Comorbidity of borderline personality disorder and posttraumatic stress disorder in the U.S. population
Open accessAbstract
While placed on different axes of the DSM classification system, borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) have important relationships with trauma, and overlap between these disorders has long been recognized. The current study is the first to examine comorbidity of PTSD and BPD in a large nationally representative sample using a reliable and valid method of assessing Axis I and II mental disorders. Data came from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Wave II (N = 34,653; response rate 70.2%). Multiple regression models were used to examine differences in psychopathology, traumatic events and health-related quality of life across individuals with PTSD alone (n = 1820), BPD alone (n = 1290) and those with comorbid PTSD-BPD (n = 643). The lifetime prevalence of PTSD and BPD were 6.6% and 5.9%, respectively. Of individuals with BPD, 30.2% were also diagnosed with PTSD, whereas 24.2% of individuals with PTSD were also diagnosed with BPD. Individuals with comorbid PTSD-BPD had a poorer quality of life, more comorbidity with other Axis I conditions, increased odds of a lifetime suicide attempt, and a higher prevalence of repeated childhood traumatic events than individuals with either condition alone. These results show that PTSD and BPD have a high degree of lifetime co-occurrence but are not entirely overlapping. Their concurrence is associated with poorer functioning compared to either diagnosis alone, emphasizing the clinical utility of diagnosing both conditions. Future research should explore the determinants of having either or both diagnoses with an aim toward improved identification, prevention, and intervention.
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Comorbid anxiety disorders and heightened aggression increase the odds of suicidal behavior in various clinical presentations, including BPD.
“Comorbid anxiety disorders (Pagura et al., 2010; Sareen, 2011) and heightened aggression (Evren, Cınar, Evren, & Celik, 2011) increase the odds for suicidal behavior in a variety of clinical presentations, including BPD.”
From Impact of dialectical behavior therapy versus community treatment by experts on emotional experience, expression, and acceptance in borderline personality disorder (2014) · cites this paper as Pagura et al., 2010
The Results (Suicidality; page not supplied) and Discussion report higher odds of lifetime suicide attempts among people with comorbid PTSD and BPD than among those with either disorder alone. Pagura et al. examine PTSD specifically, not anxiety disorders generally or a variety of clinical presentations. The heightened-aggression claim is attached to a different citation and is not assessed here. (LLM, conf=0.87)
Experimental — accuracy not yet measuredIn community samples of people with borderline personality disorder, roughly 30% also meet criteria for PTSD.
“Among individuals with BPD, the rate of co-occurring PTSD is approximately 30% in community samples (Grant et al., 2008; Pagura et al., 2010) and 50% in clinical samples (Harned, Rizvi, & Linehan, 2010; Zanarini, Frankenburg, Hennen, Reich, & Silk, 2004).”
People with both borderline personality disorder and PTSD have suicide attempt rates two to five times higher than those with either disorder alone.
“Individuals with both BPD and PTSD are a particularly high risk group, with rates of suicide attempts two and five times higher than individuals with BPD or PTSD alone (Pagura et al., 2010).”
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Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Diagnostic and Statistical Manual of Mental Disorders.
