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Personality disorders as predictors of intimate partner violence: A meta-analysis



Despite years of research demonstrating a relation between personality pathology and intimate partner violence (IPV), no meta-analysis has been published examining how well, or poorly, all ten personality disorders (PDs) predict IPV perpetration or victimization, nor has any meta-analysis examined these relations across types of IPV. Therefore, the present study was undertaken to synthesize existing research on the effects of all ten PDs, as well as psychopathy and global PD symptoms, on physical, psychological, and sexual IPV perpetration and victimization. An initial search in PsycINFO, PubMed, and Sociological Abstracts yielded 3988 results. After duplicate and irrelevant articles were removed, 163 studies were included in the analysis, representing 189 individual samples. Analysis was conducted in R using the metafor package. Main effects analyses indicate that PDs were significantly and positively related to IPV perpetration. Results were more mixed for IPV victimization. Antisocial and borderline PDs demonstrated the most robust effect sizes across both perpetration and victimization. Moderator analyses suggested that with few exceptions, main effects were consistent across a number of sample and study characteristics. Findings may help to inform prevention and intervention efforts in clinical settings.
Personality disorders as predictors of intimate partner violence: A meta-analysis
Katherine L. Collison1
Donald R. Lynam1
In press: Clinical Psychology Review
1Purdue University
The corresponding author is Katherine L. Collison. Her postal address is 703 Third St., West
Lafayette, IN, 47906. Her email is and phone number is 765-494-6991.
Despite years of research demonstrating a relation between personality pathology and
intimate partner violence (IPV), no meta-analysis has been published examining how well, or
poorly, all ten personality disorders (PDs) predict IPV perpetration or victimization, nor has any
meta-analysis examined these relations across types of IPV. Therefore, the present study was
undertaken to synthesize existing research on the effects of all ten PDs, as well as psychopathy
and global PD symptoms, on physical, psychological, and sexual IPV perpetration and
victimization. An initial search in PsycINFO, PubMed, and Sociological Abstracts yielded 3,988
results. After duplicate and irrelevant articles were removed, 163 studies were included in the
analysis, representing 189 individual samples. Analysis was conducted in R using the metafor
package. Main effects analyses indicate that PDs were significantly and positively related to IPV
perpetration. Results were more mixed for IPV victimization. Antisocial and borderline PDs
demonstrated the most robust effect sizes across both perpetration and victimization. Moderator
analyses suggested that with few exceptions, main effects were consistent across a number of
sample and study characteristics. Findings may help to inform prevention and intervention
efforts in clinical settings.
Keywords: personality disorders; intimate partner violence; perpetration; victimization;
Personality refers to patterns of thoughts, feelings, and behaviors that are manifested by
an individual. In the field of clinical psychology, personality is largely studied in the context of
personality disorders (PDs), defined as enduring patterns of inner experiences and behaviors that
lead to distress or impairment (American Psychiatric Association, 2013). PDs are currently
represented in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American
Psychiatric Association, 2013) as ten disorders: paranoid (PAR), schizoid (SZD), schizotypal
(SZT), antisocial (ASPD), borderline (BPD), histrionic (HIS), narcissistic (NPD), avoidant
(AVD), dependent (DEP), and obsessive compulsive (OCPD). Based on descriptive similarities,
these ten PDs are grouped into three clusters. Cluster A, defined by “odd or eccentric”
symptoms, includes paranoid, schizoid, and schizotypal PDs. Cluster B, defined by “dramatic,
emotional, or erratic” symptoms, includes BPD, histrionic PD, and NPD. Cluster C, defined by
“anxious or fearful” symptoms, includes avoidant PD, dependent PD, and OCPD (American
Psychiatric Association, 2013).
Although these disorders have historically been treated as distinct, categorical diagnoses,
a growing area of research has lent support to dimensional models of personality pathology
(Trull & Durrett, 2005; Widiger & Simonsen, 2005) in the context of significant comorbidity
across PD diagnoses and heterogeneity within PD diagnoses (Clark, 2007). In these models, PDs
are defined as clusters of extreme, maladaptive variants of basic personality traits (Lynam &
Widiger, 2001). For example, perfectionism as a feature of OCPD could be considered an
extreme variant of high conscientiousness, or narcissistic arrogance as an extreme variant of low
modesty (Trull & Widiger, 2013). A number of personality models have been proposed,
including the five-factor model (Lynam & Widiger, 2001), PID-5 (Hopwood et al., 2018), and
MMPI (Anderson et al., 2021), to both define and distinguish PDs using more basic personality
Both basic personality traits and PD diagnoses and symptoms have been studied in the
context of a plethora of behavioral outcomes, including aggression and antisocial behavior
(Miller & Lynam, 2001; Jones, Miller, & Lynam, 2011; Vize et al., 2018; Vize et al., 2019).
With respect to the relation between PDs and aggression, a systematic review examining the
relationship between PDs and violent behavior found ASPD and BPD diagnoses to be predictive
of violence. Importantly, the authors noted that “a significant percentage of patients with
personality disorders (if not the majority) seem not to be violent” (Fountoulakis, Leucht &
Kaprinis, 2008, p. 91), emphasizing that while ASPD and BPD features are correlated with
violent behavior, not everyone who carries an ASPD or BPD diagnosis is necessarily violent. In
addition, they and others (Allen & Links, 2012) have noted that confounding factors within PD
diagnostic criteria make it difficult to elucidate the specific traits/symptoms that serve as risk
factors for individuals to perpetrate aggression. For example, Allen and Links (2012) described
common confounds with BPD diagnoses, such as overlapping symptoms with Axis I disorders
and other Cluster B disorders, and cite an example of one study in their systematic review in
which two-thirds of patients who received one PD diagnosis received between two and nine PD
diagnoses (Westen et al., 2003). Additionally, ASPD and BPD tend to correlate with other
psychosocial factors and behaviors that are in turn correlated with antisocial and violent
behavior, such as substance use (Sansone & Sansone, 2011) and conduct problems (Capaldi et
al., 2012). For these reasons, the mechanisms underlying the relations between PDs and
aggression are unclear.
