Do BPD Sufferers And Psychopaths Have Things In Common?

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In the U.S. has been estimated that up to 30 % of those in prison suffer from borderline personality disorder (BPD) compared to 1-2% in the general population, about 20% in psychiatric institutions.and about 10% of psychiatric outpatients.(American Psychiatric Association).

Given the disproportionate number of individuals with BPD in prison, it seems reasonable to ask whether there are similarities between those who suffer from BPD and those who suffer from psychopathy.

To answer this, first let’s define what is meant by psychopathy. Whilst not an official diagnosis, it is a term used within legal and clinical settings and can be viewed as a more serious form of anti-social personality disorder (psychopaths have personality traits in addition to those displayed by individuals with anti-social personality disorder; though only a small proportion of those suffering from anti-social personality disorder are categorized as being psychopaths (Buckholtz, 2010).

Characteristics of psychopaths include:

  • persistent involvement in anti-social behaviour (which begins in childhood and adolescence)
  • impulsivity
  • deceitfulness
  • criminal activity
  • aggression

One of the main tools used to help assess the degree of an individual’s psychopathy is Hare’s Psychopathy Checklist-Revised (PCL-R, Hare, 1991). This tool measures:

  1. PSYCHOPATHIC PERSONALITY (FACTOR 1)
  2. ANTI-SOCIAL LIFESTYLE (FACTOR 2)
  3. OVERALL PSYCHOPATHY SCORE 

Those who meet the criteria to be categorized as psychopaths (as measured by item 3) also score highly on Factor 1 (psychopathic personality) and Factor 2. (anti-social lifestyle). In contrast, those ‘only’ diagnosed with anti-social personality disorder are more likely only to score highly on Factor 2 (anti-social lifestyle).

BORDERLINE PERSONALITY DISORDER (BPD) COMPARED WITH PSYCHOPATHY:

According to Conn et al, (2010), those who suffer from borderline personality disorder can have behaviours in common with individuals with psychopathy. These include:

  • lack of inhibition (click here to read about BPD and lack of inhibition)
  • drug use
  • promiscuous sexual behaviour (click here to read about BPD and sexuality).

It has also been found in other research that both those suffering from BPD and those suffering from anti-social personality disorder have suicide rates of between 3% and 10% (Solloff et al. 2012) and both those suffering from BPD and those suffering from anti-social personality disorder are prone to hostility (although BPD sufferers are more likely to internalize their anger (e.g. by self-harming) whereas those suffering from anti-social personality disorder are more likely to externalize it (e.g. by hitting someone).

However, there is only a slight, positive correlation (+0.26) between a high overall psychopathy score (3, above) and a high score on PAI (Personality Assessment Inventory) BPD scale. (Conn et al., 2010). It should also be stressed that the BPD personality has little in common with the psychopathic personality (Factor 1 on Hare’s PCL-R) and that most of the correlation is accounted for by similarities between the psychopath’s lifestyle and the BPD sufferer’s lifestyle. One major difference between those with BPD and those with anti-social personality disorder is that those suffering from BPD suffer from an array of intense emotions that they are unable to regulate whereas those with anti-social personality disorder experience extensive blunting of the emotions. Other differences include the fact that anti-social behaviour disorder is diagnosed about 5 times more frequently in men than in women whilst BPD is 3 times more likely to be diagnosed in women than in men. A final, important difference is that whilst BPD is now known to respond well to various forms of psychotherapy such as dialectical behavioural therapy this has not, so far, been shown to be the case with regards to anti-social personality disorder.

From the above then, we can say that there are overlaps between the BPD sufferer’s lifestyle and the psychopath’s lifestyle but few overlaps between the personality of the BPD sufferer and the personality of the psychopath (characteristics of the psychopaths’ personalities include: lack of remorse, lack of empathy, superficiality, manipulation and deceit – and, to stress again, these personality features do NOT correlate with the personality features of the BPD sufferer. (Conn et al., 2010). Furthermore, many of the behaviours that the BPD sufferer has in common with psychopaths can be explained by the BPD sufferer’s desperate attempts to escape severe mental pain (such escape from mental pain is sometimes referred to as dissociation.

Borderline personality disorder, then, can be seen as a quite distinct disorder from psychopathy. Indeed, some have suggested that BPD is the ‘female version’ of psychopathy and Conn draws our attention to the fact that this myth is NOT borne out by the research (Conn et al., 2010).

REFERENCES:

Conn C, Warden R, Stuewig J, et al. Borderline Personality Disorder Among Jail Inmates: How Common and How Distinct?. Correct Compend. 2010;35(4):6-13.

Kiehl KA, Buckholtz JW. Inside the Mind of a Psychopath. Scientific American Mind. 2010;21(4):22-29. doi:10.1038/scientificamericanmind0910-22

Soloff PH, Chiappetta L. Subtyping borderline personality disorder by suicidal behaviorJ Pers Disord. 2012;26(3):468-480. doi:10.1521/pedi.2012.26.3.468

David Hosier BSc Hons; MSc; PGDE(FAHE).