***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Impulsivity has been repeatedly identified as a key construct in BPD ; however , its precise definition seems to vary especially regarding the overlap with aggression . The term impulsive-aggression , also generally seen as central to an underst and ing of BPD , seems to address itself to the interface between the two , but has itself been used inconsistently in the literature , sometimes having reference to a unitary phenotypic dimension , and at other times suggesting some combination of distinct traits . This study examined the relationship between multiple measures of impulsivity , aggression , and impulsive-aggression  in a BPD sample ( N = 92 ) in order to clarify the relationship between these measured constructs in this clinical population . Results show little relationship between measures of aggression and impulsivity in BPD , with measures of impulsive-aggression correlating strongly with measures of aggression only . Implication s of the present results for future research and clinical work with BPD are discussed OBJECTIVE A community-based , longitudinal prospect i ve study was conducted to investigate whether personality disorders during adolescence are associated with elevated risk for violent behavior during adolescence and early adulthood . METHOD A  community-based sample of 717 youths from upstate New York and their mothers were interviewed in 1983 , 1985 - 1986 , and 1991 - 1993 . Axis I and II disorders were assessed in 1983 and 1985 - 1986 . Antisocial personality disorder was not assessed because most participants were less than 18 years of age in 1983 and 1985 - 1986 . Violent behavior was assessed in 1985 - 1986 and 1991 - 1993 . RESULTS Adolescents with a greater number of DSM-IV cluster A or cluster B personality disorder symptoms were more likely than other adolescents in the community to commit violent acts during adolescence and early adulthood , including arson , assault , breaking and entering , initiating physical fights , robbery , and threats to injure others . These associations remained significant after controlling for the youths ' age and sex , for parental psychopathology and socioeconomic status , and for co-occurring psychiatric disorders during adolescence . Paranoid , narcissistic , and passive-aggressive personality disorder symptoms during adolescence were independently associated with risk for violent acts and criminal behavior during adolescence and early adulthood after the covariates were controlled . CONCLUSIONS Cluster A and cluster B personality disorders and paranoid , narcissistic , and passive-aggressive personality disorder symptoms during adolescence may increase risk for violent behavior that persists into early adulthood OBJECTIVE The purpose of the study was to identify risk factors and correlates of violence committed by patients in an acute adult psychiatric inpatient unit in a district general hospital of the United Kingdom 's National Health Service . METHODS Incidents of violence committed by in patients over a one-year period in 1997 - 1998 were retrospectively analyzed . The clinical characteristics of 49 violent patients were compared with those of all patients admitted to the unit during the study period ( N=474 ) and with a r and om sample of nonviolent patients ( N=140 ) .  Logistic regression analysis was used to identify clinical variables that predicted violent behavior . RESULTS Violence was not positively associated with schizophrenia or negatively associated with depression . Frequent medication change , high use of sedative drugs , past violent behavior , an ICD-10 diagnosis of dissocial personality disorder or emotionally unstable personality disorder ( DSM-IV antisocial personality disorder or borderline personality disorder ) , and long hospitalization were the most powerful predictors of violence . Together these variables had a sensitivity of 76 percent , a specificity of 97 percent , and a positive predictive value of 90 percent in predicting which patients became violent . Compulsory ( involuntary ) admission , comorbid diagnoses , past self-harm , and nonalcohol drug abuse were also associated with violent behavior . CONCLUSIONS Clinicians ' judgment about an inpatient 's potential for violence may be augmented by knowledge of the risk factors identified in this study . Medication variables could be especially useful predictors , particularly when information about other risk factors is not available . Factors other than mental illness per se may be crucial determinants of violence in acute inpatient setting OBJECTIVE The study of personality pathology in adolescence is in its infancy . This article examined the applicability and limits of DSM-IV axis II personality disorder diagnoses in adolescents , assessed the validity of a method for assessing adolescent personality pathology , and began to develop an empirically grounded classification . METHOD A