Analysis of basic personality traits may shed light on why certain PDs may bear stronger
relations with antisocial and violent behavior than others. In the context of the five-factor model,
which posits thirty basic personality traits comprising five broad domains of personality
(neuroticism, extraversion, openness, conscientiousness, and agreeableness), Vize and colleagues
(2019) found neuroticism (r = .16), openness (r = -.05), agreeableness (r = -.38), and
conscientiousness (r = -.22) to be significantly related to antisocial behavior. All weighted effect
sizes at the domain level were significant for aggression except for extraversion, with a small
effect for openness (r = -.06) and small to moderate effects for neuroticism (r = .19),
agreeableness (r = -.40), and conscientiousness (r = -.21). At the lower-order trait level (i.e.,
facet level), facets of agreeableness and conscientiousness have demonstrated consistent,
negative relations to both antisocial behavior and aggression, whereas facets from other domains
sometimes differed in the direction and magnitude of their effect sizes (Jones, Miller & Lynam,
2011; Vize et al., 2018). These findings were consistent with the findings of Miller & Lynam
(2001), which suggest that across models and measures of personality, low agreeableness and
low conscientiousness are the strongest trait predictors of antisocial behavior. Perhaps
unsurprisingly, low agreeableness and low conscientiousness have been conceptualized as key
features of ASPD and BPD (Lynam & Widiger, 2001).
Personality has also been studied in the context of romantic relationships. One study
(South, 2014) examining the relation between PD symptoms and daily relationship conflict
found that individuals with higher levels of paranoid, schizoid, schizotypal, antisocial,
borderline, and avoidant PD symptoms, as well as higher total PD symptom counts, reported
more serious conflicts. Other research focused on dyadic personality pathology within couples
has found that over time, partners appear to “adapt” to their partner’s pathology as indicated by
relatively unchanging relationship satisfaction over the course of two years (South, Boudreaux &
Oltmanns, 2020). Notably, the same study found that baseline relationship satisfaction was lower
for individuals indicating higher levels of personality pathology for their partners (South,
Boudreaux & Oltmanns, 2020). Similarly, previous research using dyadic data from couples
found total PD symptom reports from both self and partner generally predicted lower
relationship satisfaction (South, Turkheimer & Oltmanns, 2008); however, those with higher
dependent PD symptom scores tended to endorse higher relationship satisfaction ratings. The
findings suggest that while PDs on the whole tend to lead to poor relationship outcomes,
different sets of traits may impact relationships in different ways, and couples may habituate to
their partner’s PD symptoms over time.
Intimate partner violence
Intimate partner violence (IPV) is defined broadly as physical, sexual, or psychological
harm inflicted by a current or former romantic partner or spouse (Centers for Disease Control
and Prevention, 2012). Prevalence rates of IPV victimization are high, with over one third
(37.3%) of women reporting any contact sexual violence, physical violence, and/or stalking and
nearly half (47.1%) endorsing psychological aggression in their lifetime (Smith et al., 2017).
Nearly 1 in 4 women (23.2%) has experienced severe physical violence by an intimate partner in
her lifetime. Rates of victimization are thought to be roughly equivalent for men, 30.9% of
whom reported experiencing lifetime sexual violence, physical violence, and stalking and 47.3%
reported experiencing psychological aggression (Smith et al., 2017). The high prevalence of IPV
poses a serious public health concern, particularly given the increased risk of physical and
mental health problems that have been linked to IPV, such as chronic pain (Campbell, 2002),
depression, posttraumatic stress disorder (Okuda et al., 2011), substance use, and suicidal
ideation (Afifi et al., 2009), among a host of other negative outcomes.
Several risk factors have been identified for IPV (see Capaldi et al., 2012 for a systematic
review). In terms of demographic characteristics, IPV tends to be more prevalent among couples
experiencing lower income, financial stress, and unemployment. Studies have also found that
being a member of an ethnic minority group is a risk factor for IPV, although some studies found
no difference across ethnicity after controlling for age, marital status and income (Capaldi et al.,
2012). Exposure to child abuse or harsh physical discipline has been identified as another risk
factor for IPV (Capaldi et al., 2012). In addition to contextual factors, researchers have also
examined the relation between IPV and other externalizing behaviors, such as alcohol use (e.g.,
Eckhardt, Parrott, & Sprunger, 2015), problem gambling (Dowling et al., 2016), and general
crime (Moffitt et al., 2000). The overlap between alcohol use, gambling, and IPV is likely due to
many variables, such as shared sociodemographic characteristics that place individuals at high
risk for engaging in all three behaviors. Interestingly, although some IPV perpetrators engage in
violence directed towards others, the link between partner and non-partner aggression is
inconsistent (Moffitt et al., 2000). Some work has also suggested that certain personality traits
may serve as risk factors for externalizing behaviors, such as impulsivity (Krueger et al., 2002;
Brasfield et al., 2012). This is consistent with research that has found links between attention-
deficit/hyperactivity disorder (ADHD) symptoms and IPV (see Buitelaar et al., 2015 for a
review) as well as between performance on neurocognitive tasks assessing impulsivity and IPV
(Easton et al., 2008).
Personality and IPV
It is clear that IPV occurs in the context of a complex network of risk factors, spanning
individual differences, cultural factors, and situational variables (e.g., Capaldi et al., 2012). The
purpose of the present meta-analysis was to focus on one of those domains to gain a better
understanding of how pathological personality may play a role in the perpetration and
victimization of IPV. There are important theoretical reasons that PDs may predict violent
behavior towards a partner or being in a relationship in which one experiences partner violence.
