Pathways to Aggressive Behavior: Antisocial and Borderline Personality Symptoms and the Mechanisms of Impulsivity, Negative Affect, and Distress Tolerance

Aggressive behaviors, including physical aggression toward others and non-suicidal self-injury, are high-risk behaviors that are prevalent in the college student population. Personality disorder symptoms, particularly those of antisocial personality disorder and borderline personality disorder, are associated with these aggressive behaviors. Some researchers have posited that ASPD and BPD are “mirror-image disorders” that have similar underlying traits but differing behavioral manifestations of those characteristics, namely differing in terms of the object of their aggression. The present study investigated these issues by examining the pathways from ASPD and BPD to aggressive behaviors via the mechanisms of impulsivity, negative affect, and distress tolerance with the expectation that similar pathways would emerge for the personality disorder symptoms and their respective aggressive behavior. A sample of college students (N = 520) completed questionnaires in an online format. Path analysis showed differing pathways, with ASPD being associated with physical aggression via impulsivity, BPD being associated with physical aggression via all proposed mechanisms, and BPD being associated with NSSI via all mechanisms with the exception of impulsivity. Multi-group analysis revealed no gender differences, but did reveal differences for White versus Black students with regard to the magnitude of the pathways from ASPD and BPD to physical aggression and NSSI, respectively. Overall, results do not support the idea of ASPD and BPD being mirror image disorders in a college student population

Empirically Derived Subgroups of Self-Injurious Thoughts and Behavior: Application of Latent Class Analysis.

Latent class analysis was applied to the data to identify homogenous subtypes or classes of self-injurious thoughts and behaviour (SITB) based on indicators indexing suicide ideation, suicide gesture, suicide attempt, thoughts of nonsuicidal self-injury (NSSI), and NSSI behaviour. Analyses were based on a sample of 1,809 healthy adults. Associations between the emergent latent classes and demographic, psychological, and clinical characteristics were assessed. Two clinically relevant subtypes were identified, in addition to a class who reported few SITBs. The classes were labelled: ‘low SITBs’ (25.8%), ‘NSSI and ideation’ (25%), and ‘suicidal behaviour’ (29.2%). Several unique differences between the latent classes and external measures emerged. For instance, those belonging to the ‘NSSI and ideation’ class compared with the ‘suicidal behaviour’ class reported lower levels of entrapment, burdensomeness, fearlessness about death, exposure to the attempted suicide or self-injury of family members and close friends, and higher levels of goal disengagement and acute agitation. SITBs are best explained by three homogenous subgroups that display quantitative and qualitative differences. Profiling the behavioural and cognitive components of suicidal and non-suicidal self-injury is potentially useful as a first step in developing tailored intervention and treatment programmes

Differences in Features of Non-Suicidal Self-Injury According to Borderline Personality Disorder Screening Status

Given that non-suicidal self-injury (NSSI) disorder is being considered for the upcoming Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it is important to consider how NSSI occurs with and without borderline personality disorder (BPD). Participants were 480 undergraduates who completed online questionnaires and were assigned to 4 groups based on NSSI and BPD status. Analyses revealed BPD-positive self-injurers had higher self-punishment, anti-suicide, and anti-dissociation functions of NSSI and higher rates of cutting and burning than BPD-negative self-injurers. Furthermore, difficulty in emotion regulation, not distress tolerance, was most critical in distinguishing between groups. Differences between BPD-positive and BPD-negative self-injurers provide preliminary support for NSSI as a distinct disorder. However, more research in this area is needed. © 2014 Copyright International Academy for Suicide Research