total of 296 r and omly selected clinicians described a patient age 14 - 18 in treatment for maladaptive personality patterns using axis II ratings scales and the Shedler-Westen Assessment Procedure-200 for Adolescents ( SWAP-200-A ) , a Q-sort instrument for assessing adolescent personality pathology . After examining the nature and frequency of axis II disorders in the sample , the authors used Q-factor analysis to identify naturally occurring groupings of patients on the basis of shared personality features . RESULTS Axis II diagnoses in adolescents resembled those in adults , although application of DSM-IV criteria appeared to overdiagnose antisocial and avoidant personality disorder in adolescents . Q analysis with the SWAP-200-A isolated five personality disorders ( antisocial-psychopathic , emotionally dysregulated , avoidant-constricted , narcissistic , and histrionic ) and one personality style . Patients ' dimensional scores on each diagnostic prototype showed predictable associations with ratings of current axis II disorders , measures of adaptive functioning , and symptoms assessed with the Child Behavior Checklist . CONCLUSIONS With some exceptions , personality pathology in adolescence resembles that in adults and is diagnosable in adolescents ages 14 - 18 . Categories and criteria developed for adults may not be the optimal way of diagnosing adolescents . Data from sample s of adolescents may prove useful in developing an empirically and clinical ly grounded classification of personality pathology in adolescents Violence associated with personality disorders is usually best viewed separately from psychiatric diagnosis , as a syndrome of violence rather than a syndrome of diagnosis . The authors describe eight categories of violence associated with personality disorders that may help clinicians choose treatment or management techniques : purpose ful , instrumental violence ; purpose ful , non-instrumental violence ; purpose ful , targeted , defensive violence ; targeted , impulsive violence ; nontargeted , impulsive violence incidental to emotional escape ; r and om but purpose ful  violence ; violence related to perceived or feared loss or ab and onment ; and violence related to chronic paranoia or related misconceptions . The categories are not completely mutually exclusive , nor do they represent a " decision tree . " We also point out three important principles about the relationship between personality disorders and violence : 1 ) Personality disorders are rarely ego dystonic ; 2 ) Most patients and violent situations that come to clinical attention involve comorbid conditions . 3 ) Violence and violence risk are often associated with intoxication The Life History of Aggression ( LHA ) assessment was administered to up to 252 subjects . In addition to a total LHA score , subscale scores for Aggression , Social Consequences and Antisocial Behavior , and Self-directed Aggression were calculated . Test-retest stability , interrater agreement , and internal consistency reliability were excellent both for the LHA Total score and the LHA Aggression subscore . There were moderately strong correlations between these scores and both self-reports of aggressive tendency ( Buss-Durkee Hostility Inventory : n = 214 ) and recent overt aggression ( Overt Aggression Scale-Modified for Out- patients : n = 61 ) .  LHA Total scores were highest among subjects with Antisocial or Borderline Personality Disorder . These results support the use of the  LHA assessment  , and especially the  LHA Aggression subscore , as a measure of life history of aggressive behavior Theorists and clinicians have long believed that personality psychopathology is a risk factor for aggressive behavior . Previous investigations in this area , however , have provided mixed results . In this study , the relationship between  personality psychopathology and aggressive behavior  was examined in 137 research volunteers . The influences of gender and coexisting major mental disorders were statistically controlled . Aggressive behavior was associated with criteria for 7 of the 11 personality disorders listed in the Diagnostic and Statistical Manual of Mental Disorders ( 3rd ed . , rev . ) . Except for schizoid criteria , all relationships with aggressive behavior were in the positive direction . When all personality disorders were considered simultaneously , paranoid and passive-aggressive criteria were significant predictors of aggressive behavior 
    Output:
    
Results indicate that BPD does not appear to be independently associated with increased risk of violence in the general population .
History of childhood maltreatment , history of violence or criminality , and comorbid psychopathy or antisocial personality disorder appear to be predictors of violence in patients with BPD .
This review concludes that the current evidence suggests that patients with BPD are not more violent than individuals in the general population .