The first is that PDs represent stable, enduring dispositions that may cut across situational
contexts, which may be a reason that perpetrators recidivate or victims of IPV stay in violent
relationships. There is also evidence that personality predicts the environments and individual
selects for him/herself via gene environment transactions (Scarr & McCartney, 1983),
suggesting that PDs could also impact situational as well as dispositional factors. The second is
that the nature of PDs fit well within widely studied metatheories for why and how violence
occurs (e.g., as an impelling factor in the I3 Model; Finkel, 2014; as a distal cause and person
factor in the General Aggression Model; Allen, Anderson, & Bushman, 2018). Finally, PDs have
been shown to have robust effects on violent and/or aggressive behavior more broadly, which
make them good candidates for examination in relation to violence in the context of an intimate
Much of the work that has been undertaken to elucidate the role of personality in IPV
perpetration has focused on PD diagnoses and symptoms as predictors. For example, one review
examining the relations between BPD and severity and frequency of IPV perpetration (Jackson et
al., 2015) found that across studies, individuals meeting criteria for BPD were more likely to
commit seriously violent and aggressive acts of IPV. Examination of specific mechanisms for
these relations found that emotional processing biases (such as interpreting a partner’s
ambiguous facial expression in an overly negative manner), anxious attachment, and
interactional alcohol and drug use served to increase risk of both severity and frequency of IPV
perpetration. Interestingly, none of the studies examined impulsivity as a potential mechanism
for BPD-related IPV perpetration even though it is a central feature of BPD that has also been
linked to IPV (Cohen et al., 2003). Additionally, a recently published meta-analysis examining
ASPD and BPD as risk factors of IPV reported that both PDs were significant correlates of
perpetration and victimization of physical IPV, and that they were more strongly linked to
perpetration than victimization (Spencer et al., 2019). Further meta-analytic work has found
significant relations between dependent personality traits (including, but not specific to,
dependent PD symptoms) and IPV perpetration among men (Kane & Bornstein, 2016).
Additionally, one study examining dyadic data accounting for both partners’ personality
pathology in the same statistical model have found that partner’s pathology can serve as a
predictor of whether someone perpetrates IPV (Maneta et al., 2013). In a sample of 109
heterosexual couples, men’s level of BPD traits (authors used BPD-related traits rather than
symptoms in this study) was associated with both IPV perpetration and victimization, whereas
women’s level of BPD traits was associated only with IPV victimization, when partner’s BPD
traits were taken into account. The data suggests that a person’s personality pathology may
influence their partner to behave aggressively, and that those who have higher levels of BPD
traits may choose partners who are prone to violence (Maneta et al., 2013).
It is clear that disordered personality plays a significant role in IPV perpetration and
victimization; however, what little work has been done to systematically review the state of this
research has focused primarily on antisocial PD and BPD as risk factors for IPV, and has also
solely focused on physical IPV (Spencer et al., 2019; Stith et al., 2004). Thus, it is difficult to
know how other types of personality dysfunction may play a role in predicting IPV and whether
differences exist between the experience and perpetration of physical and other (i.e.,
psychological, sexual) forms of IPV. Further, it is even more difficult to elucidate whether these
relations differ as a function of the type of IPV that is perpetrated or experienced, or by gender,
ethnicity, or other sample characteristics.
Thus, the central goal of the present study was to quantitatively synthesize the existing
research examining the relations between personality dysfunction and IPV. Specifically, the aims
were to examine whether certain PDs are more strongly related to IPV than others; to determine
if there are differences between PDs related to IPV perpetration and IPV victimization; and to
examine differences in PD correlates across different forms of IPV (i.e., physical, psychological,
sexual). Because no meta-analysis or review has synthesized studies assessing all ten PDs (and
PD-related traits, such as psychopathy), this study addresses a significant gap in the literature by
integrating research findings from the past several decades.
Identifying studies for the meta-analysis
Eligibility criteria, specific inclusion and exclusion criteria, and search terms were
determined prior to beginning the project in consultation with IPV and PD/romantic relationships
researchers, as well as in consultation with prior meta-analyses and systematic reviews that have
been conducted in this area (e.g., Spencer et al., 2019; Kane & Bornstein, 2016). Variables that
were included on the coding form were determined during this consultation process. The
literature search was conducted in PubMed, PsycINFO, and Sociological Abstracts databases to
ensure coverage of findings published in diverse fields and journals, as well as to cover
unpublished dissertations and theses included in the ProQuest database (in which PsycINFO is
subsumed). In addition, for any full texts that were unavailable and for unpublished dissertations,
the lead author emailed corresponding and/or first authors of the manuscripts in question. If
email addresses were unavailable, interlibrary loan via the lead author’s academic institution was
used to obtain full texts.
Because many terms have been used in the literature to refer to IPV, several different
search terms were utilized to capture as many studies as possible. Terms were specifically
searched for in the titles and abstracts of articles in the selected databases. These were as follow:
intimate partner* OR sexual violence OR sexual intimate partner* OR psychological intimate
partner* OR physical intimate partner* OR dating violence OR partner violence OR
interpersonal violence OR batter* OR intimate violence OR domestic violence OR dating abuse
OR partner abuse OR interpersonal abuse OR marital abuse OR spous* abuse OR abusive OR
domestic abuse OR dating assault OR partner assault OR interpersonal assault OR intimate
partner assault OR intimate assault OR domestic assault AND personality disorder* OR PD OR
MCMI OR PAI OR SNAP OR PID OR SCID OR paranoid OR schizoid OR schizotypal OR
antisocial OR psychopath* OR borderline OR histrionic OR narcissis* OR avoidant OR
dependent OR obsessive compulsive personality.
As of May 20, 2020, these searches yielded a total of 3,988 articles available in English.
After duplicate articles that appeared in both databases were removed from the list, 3,419 articles
remained. The primary researcher involved in the study read the titles and abstracts of all 3,419
articles. Of these, 404 articles were deemed eligible for full text review (see Figure 1 for the
number of studies excluded based on each criterion).
Determining eligibility
Studies were included for analysis based on a number of criteria. First, the study must
have reported empirical research (i.e., reported quantitative findings of a specific study or group
of studies). This excluded case studies, reviews of existing research, or qualitative research that
did not provide an effect size. Second, the study must also have reported relations between either
symptom count, specific symptoms, or categorical diagnosis of any PD defined in the DSM-5 (or
psychopathy, since it shares many of the features of ASPD) and IPV perpetration or
victimization outcomes. IPV perpetration and/or victimization could have been reported as a
continuous frequency variable (e.g., number of acts in the past year), a lifetime yes/no count for
any experience or perpetration of an aggressive act in a romantic relationship, a criminal record
indicating a prior or current offense involving IPV, and a treatment referral for IPV perpetration
or victimization. Where violence history was collapsed across contexts (i.e., in a romantic
relationship as well as any other type of violence), studies were excluded. The following types of
IPV perpetration and victimization were included: physical, psychological, sexual, or a
composite of any of the above. Studies examining “verbal IPV” as an outcome were included
and combined with studies examining psychological IPV. Studies including homicide as their
IPV outcome of interest (N = 5) were excluded from analysis. Finally, the study must have been
written in English. After reviewing the 404 full texts remaining from the original search using
the above criteria, 163 articles reporting the findings from 189 individual samples were included
in the final meta-analysis. Study characteristics of the included samples are included in Appendix
Identifying unpublished data
In order to minimize publication bias that results from the tendency to publish
statistically significant findings at a disproportionate rate compared to null findings (Lipsey &
Wilson, 2001), we searched for unpublished dissertations and theses via ProQuest. In addition,
when the lead author believed that researchers had collected relevant data that were not
presented, or when researchers presented their data in a format from which effect sizes could not
be estimated, the lead author emailed the researchers for those data. The lead author also emailed
any researchers who published articles whose full texts were unavailable online. In total, 94
requests were sent for additional data and 21 authors provided the requested information (six
provided effect sizes, ten provided PD measurement reliability, seven provided full texts, and
two provided both effect size and reliability). Of the 21 who replied, 15 provided data that were
ultimately usable (e.g., full texts met inclusion criteria and effect sizes were able to be
estimated). Nine additional full texts were obtained via inter-library loan where author contact
information was not listed.
