RESEARCH STARTER

Borderline personality disorder and crime

Borderline Personality Disorder (BPD) is characterized by chronic difficulties in maintaining stable interpersonal relationships, severe mood swings, impulsivity, feelings of emptiness, and a tendency to engage in self-harm or substance abuse. Individuals with BPD may be at an increased risk of engaging in criminal and antisocial behaviors, making them overrepresented in prison populations. This is partly due to their emotional instability and impulsive actions, which can manifest in reckless behaviors such as substance abuse and aggressive acts that may lead to legal consequences.

Research indicates that a significant portion of those diagnosed with BPD also experience other mental health issues, including depression and anxiety, which can exacerbate their symptoms. The disorder is particularly complex, often rooted in psychosocial factors like trauma or neglect during development, leading to intense fears of abandonment and subsequent manipulative behaviors. These behaviors can include self-harm and suicidal threats, which, while aimed at preventing abandonment, can result in life-threatening situations.

Furthermore, studies show that women are disproportionately affected by BPD, with substantial representation in correctional facilities; estimates suggest that 25 to 50 percent of incarcerated women may have the disorder. Understanding BPD's impact on behavior and relationships is essential for addressing the needs of affected individuals and the challenges they may pose in forensic settings.

Full Article

DEFINITION: Disorder in which personality characteristics are maladaptive in nature, including chronic difficulties in maintaining stable interpersonal relationships, severe mood swings that are reactive in nature, impulsivity, hostility, feelings of emptiness, and propensity to abuse drugs and alcohol and engage in self-harm behaviors.

SIGNIFICANCE: Persons with borderline personality disorder are often considered to be at high risk for engaging in criminal and antisocial behavior based on their tendency to be overrepresented in prison populations. Because of their often violent and aggressive demeanor, such individuals are extremely disruptive to forensic settings and tend to pose additional risks to themselves and others when placed within these environments.

In 2024, the American Psychiatric Association (APA) estimated that borderline personality disorder (BPD) affected 1.4 to 2.7 percent of the US general population (higher in clinical settings). According to a comprehensive review published in World Psychiatry that year, the lifetime prevalence of BPD in the general population was reported to be from 0.7 to 2.7 percent, compared to about 12 percent among psychiatric outpatients and 22 percent in psychiatric inpatients. A systematic review published in the International Journal of Law and Psychiatry that year stated that the reported prevalence of BPD among people in prison was between 9 and 30 percent.

Individuals with BPD exhibit enduring patterns of emotional and behavioral instability. The pervasive and often inflexible nature of their behavior can result in actions that are harmful and sometimes criminal. These erratic behaviors are believed to result from a dangerous combination of extreme affective instability and high levels of impulsivity. Although self-destructive in nature, these behaviors—including reckless driving, sexual promiscuity, substance abuse, and aggressive acts—may result in legal repercussions. People with BPD are highly likely to exhibit symptoms of additional psychopathology and often warrant additional comorbid diagnoses of depression, anxiety, substance use disorder, or other personality disorders that are characterized in the DSM-5 with impulse control and emotional regulation, such as narcissistic personality disorder and antisocial personality disorder. DSM-5 lists nine criteria for BPD with a requirement that the existence of five of these indicate a positive diagnosis: mood-reactivity, stress-induced paranoia, impulsive behavior, unstable relationships, desperation to avoid being abandoned, unbalanced self-image, suicidal or a tendency for self-harm, long-term feelings of emptiness, and anger management issues.

An intense fear of abandonment, often stemming from psychosocial factors during development (such as sexual abuse, neglect, separation or loss, or parental psychopathology), is believed to contribute to the deceitful and exploitative behaviors exhibited by persons with BPD. To avoid either real or imagined abandonment, persons with BPD put forth significant effort to thwart others’ attempts to leave them. In these situations, they may engage in flagrantly exploitative behaviors, including significant threats of self-harm or attempts at suicide. These behaviors, although intended to keep others from departing, can result in life-threatening or lethal injuries. In addition to such self-harm behaviors, persons with BPD often engage in self-mutilating acts such as repetitive cutting or burning; most often, they perform these acts on their forearms or legs, but sometimes they may mutilate their faces, chests, or genitals.

In addition to exhibiting unstable behavior, individuals with BPD tend to have extreme difficulty with interpersonal relationships, self-image, and moods. They often report histories of intense but stormy relationships, typically involving severe fluctuations between overidealization of friends or lovers and bitter disappointment, frustration, and disillusionment with these persons, which, at times, may lead to violence. These drastic mood shifts and difficulties modulating and controlling anger can lead individuals with BPD to display intense behavioral and emotional outbursts with little provocation.