Widiger, T. A. (2000) · Oxford University Press eBooks · doi:10.1037/10518-009 · Cited by 19,767 · see citing works
WARE, J. E., KOSINSKI, M., & KELLER, S. D. (1996) · Medical Care · doi:10.1097/00005650-199603000-00003 · Cited by 17,392 · see citing works
Posttraumatic Stress Disorder in the National Comorbidity Survey
Kessler, R. C. (1995) · Archives of General Psychiatry · doi:10.1001/archpsyc.1995.03950240066012 · Cited by 10,379 · see citing works
Diagnostic and Statistical Manual of Mental Disorders, 3rd ed
Cooper, A. M., & Michels, R. (1981) · American Journal of Psychiatry · doi:10.1176/ajp.138.1.128 · Cited by 7,417 · see citing works
Diagnostic and Statistical Manual of Mental Disorders
Raber, G., & Spokas, M. (2024) · doi:10.4135/9781071886229.n145 · Cited by 2,806 · see citing works
Complex PTSD: A syndrome in survivors of prolonged and repeated trauma
Herman, J. L. (1992) · Journal of Traumatic Stress · doi:10.1002/jts.2490050305 · Cited by 2,609 · see citing works
Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., Korslund, K. E., Tutek, D. A., Reynolds, S. K., & Lindenboim, N. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.7.757 · Cited by 2,025 · see citing works
Grant, B. F., Chou, S. P., Goldstein, R. B., Huang, B., Stinson, F. S., Saha, T. D., Smith, S. M., Dawson, D. S., Pulay, A. J., Pickering, R. P., et al. (2008) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v69n0404 · Cited by 1,618 · see citing works
Self-citationChildhood adversity and adult psychiatric disorder in the US National Comorbidity Survey
KESSLER, R. C., DAVIS, C. G., & KENDLER, K. S. (1997) · Psychological Medicine · doi:10.1017/s0033291797005588 · Cited by 1,298 · see citing works
Childhood trauma in borderline personality disorder.
Herman, J., Perry, J., & van der Kolk, B. A. (1989) · American Journal of Psychiatry · doi:10.1176/ajp.146.4.490 · Cited by 1,277 · see citing works
Grant, B. F., Dawson, D. A., Stinson, F. S., Chou, P. S., Kay, W., & Pickering, R. (2003) · Drug and Alcohol Dependence · doi:10.1016/s0376-8716(03)00070-x · Cited by 1,110 · see citing works
Self-citationAxis I Comorbidity of Borderline Personality Disorder
Zanarini, M. C., Frankenburg, F. R., Dubo, E., Sickel, A. E., Trikha, A., Levin, A., & Reynolds, V. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.12.1733 · Cited by 978 · see citing works
Posttraumatic stress disorder in abused and neglected children grown up
Widom, C. S. (1999) · American Journal of Psychiatry · doi:10.1176/ajp.156.8.1223 · Cited by 945 · see citing works
Completed Suicide After a Suicide Attempt: A 37-Year Follow-Up Study
Suominen, K. H., Isometsä, E. T., Suokas, J. T., Haukka, J. K., Achté, K., & Lönnqvist, J. K. (2004) · American Journal of Psychiatry · doi:10.1176/appi.ajp.161.3.562 · Cited by 636 · see citing works
Childhood physical abuse and combat-related posttraumatic stress disorder in Vietnam veterans.
Bremner, J., Southwick, S., Johnson, D. R., Yehuda, R., & Charney, D. (1993) · American Journal of Psychiatry · doi:10.1176/ajp.150.2.235 · Cited by 590 · see citing works
Ruan, W. J., Goldstein, R. B., Chou, S. P., Smith, S. M., Saha, T. D., Pickering, R. P., Dawson, D. A., Huang, B., Stinson, F. S., & Grant, B. F. (2008) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2007.06.001 · Cited by 557 · see citing works
Self-citationSareen, J., Cox, B. J., Stein, M. B., Afifi, T. O., Fleet, C., & Asmundson, G. J. G. (2007) · Psychosomatic Medicine · doi:10.1097/psy.0b013e31803146d8 · Cited by 541 · see citing works
Self-citationChildhood sexual and physical abuse in adult patients with borderline personality disorder.