Identifying effects from shared samples
Multiple samples reported in the same article were treated as independent samples and
were each included in the analysis. For any mention of a previous paper that had reported on the
same sample, a search was conducted through all other included articles to ensure that findings
from each individual sample were only included once. For articles publishing on publicly
available datasets (e.g., NESARC dataset), the same procedure was followed. If a particular
author was listed on multiple publications, those articles were also checked to ensure that they
were reporting findings from different samples.
Extracting relevant information
Once the final group of relevant studies was identified, the lead author extracted and
formally coded several variables. In addition to effect sizes (zero-order rs) between PD variables
and IPV perpetration and victimization outcomes, relevant demographic and other study data
were coded in order to test for potential moderators in the relations between PDs and IPV. These
were: percentage of the sample that was male, percentage of the sample that was White, mean
age, mean income, sample size, sample type (student, community, prison, patient), male-
perpetrated vs. female-perpetrated IPV, source of information for personality data and IPV
outcomes (self-report, informant-report, clinician ratings, interview, official records, laboratory
tasks), personality measure (e.g., structured clinical interview, Millon Clinical Multiaxial
Inventory, NEO PI-R), measure of IPV perpetration (e.g., Conflict Tactics Scale), scoring of IPV
measure (i.e., frequency count in past year, yes/no ever perpetrated or experienced IPV), and
reliability of both PD and IPV measures. Reliability coefficients were obtained for the purpose of
disattenuating effect sizes (see Analyses section below).
Given the variety of measures used to assess PD symptomatology in IPV literature, the
source of PD data was examined as a moderator to examine if the effect sizes varied by self-
report vs. informant report, clinician interview, or record review. The same rationale was used to
examine the source of IPV data as a potential moderator. The type of sample was also assessed
as a moderator to determine if effect sizes tended to be stronger or weaker in student, treatment,
and offender samples compared to community samples. The percentage of men and percentage
of White participants in a given sample, along with mean age, were examined as moderators to
determine if personality’s relation to IPV perpetration differed as a function of gender, race, and
age. Study characteristics are presented in Appendix A. A full list of references of studies
included in the meta-analyses are presented in Appendix B.
Reliability coder
In order to check the reliability of the primary coder for the included studies, two
independent coders (graduate students) each went through a different randomly selected group of
studies using the same coding system described above. The reliability coders coded a total of 40
studies, spanning 41 unique samples. This process yielded a 96% rate of agreement. Where there
were any coding discrepancies, the primary author reviewed the studies and variables in question
and made corrections where necessary.
Whenever possible, reported effect sizes (e.g., odds ratios, t-tests, Cohen’s d) were
converted to zero-order correlations by hand (e.g., using means, standard deviations, and sample
sizes among comparison groups and translating them to Cohen’s d, which could then be
converted to a zero-order r) and via effect size calculators using transformations recommended
by Cohen (1988), Rosenthal (1994, S. 239), and Borenstein et al. (2009). When this was not
possible, study authors were solicited for more information so that calculation of the effect size
was possible (see above).
In order to account for the attenuation of effect sizes due to measurement reliability,
effect sizes were disattenuated for unreliability in the predictor variables using Spearman’s
(1904; 1910) formula. Where studies did not include information about the reliability of their PD
measures, the lead author sent email requests for this information. If authors did not respond by
the deadline provided by the lead author, reliability coefficients were imputed in one of two
ways. First, if at least three other studies had reported reliability for a given PD variable (e.g.,
BPD) using the same measure as the study in question, the average of those reliabilities was
imputed for the studies missing reliability data. In cases for which there were not three other
studies that had used the same measure for a given PD variable, the mean of all other reported
reliability coefficients for that PD was imputed for studies missing those values. A total of 225
reliability coefficients for PD measures were imputed (out of 662 total effect sizes for which
reliability was coded).
There were a number of cases for which it became necessary to combine/collapse across
effect sizes. These cases were the total PD predictor variable, the total IPV perpetration and total
IPV victimization outcome variables, and any studies for which more than one measure was used
to assess the same PD or IPV outcome. In these cases, effect sizes were Fisher’s z-transformed,
averaged, and then transformed back to an unstandardized zero-order r to yield a weighted mean
effect size that is less biased by sampling distribution skew than simply averaging two
correlation coefficients (Corey, Dunlap, & Burke, 1998). This procedure was used for studies
reporting three or more PD effect sizes (collapsed into total PD), studies reporting more than one
type of IPV perpetration or victimization (collapsed into total IPV perpetration or victimization),
and multiple measures of the same variable (collapsed into a single effect size for that variable).
The main effects and moderator analyses for the meta-analysis were conducted in R 4.0.2
(R Development Core Team, 2015) using the metafor package (Viechtbauer, 2010). Main effects
were analyzed using a random effects model. Moderator analyses were conducted for any
PD/moderator pairing for which there were: 1) at least five studies including an effect size for a
given PD and IPV outcome; 2) at least two levels of the moderating variable represented; and 3)
at least two studies in each level of the moderating variable. For continuous moderating variables
(such as percentage male, percentage White), there needed to be at least three different values for
the moderating variable, or two different values if more than one study was represented by each
level of the moderator (e.g., two studies had samples that were 50% male and the rest had
samples that were 100% male). Heterogeneity among the studies was also calculated to
determine how heterogeneous the studies were that were included in the meta-analysis. These are
reported using the I2 statistic, as recommended by Higgins and Thompson (2002), which
represents the proportion of total variance in the outcome of interest (here, a type of IPV
perpetration or victimization) that is due to heterogeneity between studies.