Bibliography

American Psychiatric Association. “Updated Practice Guideline for Treatment of Patients with Borderline Personality Disorder.” psychiatry.org, 9 Dec. 2024, www.psychiatry.org/news-room/news-releases/updated-borderline-personality-disorder-guideline. Accessed 26 Dec. 2025.

Bozzatello, Paola, et al. “Gender Differences in Borderline Personality Disorder: A Narrative Review.” Frontiers in Psychiatry, 12 Jan. 2024, doi:10.3389/fpsyt.2024.1320546. Accessed 26 Dec. 2025.

Chapman, J., et al. Borderline Personality Disorder. StatPearls Publishing, 2025, www.ncbi.nlm.nih.gov/books/NBK430883/. Accessed 26 Dec. 2025.

Dahlenburg, Sophie C., et al. “Global Prevalence of Borderline Personality Disorder and Self-Reported Symptoms of Adults in Prison: A Systematic Review and Meta-Analysis.” International Journal of Law and Psychiatry, vol. 97, 2024, art. 102032, doi.org/10.1016/j.ijlp.2024.102032. Accessed 26 Dec. 2025.

Davison, Sophie, and Aleksandar Janca. “Personality Disorder and Criminal Behaviour: What Is the Nature of the Relationship?” Current Opinion in Psychiatry, vol. 25, no. 1, 2012, pp. 39–45.

Friedel, Robert O. Borderline Personality Disorder Demystified: An Essential Guide for Understanding and Living with BPD. 2nd ed., Da Capo Lifelong Books, 2018.

Gacono, Carl B. The Clinical and Forensic Assessment of Psychopathy: A Practitioner’s Guide. Routledge, 2014.

Kreisman, Jerold J., and Hal Straus. I Hate You—Don’t Leave Me: Understanding the Borderline Personality. Penguin, 2012.

Kreisman, Jerold J., and Hal Straus. Sometimes I Act Crazy: Living with Borderline Personality Disorder. John Wiley & Sons, 2006.

Leichsenring, Falk, et al. "Borderline Personality Disorder: A Comprehensive Review of Diagnosis and Clinical Presentation, Etiology, Treatment, and Current Controversies." World Psychiatry, vol. 3, no. 1, 2024, pp. 4-25, doi.org/10.1002/wps.21156. Accessed 30 Dec. 2025.

Mason, Paul T., and Randi Kreger. Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder. New Harbinger, 2010.

Math, Suresh Bada, et al. Minds Imprisoned: Mental Health Care in Prisons. National Institute of Mental Health Neuro Sciences, 2011, pp. 95–109.

Sansone, R.A., et al. “Borderline Personality Symptomatology and Legal Charges Related to Drugs.” International Journal of Psychiatry in Clinical Practice, vol. 18, no. 2, 2014, pp.150–52, doi:10.3109/13651501.2013.847107. Accessed 26 Dec. 2025.

Silagadze, Teimuraz, and Jijikhia Rusudan. “Personality Disorders and Crime.” World Science, vol. 2, no. 80, 2023, doi:10.31435/rsglobal_ws/30062023/7982. Accessed 26 Dec. 2025.

Full Article

DEFINITION: Disorder in which personality characteristics are maladaptive in nature, including chronic difficulties in maintaining stable interpersonal relationships, severe mood swings that are reactive in nature, impulsivity, hostility, feelings of emptiness, and propensity to abuse drugs and alcohol and engage in self-harm behaviors.

SIGNIFICANCE: Persons with borderline personality disorder are often considered to be at high risk for engaging in criminal and antisocial behavior based on their tendency to be overrepresented in prison populations. Because of their often violent and aggressive demeanor, such individuals are extremely disruptive to forensic settings and tend to pose additional risks to themselves and others when placed within these environments.

In 2024, the American Psychiatric Association (APA) estimated that borderline personality disorder (BPD) affected 1.4 to 2.7 percent of the US general population (higher in clinical settings). According to a comprehensive review published in World Psychiatry that year, the lifetime prevalence of BPD in the general population was reported to be from 0.7 to 2.7 percent, compared to about 12 percent among psychiatric outpatients and 22 percent in psychiatric inpatients. A systematic review published in the International Journal of Law and Psychiatry that year stated that the reported prevalence of BPD among people in prison was between 9 and 30 percent.

Individuals with BPD exhibit enduring patterns of emotional and behavioral instability. The pervasive and often inflexible nature of their behavior can result in actions that are harmful and sometimes criminal. These erratic behaviors are believed to result from a dangerous combination of extreme affective instability and high levels of impulsivity. Although self-destructive in nature, these behaviors—including reckless driving, sexual promiscuity, substance abuse, and aggressive acts—may result in legal repercussions. People with BPD are highly likely to exhibit symptoms of additional psychopathology and often warrant additional comorbid diagnoses of depression, anxiety, substance use disorder, or other personality disorders that are characterized in the DSM-5 with impulse control and emotional regulation, such as narcissistic personality disorder and antisocial personality disorder. DSM-5 lists nine criteria for BPD with a requirement that the existence of five of these indicate a positive diagnosis: mood-reactivity, stress-induced paranoia, impulsive behavior, unstable relationships, desperation to avoid being abandoned, unbalanced self-image, suicidal or a tendency for self-harm, long-term feelings of emptiness, and anger management issues.