Ogata, S., Silk, K., Goodrich, S., Lohr, N., Westen, D., & Hill, E. M. (1990) · American Journal of Psychiatry · doi:10.1176/ajp.147.8.1008 · Cited by 529 · see citing works
Zanarini, M. C., Frankenburg, F. R., Hennen, J. A., Reich, D. B., & Silk, K. R. (2004) · American Journal of Psychiatry · doi:10.1176/appi.ajp.161.11.2108 · Cited by 525 · see citing works
Childhood experiences of borderline patients
Zanarini, M. C., Gunderson, J. G., Marino, M. F., Schwartz, E. O., & Frankenburg, F. R. (1989) · Comprehensive Psychiatry · doi:10.1016/0010-440x(89)90114-4 · Cited by 447 · see citing works
Estimating the Prevalence of Borderline Personality Disorder in the Community
Swartz, M. S., Blazer, D. G., George, L. K., & Winfield, I. (1990) · Journal of Personality Disorders · doi:10.1521/pedi.1990.4.3.257 · Cited by 356 · see citing works
Axis I diagnostic comorbidity and borderline personality disorder
Zimmerman, M. A., & Mattia, J. I. (1999) · Comprehensive Psychiatry · doi:10.1016/s0010-440x(99)90123-2 · Cited by 350 · see citing works
Risk factors for post-traumatic stress disorder among UK Armed Forces personnel
Iversen, A. C., Fear, N. T., Ehlers, A., Hughes, J. H., Hull, L., Earnshaw, M., Greenberg, N. L., Rona, R. J., Wessely, S. C., & Hotopf, M. H. (2008) · Psychological Medicine · doi:10.1017/s0033291708002778 · Cited by 325 · see citing works
The phenomenological and conceptual interface between borderline personality disorder and PTSD
Gunderson, J. G., & Sabo, A. N. (1993) · American Journal of Psychiatry · doi:10.1176/ajp.150.1.19 · Cited by 302 · see citing works
Yen, S., Shea, M. T., Battle, C. L., Johnson, D. M., Zlotnick, C., Dolan‐Sewell, R., Skodol, A. E., Grilo, C. M., Gunderson, J. G., Sanislow, C. A., et al. (2002) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200208000-00003 · Cited by 301 · see citing works
Oquendo, M. A., Brent, D. A., Birmaher, B. B., Greenhill, L. L., Kolko, D. J., Stanley, B., Zelazny, J. M., Burke, A. K., Firinciogullari, S., Ellis, S. P., et al. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.3.560 · Cited by 293 · see citing works
Sareen, J., Houlahan, T., Cox, B. J., & Asmundson, G. J. G. (2005) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000168263.89652.6b · Cited by 286 · see citing works
Self-citationCabrera, Ó., Hoge, C. W., Bliese, P. D., Castro, C. A., & Messer, S. C. (2007) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2007.03.019 · Cited by 284 · see citing works
Rinne, T., de Kloet, E. R., Wouters, L., Goekoop, J. G., DeRijk, R. H., & van den Brink, W. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01395-1 · Cited by 279 · see citing works
Golier, J. A., Yehuda, R., Bierer, L. M., Mitropoulou, V., New, A. S., Schmeidler, J., Silverman, J. M., & Siever, L. J. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.11.2018 · Cited by 266 · see citing works
Zanarini, M. C., Frankenburg, F. R., Reich, D. B., Fitzmaurice, G. M., Weinberg, I., & Gunderson, J. G. (2008) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2008.01155.x · Cited by 227 · see citing works
Oquendo, M. A., Friend, J. M., Halberstam, B., Brodsky, B. S., Burke, A. K., Grunebaum, M. F., Malone, K. M., & Mann, J. J. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.3.580 · Cited by 225 · see citing works
Harned, M. S., Chapman, A. L., Dexter-Mazza, E. T., Murray, A., Comtois, K. A., & Linehan, M. M. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0014044 · Cited by 169 · see citing works
Personality disorders in treatment-seeking combat veterans with posttraumatic stress disorder
Southwick, S. M., Yehuda, R., & Giller, E. L. (1993) · American Journal of Psychiatry · doi:10.1176/ajp.150.7.1020 · Cited by 159 · see citing works