Publication Bias
In order to examine and adjust for the effects of publication bias on the studies that were
included in the present analyses, the trim and fill method was used (Duval & Tweedie, 2000). Of
the 74 meta-analyses conducted in the present study, 11 demonstrated funnel asymmetry and had
a range of 1-2 studies added (mean = 1.45). Adjusted effect sizes for those analyses are presented
alongside unadjusted effect sizes in Tables 1, 2 and 3. Additionally, study quality was evaluated
using several criteria, including sample size, reliability of study measures, and whether or not
authors reported pre-registering their studies. These criteria, along with the quality score range,
median, and mode, are reported in Supplemental Materials (Table S1).
Total IPV Perpetration
Visualizations of main effects across all meta-analyses conducted in this study are
presented in Figures 2 and 3. Forest plots for each individual meta-analysis are included in
Supplemental Materials (Figure S1).
The total IPV perpetration variable represented any perpetration outcome reported for an
individual sample, regardless of the type of IPV. For studies that reported more than one type of
IPV for a given sample, effect sizes were aggregated to create one “total IPV” variable. The
number of studies that reported effect sizes between a PD variable and IPV perpetration ranged
from 12 (OCPD) to 76 (ASPD). Full results are reported in Table 1. Total N across those studies
ranged from 1,352 to 445,599. In general, PDs were significantly and positively related to total
IPV perpetration, with the exception of histrionic PD (r = .10) and OCPD (r = .02). The strongest
effect was found for ASPD, which had a combined effect size of r = .35 (p < .001). Following
close behind were BPD (r = .32, p < .001), paranoid PD (r = .30, p < .001), and schizotypal PD
(r = .29, p < .001).
Moderating variables
Main effects for each type of PD on total IPV perpetration did not vary by publication
status (i.e., published vs. unpublished), age, or percentage of the sample that was male. Source of
IPV data was a significant moderator for a number of PDs. In particular, effects of dependent PD
(B = -.33, p < .05) and OCPD (B = -.54, p < .05) were smaller in studies using informant reports
for IPV data in comparison to studies using self-report IPV data. Additionally, effects of total PD
(B = -.14, p < .05) and OCPD (B = -.37, p < .05) were smaller in studies using record reviews for
IPV data in comparison to studies using self-report IPV data. Conversely, the effect of
psychopathy was greater among studies using record reviews, rather than self-reports, for IPV
data (B = .12, p < .05). Finally, in comparison with studies using self-report IPV data, the effects
of ASPD and dependent PD were greater among studies using clinician interviews to gather IPV
data (B = .23, p < .05, and B = .37, p < .05, respectively).
When sample type was examined as a moderator (with community as the reference
group), there was a moderating effect for ASPD such that the effect of ASPD was significantly
smaller among student samples (B = -.16, p < .05). Additionally, main effects of paranoid PD
were found to be smaller in prison samples in comparison to community samples (B = -.16, p <
.05). Further, the effect of OCPD was significantly smaller for treatment samples than
community samples (B = -.52, p < .001), whereas the effect of psychopathy was larger among
treatment samples compared to community samples (B = .17, p < .05).
In terms of the percentage of White participants, there was a slight (but statistically
significant) moderating effect such that the effect size of paranoid PD was greater as percentage
of White participants increased (B = .01, p < .01). In terms of the source of personality data,
effects of avoidant PD and dependent PD were found to be significantly smaller in studies using
informant reports of PD symptoms compared to self-report PD symptoms (B = -.48, p < .001 and
B = -.33, p < .05, respectively). Additionally, the effect of dependent PD on total IPV
perpetration was greater in studies using clinician interviews to measure PD symptoms (B = .36,
p < .05). Further, the effect of psychopathy was smaller in studies using a combination of
personality data sources (B = -.12, p < .05). Finally, there was a moderating effect for total PD
score such that the effect of total PD on IPV perpetration was smaller in studies using record
reviews for PD data (B = -.19, p < .05). For all other main effects that were analyzed, moderator
effects were either nonsignificant or excluded from analysis due to insufficient number of
Total IPV Victimization
Similar to the total IPV perpetration outcome variable, the total IPV victimization
variable represented any victimization outcome reported by a study regardless of what kind of
IPV participants had experienced. An average effect size was used for studies reporting multiple
kinds of victimization within a sample. Generally speaking, PDs tended to be positively
associated with IPV victimization, though not to the same degree as IPV perpetration (Table 1).
In addition, there were far fewer studies that examined PDs as predictors of IPV victimization
compared to perpetration, with number of studies ranging from 3 (OCPD) to 30 (BPD) and total
samples within each PD ranging from 686 to 18,059. Thus, although some effect sizes were of
similar magnitudes to those predicting IPV perpetration, the confidence intervals were much
wider and there were fewer statistically significant effects. The most robust effects were found
for avoidant PD (r = .33, p < .001), dependent PD (r = .32, p < .001), BPD (r = .30, p < .001),
and total PD (r = .28, p < .001).
In comparison with total IPV perpetration, although both were generally positively
related to PDs overall, there were a few divergent relations. NPD was more strongly related to
IPV perpetration than victimization (r = .16 compared to r = .02). However, psychopathy,
avoidant PD, and dependent PD were much more strongly related to IPV victimization than they
were to perpetration. It is important to note that in the case of psychopathy, the confidence
interval was rather large and indicates that there is a fair amount of variability in what the true
effect size may be.
