The murder trial of Jodi Arias, accused of viciously killing her boyfriend has attracted much media attention. Salacious details of adventurous sex and the dramatic personalities of those involved have captured much interest and speculation about the accused. Psychological experts have argued over possible psychiatric diagnoses, including Borderline Personality Disorder (BPD). If this label is accurate, it raises the question of how frequent BPD is associated with violence.
Despite portrayals in movies and other media of psychiatric patients committing violent acts, it is well established that externalized aggression is rare among the mentally ill. Indeed, BPD is more often associated with self-harm, especially cutting or burning, than violence toward others. And with a suicide rate approaching 10%, harm to oneself is considered a much greater risk than threat to others. Sometimes, however, threats of suicide or self-harm may be a passive manipulation to inflict emotional retribution on another: “See what you made me do!” “If I kill myself, it will be all your fault!” “You don’t love me. I might as well die!” Masochistic threats or behavior may project sadistic intent on the other.
In the well-known 1987 film, Fatal Attraction, often cited as an extreme representation of BPD, the woman, jilted by her married lover, first cuts her wrists, but later seeks revenge by attempting to kill her paramour’s wife. Interestingly, the original screenplay of the film offered a different and, perhaps, more representative ending. In that rendering the woman commits suicide in a scenario that suggests her lover will be accused of murdering her.
Only a few studies have investigated externalized aggression in BPD. Compared with other patients who seek routine treatment in a general medical clinic, those who fulfill criteria defining BPD are much more likely to endorse a history of violence, including breaking items, punching a wall, shoving a partner, and threatening someone with a weapon. The interior agony of BPD can also spill its rage and pain onto others.