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Morcuende A, Sadler AG, Mengeling M, Torner J, Booth B. Comorbid PTSD and Borderline Personality Disorder in Women Veterans. Poster session presented at: AcademyHealth Annual Research Meeting; 2011 Jun 12; Seattle, WA.
Objectives/Specific aims: To study the association between type and timing of traumatic events and diagnosis of PTSD+BPD. Methods: Cross-sectional study of a retrospective cohort. Participants (N = 875) completed a computer-assisted telephone interview assessing demographics, childhood and adult rape history, combat and civilian traumas, and self-report of lifetime diagnoses of depression, PTSD, or BPD. Subjects with other mental health diagnoses were excluded. Analyses were conducted using contingency tables and Chi-Square tests. Study population: Women veterans enrolled at the Iowa City and Des Moines VA Medical Centers or their outlying clinics within the 5 years preceding research interview. Results/Anticipated results: Depression was diagnosed in 36% of participants, PTSD in 23%, BPD in 2%, and BPD+PTSD in 4%. Women with PTSD+BPD were more likely to report having been raped two or more times (75%) compared to women with depression (37%), PTSD (50%), or BPD (55%) (p < .0001). More participants with PTSD+BPD (58%) and BPD (55%) had their first rape in childhood, compared to those with depression (35%) or PTSD (36%) (p < .0001). Women with PTSD+BPD (64%) were more likely to acknowledge rape in two or more time periods (childhood, adult civilian life, or military life) compared to those with depression (22%), PTSD (31%) or BPD (40%) (p < .0001). Women with BPD+PTSD (61%) were more likely to report three or more types of trauma (childhood rape, adult rape, combat trauma, or civilian trauma) compared to those with depression (24%), PTSD (40%), or BPD (40%) (p < .0001). Conclusions: These findings support previous research indicating extensive exposure to lifetime trauma in women veterans. Women with history of childhood rape, multiple rapes, and exposure to different types of trauma over time are at elevated risk of diagnosis with both PTSD+BPD. Implications for policy, delivery, or practice: Comorbid PTSD+BPD is associated with increased severity of symptoms, poorer social functioning, and higher healthcare utilization than each disorder alone. Current treatment models focused only on PTSD ignore necessary interventions for BPD. Therapeutic interventions available for women veterans exposed to multiple traumatic events across the lifespan must include models especially designed for the treatment of PTSD in the context of BPD.