Moderating variables
For the total IPV victimization outcome, there was an insufficient number of studies to
examine moderators of interest for schizoid PD, schizotypal PD, histrionic PD and OCPD. There
was no moderating effect for percentage of male participants, percentage of White participants,
age, or publication status for any of the PDs that were eligible for analysis. There was a
significant moderating effect of source of IPV data such that the relation between psychopathy
and total IPV victimization was much higher among samples that gathered IPV data from record
reviews compared to self-report (B = .67, p < .001). Additionally, effects of BPD and ASPD on
IPV victimization were smaller in studies using informant reports of IPV compared to self-report
IPV (B = -.31, p < .05 and B = -.39, p < .05, respectively). There was also a moderating effect of
source of personality data such that the effects of ASPD and dependent PD on total IPV
victimization were significantly larger in studies that gathered personality data from clinician
interview compared to studies using self-reports (B = .37, p < .01 and B = .41, p < .05,
respectively). Finally, there was a moderating effect of sample type such that the effect of total
PD was greater among studies using treatment samples in comparison to studies using
community samples (B = .20, p < .05).
Physical IPV Perpetration
After analyzing perpetration and victimization outcomes as a whole, each type of IPV
and its relations to PDs were analyzed separately, both in terms of perpetration and victimization.
The vast majority of studies examining PDs and IPV outcomes focused primarily on physical
IPV (e.g., 65/76 for ASPD and IPV Perpetration, 26/38 for NPD and IPV Perpetration). Thus,
the pattern of relations between PDs and physical IPV perpetration were very similar to the
relations between PDs and general IPV perpetration (Table 2). The largest effect size was found
for ASPD (r = .35, p < .001), followed by the adjusted effect size for BPD (r = .30, p < .001).
Paranoid and schizotypal PDs were also moderately correlated with physical IPV perpetration (r
= .29, p < .001 for both). Similar to the total IPV perpetration outcome, histrionic PD and OCPD
were not significantly related to physical IPV perpetration, although histrionic PD became
significantly related to physical perpetration after adjusting for publication bias (r = .22, p < .01).
Although similar in magnitude to its effect size for total IPV perpetration, dependent PD became
statistically significant only after adjusting for publication bias (r = .17, p < .05).
Moderating variables
None of the main effects varied by age, publication status, or percentage of the sample
that was male. The effects of total PD and BPD on physical IPV perpetration were slightly yet
significantly greater in studies with higher percentages of White participants (B = .002, p < .05
and B = .003, p < .05, respectively). With respect to sample type, the effect of OCPD was
significantly smaller among treatment samples compared to community samples (B = -.52, p <
.001). Conversely, the effect of psychopathy was greater among studies using treatment samples
compared to community samples (B = .21, p < .01). Additionally, the effect of ASPD was
smaller in studies using student samples compared to community samples (B = -.22, p < .05). In
terms of the source of IPV data, significant moderating effects were found for dependent PD and
OCPD such that their effects on physical IPV perpetration were significantly smaller when IPV
data came from informant reports compared to self-reports (B = -.31, p < .01 and B = -.54, p <
.05, respectively). In the case of dependent PD, effects were also significantly larger for studies
using clinician interview for IPV data (B = .38, p < .01), as was the case for ASPD (B = .23, p <
.05). In the case of total PD, effects were smaller among studies using record reviews for IPV
data (B = -.15, p < .05). Conversely, the effect of psychopathy was greater among studies using
record reviews, rather than self-report, for IPV data (B = .17, p < .01).
The source of personality data had a moderating effect for total PD, schizoid PD,
avoidant PD and dependent PD. In the case of total PD, effects were smaller in studies using
record review for personality data compared to studies using self-report personality data (B = -
.21, p < .05). Effects of schizoid PD were smaller in studies using informants for PD data
compared to self-reports (B = -.37, p < .05). The same was true for avoidant PD and dependent
PD (B = -.49, p < .001 and B = -.32, p < .01, respectively). Additionally, the effect of dependent
PD was greater among samples that obtained personality data using clinician interviews (B = .37,
p < .01).
Physical IPV Victimization
Most of the IPV victimization research included in this meta-analysis focused on the
experience of physical IPV; as such, as was the case with perpetration studies, the relations
between PDs and physical victimization were similar to the relations between PDs and general
IPV victimization. The most robust effect size was found for avoidant PD (r = .31, p < .001),
which was closely followed by total PD (r = .28, p < .01) and BPD (r = .26, p < .001). For
several PDs (OCPD, histrionic, schizotypal, schizoid), there were only three studies that reported
effect sizes for physical IPV; thus, while they are included in Table 2, it is unlikely that any firm
conclusions can be drawn for those predictors.
Moderating variables
ASPD, psychopathy, NPD, BPD, dependent PD, and total PD were the only PDs for
which there were sufficient studies to test with potential moderators for the physical IPV
victimization outcome. None of the effects of these PDs on physical victimization were
moderated by publication status, percentage of the sample that was male and percentage of the
sample that was White. Source of IPV information moderated the effect of psychopathy such that
effects were significantly greater among studies using record reviews to obtain IPV data (B =
.74, p < .001). In terms of sample type, the effect size of total PD was significantly greater
among treatment samples compared to community samples (B = .29, p < .05). Additionally, there
was a moderating effect of age such that as the mean age of the sample increased, the effect of
ASPD on experiencing physical IPV decreased slightly but significantly (B = -.02, p < .01).
Finally, the effects of ASPD and dependent PD were moderated such that both had significantly
larger effects in studies using clinician interviews for personality compared to self-report (B =
.39, p < .01 and B = .50, p < .05, respectively).
Psychological IPV Perpetration
All PDs were examined with respect to psychological IPV perpetration (Table 3). The
number of studies included in each individual meta-analysis ranged from three to 25, with total N
ranging from 450 to 6,547. For BPD, trim and fill analysis indicated possible publication bias,
which resulted in the imputation of two extra effect sizes. All PDs were significantly and
positively related to psychological IPV perpetration. Both adjusted and non-adjusted BPD were
the most strongly correlated with psychological IPV perpetration (r = .47, p < .001 and r = .44, p
< .001, respectively), followed closely by ASPD (r = .38, p < .001) and paranoid PD (r = .35, p <
Of the PDs for which there was a sufficient number of studies to examine potential
moderators (BPD, ASPD, NPD, and psychopathy), two moderating effects were found for
ASPD. Specifically, the effect of ASPD on psychological IPV perpetration were slightly but
significantly smaller as mean age (B = -.01, p < .05) and percentage of White participants (B = -
.01, p < .05) increased in a given sample.
