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Post‐traumatic stress disorder and the outcome of dialectical behaviour therapy for borderline personality disorder

Barnicot, Kirsten, Priebe, Stefan·2013·Personality and Mental Health
DOI 10.1002/pmh.1227
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Abstract

Background: Individuals with borderline personality disorder (BPD) and comorbid post‐traumatic stress disorder (PTSD) have a worse prognosis than individuals with BPD alone. A common view is that the emotional instability and impulsivity of BPD should be treated before attempting to address trauma. However, PTSD symptoms may interfere with patients' ability to benefit from such ‘stabilizing’ treatments. Methods: The effect of BPD–PTSD comorbidity on self‐harm and BPD symptom outcomes was evaluated in 89 patients receiving dialectical behaviour therapy, using multilevel modelling. Results: Patients with comorbid BPD–PTSD showed a trend towards elevated BPD symptoms throughout the treatment year (β = 2.12, 95% CI = −0.21–4.44, p = 0.07). There was a three‐way interaction between PTSD comorbidity, treatment completion and time, whereby PTSD comorbidity was associated with less reduction in self‐harm frequency over time, but only in those completing the full 12 months of treatment (incident risk ratio = 1.16, 95% CI = 1.04–1.30, p < 0.01). Conclusion: Patients with comorbid PTSD had a poorer outcome from dialectical behaviour therapy than those with BPD alone, possibly because of the negative impact of unaddressed trauma. The results provide further grounds for recently developed treatments targeting BPD traits and PTSD symptoms simultaneously. Copyright © 2013 John Wiley & Sons, Ltd.

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  • Clients with comorbid BPD and PTSD were less likely to reduce their rates of NSSI compared to clients with BPD alone over a one-year period.

    “Barnicot and Priebe (2013) found that clients with comorbid BPD and PTSD were less likely to reduce their rates of NSSI compared to clients with BPD alone over a one-year period.”

    From Transdiagnostic applications of DBT for adolescents and adults (2015) · cites this paper as Barnicot and Priebe (2013)

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Authors
Barnicot, K., & Priebe, S.
Affiliations
Unit for Social and Community Psychiatry Queen Mary University of London London UK
Venue
Personality and Mental Health
Publisher
Wiley
Published
2013-03-18
Volume
7
Issue
3
Pages
181-190
ISSN
  • 1932-8621
  • 1932-863X
DOI
10.1002/pmh.1227
Cited by
31
References
8
Language
en
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Funders
  • NIHR Doctoral Research Fellowship (DRF-2009-02-11)
  • NIHR Research for Patient Benefit (PB-PG-0906-10540)

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