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Clinical Features and Impairment in Women with Borderline Personality Disorder (BPD) with Posttraumatic Stress Disorder (PTSD), BPD Without PTSD, and Other Personality Disorders with PTSD

Zlotnick, Caron PhD*‡; Johnson, Dawn M. PhD*; Yen, Shirley PhD*; Battle, Cynthia L. PhD; Sanislow, Charles A. PhD§; Skodol, Andrew E. MD; Grilo, Carlos M. PhD§; McGlashan, Thomas H. MD§; Gunderson, John G. MD; Bender, Donna S. PhD; Zanarini, Mary C. EdD; Tracie Shea, M. PhD*

The Journal of Nervous and Mental Disease: November 2003 - Volume 191 - Issue 11 - p 706-713
doi: 10.1097/01.nmd.0000095122.29476.ff
Original Articles

The aims of this study were to examine differences in clinical features, impairment, and types of childhood traumas among women with borderline personality disorder (BPD), women with BPD and posttraumatic stress disorder (PTSD), and those with other personality disorders and PTSD. Using baseline data from the Collaborative Longitudinal Study of Personality Disorders, 186 women were divided into 3 groups (BPD+PTSD, BPD, PTSD), based on structured diagnostic interviews for Axis I and Axis II disorders and compared on selected clinical variables. The additional diagnosis of PTSD in borderline women did not significantly increase the degree of borderline pathology and psychiatric morbidity but did significantly increase general dysfunction and the occurrence of hospitalization. The additional diagnosis of BPD in women with PTSD significantly increased the features of suicide proneness and impulsiveness. Both groups of women with PTSD reported significantly more types of childhood traumas relative to borderline women without PTSD. Consistent with other research, the findings suggest that PTSD does not appear to alter the central features of BPD. The clinical implications of our findings are considered.

*Brown University School of Medicine, Department of Psychiatry and Human Behavior, Butler Hospital, Providence, RI; ‡Women and Infant’s Hospital, Providence, RI; §Department of Psychiatry, Yale University School of Medicine, New Haven, CT; ¶New York State Psychiatric Institute/Columbia University, New York, NY; ∥McLean Hospital/Harvard Medical School, Belmont, MA.

Send reprint requests to Dr. Zlotnick, Butler Hospital/Brown University, 345 Blackstone Blvd., Providence, RI 02906.

From the Collaborative Longitudinal Personality Disorders Study (CLPS). The CLPS is an ongoing, longitudinal multisite study of personality disorders supported by National Institutes of Mental Health grants MH 50837, 50838, 50839, 50840, 50850, and K05 MH 01645 (McGlashan). This publication has been reviewed and approved by the Publications Committee of the Collaborative Longitudinal Personality Disorders Study.

© 2003 Lippincott Williams & Wilkins, Inc.