Table 2 Studies investigating aggression in ♀ and/or ♂ BPD patients using neurobiological methods

Bertsch et al.

39 ♂ BPD patients with comorbid ASPD (BPD-ASPD), 14 HC

BPD: International Personaliy Disorder Examination (IPDE)

♂ BPD-ASPD patients displayed volume reduction in the left frontal pole, left orbital frontal cortex and right ventromedial prefrontal cortex compared to ♂ HC (all p < .05, ROI-analysis).

Neuroimaging: strucutural magnetic resonance imaging (stMRI), voxel based morphometry (VBM)

Brambilla

10 BPD patients ((6 ♀, 4 ♂), 20 HC (gender ratio: n/a)

BPD: IPDE

BPD showed higher volume of the putamen (p = .002) compared with HC.

Neuroimaging: stMRI, manual tracing

Coccaro et al.

31 ♂ personality-disorders subjects, including 4 BPD patients

BPD: SCID-II

Testosterone CSF concentration of ♂ personality disordered patients, including BPD, is not correlated with aggression (p = .34).

Aggression: Life History of Aggression (LHA), criteria for Intermittend Explosive Disorder

Neurochemistry: Cerebrospinal fluid (CSF) concentration of testosterone

Coccaro et al.

26 personality-disordered subjects, including 7 BPD patients (8 ♀, 18 ♂)

BPD: According to DSM-IV criteria

In the personality-disordered patients, including BPD, vasopressin CSF concentration was positively correlated with aggression (r = .41, p = .04), which was stronger in ♂ (r = .65) than in ♀ subjects (r = .27).

Aggression: LHA

Neurochemistry: CSF concentration of vasopressin

Hazlett et al.,

50 BPD patients (23 ♀, 27 ♂), 50 HC (20 ♀, 30 ♂)

BPD: Structured Interview for DSM-III-R Personality

BPD showed reduced gray matter and more white matter volume in BA 24 and 31 of the cingulate compared with HC (all p < .01,ROI analysis).

Neuroimaging: stMRI, manual tracing

Hollander et al.

12 BPD patients (8 ♀, 4 ♂), 15 HC (3 ♀, 12 ♂)

BPD: SCID-II

Diminished serotonergic responsivity in ♂, but not ♀ BPD patients compared to gender-matched HC (p = .010)

Neurochemistry: Serotonergic responsivity via m-chlorophenylpiperazine (m-CPP)

Martial et al.

5 ♀ BPD patients

BPD: DIB-R

No diminished serotonergic responsivity of ♀ BPD patients.

Neurochemistry: Serotonergic responsivity via d-fenfluramine (FEN)

Minzenberg

12 BPD-patients (5 ♀, 7 ♂), 12 HC (6 ♀, 6 ♂)

BPD: Structured Interview for DSM-IV Personality

BPD had reduced gray matter volume in the anterior cingulate (BA 24/32) compared to HC (p < .003-007, ROI analysis).

Neuroimaging: stMRI, VBM

New/Perez-Rodriguez et al.

38 BPD with comorbid intermittent-explosive-disorder (16 ♀, 22 ♂), 36 HC (18 ♀, 18 ♂)

BPD: SCID-II

No group x gender interaction in the OAS-M, BDHI and the AQ. ♀ BPD patients chose the “right” answer in the PSAP more often than ♀ HC. ♂ BPD patients chose the “right” answer in the PSAP less frequently than ♂ HC (p < 0.005). ♂ BPD displayed reduced glucose metabolism rate in the striatum when performing the PSAP compared to ♀ BPD and HC of both gender (p < .01). No gender differences in prefrontal and amygdala regions.

Aggression: modified Overt Aggression Scale (OAS-M),

Buss-Durkee Hostility Inventory (BDHI), AQ, PSAP

Neuroimaging: PET while performing PSAP

Niedtfeld et al.

23 ♀ BPD patients, 26 ♀ HC

BPD: International Personality Disorders Examination (IPDE)

♀ BPD patients displayed increased amygdala reactivity in response to neutral and negative emotional stimuli when compared to ♀ HC.

Neuroimaging: functional magnetic resonance (fMRI) during presentation of emotional & neutral pictures

Prehn et al.

15 ♂ BPD-ASPD, 17 ♂ HC

BPD: IPDE

♂ BPD-ASPD displayed increased amygdala activity exclusively in response to high, but not neutral and low emotional stimuli when compared to ♂HC.

Neuroimaging: fMRI during presentation of emotional & neutral pictures

Rinne et al.

12 ♀ BPD patients, 9 ♀ HC

BPD: Structured Interview for DSM III-R Personality

♀ BPD patients displayed diminished serotonergic responsivity than ♀ HC (p < .05).

Disorders

Neurochemistry: Serotonergic responsivity via m-CPP

Soloff et al.

64 BPD patients (44 ♀, 20 ♂), 57 HC (21 ♀, 36 ♂)

BPD: IPDE

♂ BPD patients showed higher scores in the BDHI (p = 0.03) and the BG-LHA (p = .002) than the ♀ BPD patients. ♂, but not ♀, BPD patients, had significantly lower delta-prl (p < .02), peak-prl (p < .001) and AUC-prl (p < .003) compared to gender-matched HC. In ♂, but not ♀, BPD patients serotonergic responsivity was inversely correlated with scores of the LHA (p < .05)

Aggression: BDHI, Brown-Goodwin Lifetime History of aggression (BG-LHA)

Neurochemistry: Serotonergic responsivity via FEN

Soloff et al.

22 BPD patients (15 ♀, 7 ♂), 24 HC (14 ♀, 10 ♂)

BPD: IPDE, DIB-R

♀, but not ♂, BPD patients displayed reduced glucose metabolism rate in the prefrontal cortex during baseline condition compared to gender-matched HC (p < .05). When tested for serotonergic responsivity ♂ BPD patients, but not ♀ BPD patients, showed decreased glucose metabolization in the lt. temporal and frontal lobe (p < .05)

Aggression: BG-LHA

Neurochemistry: serotonergic responsivity via FEN Neuroimaging: PET during baseline and serotonergic responsivity condition

Soloff et al.

34 BPD patients (22 ♀, 12 ♂); among them 2 ♀ BPD-ASPD and seven ♂ BPD-ASPD, 30 HC (19 ♀, 11 ♂)

BPD: IPDE

♂ BPD patients had higher scores in the BG-LHA than ♀ BPD patients (p = .03). ♀, but not ♂, BPD patients showed a gray volume reduction the amygdala, hippocampus bilaterally compared to gender-matched HC (all p_fwe < .05). ♂, but not ♀, BPD patients showed a gray matter volume reduction in the anterior cingulate cortex (p_cluster = .001) and a gray matter volume increase in the right putamen (p_cluster = .024) when compared to gender-matched HC.

Aggression: BG-LHA

Neuroimaging: stMRI, VBM

Völlm et al.

7 ♂ BPD patients, 6 ♂ HC

BPD: SCID-II

♂ BPD patients showed gray matter volume reduction in the medial, middle and superior frontal gyrus, bilaterally, and the left orbitofrontal cortex and right anterior cingulate cortex compared to ♂ HC (all at least p_uncorr. < .001).

Neuroimaging: stMRI, VBM