Citation

Critchfield KL, Levy KN, Clarkin JF, Kernberg OF. J. Clin. Psychol. (Hoboken) 2008; 64(1): 67-82.

Affiliation

IRT Clinic, University of Utah Neuropsychiatric Institute, Salt lake City, UT 84108, USA. ken.critchfield@psych.utah.edu

Copyright

(Copyright © 2008, John Wiley and Sons)

DOI

10.1002/jclp.20434

PMID

18161033

Abstract

Attachment theory provides a framework for understanding and predicting critical aspects of aggression in the personality disorders. An association between borderline personality disorder (BPD) and insecure forms of adult attachment marked by high relationship anxiety has been repeatedly observed in the empirical literature. Aggression also has been linked to insecure attachment. The present study extends previous work by exploring the degree to which the underlying attachment dimensions of relationship anxiety and avoidance are associated in BPD with the following forms of hostility: (a) direct aggression (verbal or physical) initiated towards others, (b) expectation/perception of aggression from others (including "reactive" counteraggression when/if provoked), (c) aggression directed towards the self in the form of suicidality or parasuicidality, and (d) affective experience of irritability or anger. The issue was studied in a sample of 92 patients diagnosed with BPD. Results show significant association between more fearful forms of attachment (simultaneous presence of relationship anxiety and avoidance) and the more reactive form of aggression involving expectation of hostility from others. Self-harm was significantly associated only with relational avoidance while anger and irritability were associated only with relational anxiety. Implications for understanding relational aspects of BPD aggression in research and clinical work are discussed.

Language: en