Psychological IPV Victimization
Meta-analyses examining psychological IPV victimization were conducted for BPD,
NPD, ASPD, psychopathy, avoidant PD, dependent PD, and total PD (Table 3). The number of
studies in each analysis was relatively small: k ranged from 2 to 11 and total N ranged from 416
to 14,200. BPD (r = .28, p < .001), ASPD (r = .21, p < .01), psychopathy (r = .13, p < .001), and
total PD (r = .35, p < .05) were significantly and positively correlated with psychological
victimization. Each of these PDs bore smaller relations with psychological victimization
compared with perpetration except for total PD; however, only two studies were included in the
victimization meta-analysis and its confidence interval was wide, indicating a less robust effect
Given the small number of studies reporting effect sizes for psychological IPV
victimization, moderating effects could only be examined for ASPD and BPD. Only IPV source
was found to moderate the effects of ASPD and BPD. In each case, effects were smaller among
studies using informant reports for IPV data compared to self-report (B = -.31, p < .01 for ASPD;
B = -.36, p < .05 for BPD).
Sexual IPV Perpetration
With respect to sexual IPV perpetration, four studies reported effect sizes for BPD (total
n = 656, I2 = 70.75%), three studies reported effect sizes for NPD (total n = 650, I2 = 0%), four
studies reported effect sizes for ASPD (total n = 5,328, I2 = 93.26%), and 12 studies reported
effect sizes for psychopathy (total n = 2,329, I2 = 74.34%). There were insufficient studies to
conduct meta-analyses for the other PDs. BPD (r = .15, CI [.01 - .29], p < .05), NPD (r = .15, CI
[.07 - .22], p < .001), ASPD (r = .25, CI [.09 - .42], p < .01), and psychopathy (r = .16, CI [.08 -
.24], p < .001) were all positively and significantly correlated with sexual IPV perpetration.
Given the small number of samples including this outcome and lack of variability in moderator
variables or missing data, we were only able to examine moderator effects for studies using
psychopathy as the predictor of interest. No significant moderating effects were found.
Sexual IPV Victimization
With respect to sexual IPV victimization, four studies reported effect sizes for BPD (total
n = 9,972, I2 = 85.52%), two studies reported effect sizes for ASPD (total n = 9,111, I2 = 0%),
and two studies reported effect sizes for dependent PD (total n = 591, I2 = 22.63%). Given the
lack of studies reporting effect sizes for sexual IPV victimization, no other meta-analyses were
conducted examining that as the outcome. Effect sizes were small (r = .07 for BPD, r = 0 for
ASPD, and r = .08 for dependent PD) and none were statistically significant. There was an
insufficient number of studies including sexual IPV victimization as an outcome to examine
moderator effects.
The goal of the present study was to synthesize existing research on PDs and the most
commonly researched categories of IPV perpetration and victimization. Of particular interest was
whether certain PDs were more strongly related to these outcomes than others, whether
differences existed in which types of PD are related to perpetration and victimization, and if
there were any differences in effect size based on the type of IPV being examined. This was the
first study of its kind to systematically examine the full range of PDs as well as the first to
separately examine multiple types of perpetration and victimization of IPV.
At the global, “total” IPV perpetration level, every PD except for histrionic PD and
OCPD demonstrated significant and positive effects. Perhaps unsurprisingly, the largest effect
sizes were found for ASPD and BPD, which are also the two most widely studied PDs in relation
to IPV. The same pattern of results was found for physical IPV, with the exception of dependent
PD, which demonstrated a significant, positive effect only after being adjusted for possible
publication bias. Dependent PD also bore the smallest relation with psychological IPV
perpetration. It is not entirely unexpected that dependent PD would be less consistently related to
IPV given its symptoms that are related to difficulty expressing disagreement with others
because of fear of loss of support and going to excessive lengths to obtain nurturance from
others; however, it may be that in some cases, this insecurity combined with difficulty expressing
disagreement could result in handling conflict in unhealthy and potentially aggressive ways.
The same possible explanation could be applied to the significant and positive relations
between the interpersonally “detached” PDs and IPV perpetration. For example, individuals with
schizoid PD tend to seek solitary activities and do not usually seek or enjoy close relationships,
yet schizoid PD was significantly and positively related to total, physical, and psychological IPV
perpetration. Part of this indifference to intimacy is showing emotional coldness or detachment,
which may result in a dysfunctional set of strategies for handling conflict with an intimate
partner. Schizotypal PD bore similar relations to IPV perpetration and is also characterized by
acute discomfort with and reduced capacity for close relationships. One distinguishing feature of
schizotypal PD that may help to further explain its relations to IPV perpetration is its paranoia
and suspiciousness, which may increase the likelihood of conflict in a relationship dynamic that
is potentially already strained. Similarly, avoidant PD was also related to physical and
psychological IPV perpetration. Although one symptom of avoidant PD is showing restraint in
intimate relationships, other symptoms are characterized by a hypersensitivity to threat and
rejection, which may represent an emotional reactivity that could be related to escalation of
violence in a conflict.
There were only four meta-analyses that could be examined with sexual IPV perpetration
as the outcome. These were for BPD, ASPD, psychopathy and NPD, all of which demonstrated
modest but significant effect sizes and most of which were only represented by a handful of
studies. Given the small number of studies examining PDs as predictors of sexual IPV
perpetration, as well as significant heterogeneity between studies, it is clear that more research is
needed to draw firmer conclusions about what kinds of personality characteristics are most
strongly linked to this particularly form of IPV.
Across all total, physical, and psychological IPV victimization, BPD and psychopathy
demonstrated significant and positive effects. The largest effect sizes were found for avoidant PD
and dependent PD. As described previously, it may be the case that individuals with avoidant or
dependent PD may not feel capable of handling conflict in effective ways with partners, which
potentially could make them more willing to tolerate partner aggression. The mechanisms for
this tolerance, however, may differ. With respect to dependent PD, some research (South,
Turkheimer & Oltmanns, 2008) has found that individuals with high levels of dependent PD
traits tend to have higher ratings of relationship satisfaction, which may mean that those with
dependent PD see their relationship in a more positive light and cause them to downplay the IPV
they experience. In terms of avoidant PD, one feature that an individual may demonstrate is
showing restraint within intimate relationships out of fear of being ridiculed. This fear may
prevent the individual from appropriately asserting themselves and setting boundaries with
partners who are engaging in IPV. Additionally, both avoidant and dependent PDs are also
characterized by lack of self-efficacy, which could make it more likely that an individual
continues to stay in a relationship in which IPV occurs because of a perceived lack of autonomy.
