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J Pers Disord. 2018 Oct 11:1-16. doi: 10.1521/pedi_2018_32_358. [Epub ahead of print]

Respiratory Sinus Arrhythmia Mediates Links Between Borderline Personality Disorder Symptoms and Both Aggressive and Violent Behavior.

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Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University Health, Richmond, Virginia, and University of Durham, Durham, UK.
The Ohio State University, Columbus, Ohio.


Although emotion dysregulation (ED) is a core symptom of borderline personality disorder (BPD), tests of associations between ED and aggression and violence-which are common to BPD-are sparse. The authors evaluated mediating effects of an autonomic vulnerability to ED on links between BPD symptoms and (a) reactive aggression, (b) proactive aggression, and (c) histories of interpersonal violence in a sample of young adults (N = 104), ages 18-22 years. Low baseline respiratory sinus arrhythmia (RSA) mediated the association between BPD symptoms and reactive aggression. In contrast, although BPD symptoms were correlated with proactive aggression, no mediational effect was found. In addition, low RSA mediated the association between BPD symptoms and histories of interpersonal violence. Collectively, these findings add evidence that neurobiological vulnerability to ED contributes to aggressive and violent behavior among those with BPD.


borderline personality disorder; emotion dysregulation; proactive aggression; reactive aggression; respiratory sinus arrhythmia; violence


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