那样，与健康参与者相比，BPD患者报告其体验到的愤怒具有更大的不稳定性。最有趣的是，在BPD组中，攻击行为的发生与愤怒强度以及愤怒不稳定性显著相关。更确切地说，如果BPD患者有攻击行为，他们报告的愤怒强度和愤怒不稳定性要高于无攻击行为的日子。
了解具有攻击行为的日子的特征，可能有助于改进干预措施以减少攻击行为，从而减轻攻击行为给BPD患者、其周围环境和社会造成的负担。