An intense fear of abandonment, often stemming from psychosocial factors during development (such as sexual abuse, neglect, separation or loss, or parental psychopathology), is believed to contribute to the deceitful and exploitative behaviors exhibited by persons with BPD. To avoid either real or imagined abandonment, persons with BPD put forth significant effort to thwart others’ attempts to leave them. In these situations, they may engage in flagrantly exploitative behaviors, including significant threats of self-harm or attempts at suicide. These behaviors, although intended to keep others from departing, can result in life-threatening or lethal injuries. In addition to such self-harm behaviors, persons with BPD often engage in self-mutilating acts such as repetitive cutting or burning; most often, they perform these acts on their forearms or legs, but sometimes they may mutilate their faces, chests, or genitals.

In addition to exhibiting unstable behavior, individuals with BPD tend to have extreme difficulty with interpersonal relationships, self-image, and moods. They often report histories of intense but stormy relationships, typically involving severe fluctuations between overidealization of friends or lovers and bitter disappointment, frustration, and disillusionment with these persons, which, at times, may lead to violence. These drastic mood shifts and difficulties modulating and controlling anger can lead individuals with BPD to display intense behavioral and emotional outbursts with little provocation.




Bibliography

American Psychiatric Association. “Updated Practice Guideline for Treatment of Patients with Borderline Personality Disorder.” psychiatry.org, 9 Dec. 2024, www.psychiatry.org/news-room/news-releases/updated-borderline-personality-disorder-guideline. Accessed 26 Dec. 2025.

Bozzatello, Paola, et al. “Gender Differences in Borderline Personality Disorder: A Narrative Review.” Frontiers in Psychiatry, 12 Jan. 2024, doi:10.3389/fpsyt.2024.1320546. Accessed 26 Dec. 2025.

Chapman, J., et al. Borderline Personality Disorder. StatPearls Publishing, 2025, www.ncbi.nlm.nih.gov/books/NBK430883/. Accessed 26 Dec. 2025.

Dahlenburg, Sophie C., et al. “Global Prevalence of Borderline Personality Disorder and Self-Reported Symptoms of Adults in Prison: A Systematic Review and Meta-Analysis.” International Journal of Law and Psychiatry, vol. 97, 2024, art. 102032, doi.org/10.1016/j.ijlp.2024.102032. Accessed 26 Dec. 2025.

Davison, Sophie, and Aleksandar Janca. “Personality Disorder and Criminal Behaviour: What Is the Nature of the Relationship?” Current Opinion in Psychiatry, vol. 25, no. 1, 2012, pp. 39–45.

Friedel, Robert O. Borderline Personality Disorder Demystified: An Essential Guide for Understanding and Living with BPD. 2nd ed., Da Capo Lifelong Books, 2018.

Gacono, Carl B. The Clinical and Forensic Assessment of Psychopathy: A Practitioner’s Guide. Routledge, 2014.

Kreisman, Jerold J., and Hal Straus. I Hate You—Don’t Leave Me: Understanding the Borderline Personality. Penguin, 2012.

Kreisman, Jerold J., and Hal Straus. Sometimes I Act Crazy: Living with Borderline Personality Disorder. John Wiley & Sons, 2006.

Leichsenring, Falk, et al. "Borderline Personality Disorder: A Comprehensive Review of Diagnosis and Clinical Presentation, Etiology, Treatment, and Current Controversies." World Psychiatry, vol. 3, no. 1, 2024, pp. 4-25, doi.org/10.1002/wps.21156. Accessed 30 Dec. 2025.

Mason, Paul T., and Randi Kreger. Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder. New Harbinger, 2010.

Math, Suresh Bada, et al. Minds Imprisoned: Mental Health Care in Prisons. National Institute of Mental Health Neuro Sciences, 2011, pp. 95–109.

Sansone, R.A., et al. “Borderline Personality Symptomatology and Legal Charges Related to Drugs.” International Journal of Psychiatry in Clinical Practice, vol. 18, no. 2, 2014, pp.150–52, doi:10.3109/13651501.2013.847107. Accessed 26 Dec. 2025.

Silagadze, Teimuraz, and Jijikhia Rusudan. “Personality Disorders and Crime.” World Science, vol. 2, no. 80, 2023, doi:10.31435/rsglobal_ws/30062023/7982. Accessed 26 Dec. 2025.

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