Feeny, N. C., Zoellner, L. A., & Foa, E. B. (2002) · Journal of Personality Disorders · doi:10.1521/pedi.16.1.30.22555 · Cited by 159 · see citing works
Mortality and suicide after non-fatal self-poisoning: 16-year outcome study
Owens, D., Wood, C., Greenwood, D. C., Tom, H., & Dennis, M. (2005) · The British Journal of Psychiatry · doi:10.1192/bjp.187.5.470 · Cited by 129 · see citing works
Heffernan, K., & Cloître, M. (2000) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-200009000-00005 · Cited by 119 · see citing works
Zlotnick, C., Johnson, D. M., Yen, S., Battle, C. L., Sanislow, C. A., Skodol, A. E., Grilo, C. M., McGlashan, T. H., Gunderson, J. G., Bender, D. S., et al. (2003) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000095122.29476.ff · Cited by 117 · see citing works
Clarke, S. B., Rizvi, S. L., & Resick, P. A. (2007) · Behavior Therapy · doi:10.1016/j.beth.2007.05.002 · Cited by 105 · see citing works
Sabo, A. N. (1997) · Journal of Personality Disorders · doi:10.1521/pedi.1997.11.1.50 · Cited by 102 · see citing works
Physical and sexual abuse histories among children with borderline personality disorder
Goldman, S. J., D’Angelo, E. J., DeMaso, D. R., & Mezzacappa, E. (1992) · American Journal of Psychiatry · doi:10.1176/ajp.149.12.1723 · Cited by 92 · see citing works
Van Den Bosch, L. M. C., Verheul, R., Langeland, W., & Van Den Brink, W. (2003) · Australian & New Zealand Journal of Psychiatry · doi:10.1046/j.1440-1614.2003.01199.x · Cited by 86 · see citing works
Zlotnick, C., Franklin, C. L., & Zimmerman, M. A. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.11.1940 · Cited by 57 · see citing works
Basal cortisol and DHEA levels in women with borderline personality disorder
Jogems-Kosterman, B. J. M., de Knijff, D. W. W., Kusters, R., & van Hoof, J. J. M. (2007) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2006.07.019 · Cited by 55 · see citing works
Lange, W., Wulff, H., Berea, C., Beblo, T., Saavedra, A. S., Mensebach, C., Wingenfeld, K., & Drießen, M. (2005) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2005.02.009 · Cited by 53 · see citing works
Commonality and Specificity of Personality Disorder Profiles in Subjects with Trauma Histories
Shea, M. T., Zlotnick, C., & Weisberg, R. B. (1999) · Journal of Personality Disorders · doi:10.1521/pedi.1999.13.3.199 · Cited by 52 · see citing works
Han, O., Lee, H., Ahn, J., Park, J.-I., Cho, M., Hong, J., Hahm, B., & Kim, C.-Y. (2003) · Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000061140.93952.28 · Cited by 47 · see citing works
Kolla, N. J., Eisenberg, H., & Links, P. S. (2008) · Archives of Suicide Research · doi:10.1080/13811110701542010 · Cited by 45 · see citing works
Murray, J. B. (1993) · The Journal of Psychology · doi:10.1080/00223980.1993.9914905 · Cited by 45 · see citing works
Rüsch, N., Corrigan, P. W., Bohus, M., Kühler, T., Jacob, G. A., & Lieb, K. (2007) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e318064e7fc · Cited by 42 · see citing works
Posttraumatic Stress Disorder among Children Clinically Diagnosed as Borderline Personality Disorder
Famularo, R., Kinscherff, R. T., & Fenton, T. (1991) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199107000-00007 · Cited by 42 · see citing works
Wingenfeld, K., Drießen, M., Adam, B., & Hill, A. (2006) · European Psychiatry · doi:10.1016/j.eurpsy.2006.09.002 · Cited by 41 · see citing works
Connor, K. M., Davidson, J. R. T., Hughes, D. C., Swartz, M. S., Blazer, D. G., & George, L. K. (2002) · Comprehensive Psychiatry · doi:10.1053/comp.2002.29846 · Cited by 33 · see citing works