It is important to note that PD symptoms were elevated for both perpetration and
victimization of IPV, and that there was overlap in terms of which PDs had the strongest effect
sizes for both. There are a few reasons this may be the case. The first is that all PDs are related to
interpersonal dysfunction. During conflict situations, it may be the case that both partners of a
dyad in which IPV occurs use unhealthy ways of handling conflict, which for some may result in
becoming aggressive and for others may involve retreating and tolerating aggression to maintain
the relationship. A second reason is that research suggests that IPV often occurs bidirectionally
(Stith et al., 2004); that is, those who experience IPV tend to also be perpetrators of IPV and vice
versa. Therefore, it may be difficult to tease apart “victims” and “perpetrators” in relationships in
which IPV occurs. It may also be the case that those who have impairing personality
characteristics may seek out partners who also experience similar or complementary dysfunction.
For example, both experience the relationship insecurity that is characteristic of BPD or
dependent PD, or one partner demonstrates relationship insecurity and dependence while the
other demonstrates emotional detachment and coldness.
Broader implications for personality research
Although the focus of the present study was on clinical PD diagnoses and symptoms
rather than more basic personality traits, it is possible to examine the PDs that were most
robustly correlated with IPV to start to get a sense of which types of personality dysfunction tend
to be most predictive of this type of aggression. There did not appear to be a PD cluster (i.e.,
Clusters A, B and C as defined by DSM-5) that was most predictive of IPV, as PDs within each
of the clusters showed robust effects with both perpetration and victimization. However, when
examining the more specific content within the PDs with the strongest effects, one can elucidate
some degree of shared content across these diagnoses. Past research has conceptualized PDs as
clusters of basic personality traits, specifically traits underlying the five-factor model (FFM) of
personality (Lynam & Widiger, 2001). For example, using an expert rating approach in which
each PD was rated in terms of its representativeness of a given facet of the FFM, ASPD can be
conceptualized as largely a construct of traits related to low agreeableness and low
conscientiousness, whereas BPD can be largely conceptualized as a construct of high
neuroticism (Lynam & Widiger, 2001).
Qualitatively examining the PDs for which effect sizes were the largest for IPV
perpetration (BPD, ASPD, paranoid PD, schizotypal PD) in the present study, it appears that the
types of personality dysfunction that may be most predictive of IPV perpetration could be some
combination of low agreeableness, low conscientiousness, and high neuroticism. These traits are
consistent with meta-analytic findings regarding which personality traits bear the strongest
relations to general aggression (Jones, Miller, & Lynam, 2011; Vize et al., 2019). Examining the
core features of these PDs can also provide a mechanism for explaining the high degree of
comorbidity among certain PDs, such as ASPD and BPD, particularly in forensic settings in
which ASPD and BPD can be difficult to distinguish (Anderson et al., 2021). For this reason,
conceptualizing pathological personality profiles in terms of more basic traits, rather than
heterogeneous and overlapping PD diagnoses, may be more helpful in determining specific
personality correlates of IPV. Given the relative dearth of basic personality trait research in IPV
literature, this represents a potentially fruitful area for future research. Examining the PD
correlates of IPV victimization in the present study, neuroticism seems to play a larger role given
that the strongest effects were found for BPD, ASPD, dependent PD, and avoidant PD.
The present study is not without limitations. The first is that there was a high degree of
variability in terms of measurement methods and ways of gathering information about IPV and
PD symptoms. Although these were included as moderating variables in the analyses, it is likely
that the differences in methodology across studies contributed in large part to the significant
heterogeneity across studies. The second was the small number of studies that reported effect
sizes for several variables of interest, particularly with respect to psychological and sexual IPV.
As a result, the confidence intervals for those effect sizes are much wider than those effect sizes
for which there were more studies available for inclusion. As such, these effects should be
interpreted with caution. Finally, dyadic data was not coded separately to attempt to elucidate
one partner’s PD data matched to another partner’s PD data. Future research should include this
data to shed more light on the interpersonal dynamics at play in a given dyad that may help to
explain why similar PDs correlate with both perpetration and experience of IPV.
Future Directions
Given the high degree of symptom overlap between PDs, and research that has called into
question the utility of categorical PD diagnoses (e.g., Trull & Durrett, 2005), it may be more
useful to examine the personality correlates of IPV on a dimensional level. This is particularly
important given the dearth of research that has reported effect sizes between basic personality
traits and IPV perpetration and victimization. Not only would this help to have a finer-grained
understanding of which facets of these PDs are the most important “active ingredients” in
predicting IPV, but it would also help to link IPV research with broader personality research. For
example, meta-analyses (Jones, Miller, & Lynam, 2011; Vize et al., 2019) have examined
various types of aggression (e.g., proactive, reactive, general, sexual) in the context of the Big
Five model of personality but have not included IPV as an outcome of interest. Future research
could examine how these traits predict IPV and determine if there are meaningful differences
between the personality correlates of partner- and non-partner-directed aggression. This is
particularly important given research suggesting that there may be differential predictors of IPV
compared to those that have been identified for other types of aggression (Ulloa et al., 2016).
Funding Sources: This research did not receive any specific grant from funding agencies in the
public, commercial, or not-for-profit sectors.
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Figure 1. PRISMA flow diagram of included and excluded studies.
Records identified through database
(n = 3,988)
Records after duplicates removed
(n = 3,419)
Records screened
(n = 3,419)
Records excluded
-Not empirical (n = 459)
-Included neither IPV nor PD
(n = 1,602)
-Did not include either IPV
or PD (n = 929)
-Full text unavailable (n =
Full-text articles assessed
for eligibility
(n = 404)
Full-text articles excluded
-Not empirical (n = 3)
-Authors did not respond
with necessary information (n
= 72)
-Did not include either IPV
or PD (n = 94)
-No comparison group or
norms unavailable (n = 45)
-Homicide as outcome (n =
-Redundant sample (n = 19)
-PID-5 (n = 3)
Studies included in
quantitative synthesis
(n = 163, representing 189
unique samples)
Appendix B. Studies included in meta-analysis.
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