What is Borderline Aggression?

This video answers the question: what is the aggression that we see associated with borderline personality disorder? Aggression is defined as behavior directed toward another individual or other individuals with the proximate intent to cause harm. Anger is a feeling or an emotion, but aggression is really activity-based. We think of aggression as a core feature of borderline personality disorder. One of the symptom criterion for the disorder is inappropriate, intense anger or difficulty controlling anger. That phrase “difficulty controlling anger,” that's where we would see the aggression. It's important to note here that aggression is not required for a diagnosis of borderline personality and neither is anger. When we think of aggression, we know that there are two main types: instrumental and reactive. Instrumental anger is planned and goal-directed. Reactive aggression, however, is triggered by provocation, threats, frustration, and has an association with negative emotion. The type of aggression we see most strongly associated with borderline personality is reactive versus instrumental. Reactive aggression, as we see it in borderline personality disorder, is associated with having relational dysfunction, predicts future aggression, is most present in close relationships (particularly romantic relationships), and we also see that's associated with intimate partner violence.
There are several dimensions that are put forward as being related to reactive anger in borderline personality including: affective dysregulation, impulsivity, threat hypersensitivity, and empathic functioning. The ability to empathize is usually divided into cognitive empathy and affective empathy. What we see with borderline personality disorder is the cognitive empathy piece and this is the type of empathy where you can infer the mental states of other individuals. This tends to be decreased in individuals with borderline personality disorder. Interestingly, affective empathy, which is the emotional engagement part of empathy, is intact in most instances of borderline personality disorder. This is a bit of a surprising finding when we think of empathy and borderline personality disorder. We usually think of it in terms of a global deficit, which is a deficit in cognitive empathy and in affective empathy. It's also interesting to consider empathy and borderline personality disorder and comparing it to empathy and narcissistic personality disorder. Narcissistic personality disorder is also a Cluster B personality disorder. In narcissistic personality disorder we see that cognitive empathy tends to be intact and there's a deficit an affective empathy. It is interesting how these two personality disorders are different just in relation to empathy. The ability to empathize is compromised with both disorders, but in different ways.