Profiles of non-suicidal self-injurers and associated patterns of alcohol use

This study used latent variable mixture modeling (LVMM) with a combined sample of undergraduates and internet users who endorsed non-suicidal self-injury (NSSI; N0440) to identify profiles of non-suicidal self-injurers. LVMM results revealed four distinct subtypes (Experimental NSSI, Mild NSSI, Multiple Functions/Anxious, and Automatic Functions/Suicidal groups) that were similar to those found in a prior study of undergraduates Klonsky and Olino (Journal of Consulting and Clinical Psychology 76:22-27, 2008), with an additional fifth Multimethod. ANOCOVAs and logistic regressions showed the first four groups differed on aspects of psychopathology in a similar fashion to the previous study. Specifically, the Experimental and Mild NSSI groups had the lowest levels of psychopathology, and the AF/Suicidal group had higher levels of psychopathology than the first three groups except for anxiety, which was higher for the MF/Anxious group. The additional Multi-method group was found to have higher levels of psychopathology than all other groups, but not significantly different from theMF/Anxious group.With regard to alcohol use and drinking motives, the MF/Anxious group had the highest level of hazardous drinking and drinking motives related to coping with depression and anxiety, enhancement, and conformity. The other four groups were not differentiated from one another on any drinking variable. Findings suggest that NSSI may be better conceptualized as a heterogeneous syndrome in clinical and research settings, with one subgroup being more at-risk for hazardous alcohol use. © Springer Science+Business Media, LLC 2012

Health-related quality of life among heavy-drinking college students

Objective: To examine unique contributions of depression, alcohol consumption, and alcohol-related consequences on functional health outcomes in college students. Methods: Participants were heavy-drinking undergraduate students (N = 207) who completed self-report questionnaires. Results: For men and women, depression predicted overall general health and mental health ratings. For women, depression predicted number of days of role limitations due to poor physical or mental health and number of days of not getting enough sleep or rest. Conclusions: Findings suggest that depression may have a more pervasive association with HRQOL than alcohol misuse or alcohol-related consequences in college students

Brief intervention to reduce hazardous drinking and enhance coping among OEF/OIF/OND veterans

Hazardous drinking among US Military combat veterans is an important public health issue. Because recent combat veterans are difficult to engage in specialty mental health and substance abuse care, there is a need for opportunistic interventions administered in settings visited by recent combat veterans such as primary care. This paper describes a brief intervention (single session, following an assessment) that was recently developed and tested in a sample of veterans of Operations Enduring Freedom, Iraqi Freedom, and New Dawn (OEF/OIF/OND). The intervention consists of a counseling session delivered in a motivational interviewing style using a packet of personalized feedback about alcohol misuse, symptoms of PTSD and depression, as well as coping skills. The treatment is described and data from a single case treated with this intervention are presented

Randomized controlled trial of two brief alcohol interventions for OEF/OIF veterans.

Objective: The purpose of this study was to test the efficacy of 2 brief interventions for alcohol misuse in a sample of combat veterans of the wars in Iraq and Afghanistan. Method: Participants were 68 combat veterans (91.2% male; 64.7% White, 27.9% Black) with a mean age of 32.31 years (SD = 8.84) who screened positive for hazardous drinking in a Veterans Affairs Medical Center primary care clinic using the Alcohol Use Disorders Identification Test (Babor, Higgins-Biddle, Saunders, & Monteiro, 2001). More than half of the sample (57.4%) met criteria for posttraumatic stress disorder (PTSD; based on the Clinician-Administered PTSD Scale; Blake et al., 1995). Eligible veterans who elected to participate completed a baseline assessment and were randomized to receive 1 of 2 interventions (personalized feedback delivered with or without a motivational interviewing counseling session). Both interventions included information on hazardous drinking, PTSD symptoms, depression, and coping. Follow-up assessments were conducted at 6 weeks and 6 months post-intervention. Results: Both conditions resulted in statistically significant reductions in quantity and frequency of alcohol use as well as frequency of binge drinking and alcohol-related consequences. Within-group effect sizes (ds) were in the small to medium range (.21-.55) for quantity and frequency of alcohol use. There were no statistically significant Condition × Time interactions, suggesting that both interventions were similarly effective. PTSD and non-PTSD veterans responded equally well to both interventions, but veterans with PTSD assigned to feedback plus motivational interviewing reported greater reductions in weekly drinking at the 6-week follow-up. Conclusions: These findings suggest that brief interventions for alcohol misuse may be effective for reducing drinking, even in an Operation Enduring Freedom/Operation Iraqi Freedom veteran population with a high degree of PTSD. © 2014 APA