Symptom correlates of posttraumatic stress disorder in clients with borderline personality disorder
Bolton, E. E., Mueser, K. T., & Rosenberg, S. D. (2006) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2005.12.002 · Cited by 30 · see citing works
Dexamethasone suppression test in borderline personality disorder: Impact of PTSD symptoms
Wingenfeld, K., Hill, A., Adam, B., & Drießen, M. (2007) · Psychiatry and Clinical Neurosciences · doi:10.1111/j.1440-1819.2007.01728.x · Cited by 26 · see citing works
Wingenfeld, K., Lange, W., Wulff, H., Berea, C., Beblo, T., Saavedra, A. S., Mensebach, C., & Driessen, M. (2007) · Journal of Clinical Psychology · doi:10.1002/jclp.20396 · Cited by 18 · see citing works
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- Stinson FS Dawson DA Goldstein RB Chou SP Huang B Smith SM Ruan WJ Pulay AJ Saha TD Pickering RP Grant BF Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions Journal of Clinical Psychiatry 2008 69 7 1033 1045 18557663 PMC2669224
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Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., Van Ameringen, M., & the Canadian Anxiety Guidelines Initiative Group on behalf of the Anxiety Disorders Association of Canada/Association Canadienne des troubles anxieux and McGill University (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-s1-s1 · Cited by 1,090 · see citing works
“Patients with comorbid PTSD and BPD had a poorer QoL, more comorbidity with other psychiatric conditions, and increased odds of a lifetime suicide attempt versus patients with either condition alone [20,874].”
BackgroundPosttraumatic Stress Disorder in Adults: Impact, Comorbidity, Risk Factors, and Treatment
Sareen, J. (2014) · The Canadian Journal of Psychiatry · doi:10.1177/070674371405900902 · Cited by 467 · see citing works
Self-citationDistinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis
Cloitre, M., Garvert, D. W., Weiss, B., Carlson, E. B., & Bryant, R. A. (2014) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v5.25097 · Cited by 468 · see citing works
Childhood adversity and borderline personality disorder: a meta‐analysis
Porter, C., Palmier‐Claus, J., Branitsky, A., Mansell, W., Warwick, H., & Varese, F. (2020) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.13118 · Cited by 450 · see citing works
Hasin, D. S., & Grant, B. F. (2015) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-015-1088-0 · Cited by 452 · see citing works
Self-citationHarned, M. S., Korslund, K. E., & Linehan, M. M. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.01.008 · Cited by 388 · see citing works
Borderline personality disorder
Bohus, M., Stoffers-Winterling, J., Sharp, C., Krause-Utz, A., Schmahl, C., & Lieb, K. (2021) · The Lancet · doi:10.1016/s0140-6736(21)00476-1 · Cited by 347 · see citing works
Leichsenring, F., Fonagy, P., Heim, N., Kernberg, O. F., Leweke, F., Luyten, P., Salzer, S., Spitzer, C., & Steinert, C. (2024) · World Psychiatry · doi:10.1002/wps.21156 · Cited by 344 · see citing works
Harned, M. S., Korslund, K. E., Foa, E. B., & Linehan, M. M. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.02.011 · Cited by 288 · see citing works
Prevalence of post-traumatic stress disorder in the United States: a systematic literature review
Schein, J., Houle, C., Urganus, A., Cloutier, M., Patterson-Lomba, O., Wang, Y., King, S., Levinson, W., Guérin, A., Lefebvre, P., et al. (2021) · Current Medical Research and Opinion · doi:10.1080/03007995.2021.1978417 · Cited by 288 · see citing works
Panagioti, M., Gooding, P. A., & Tarrier, N. (2012) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2012.02.009 · Cited by 280 · see citing works
Bohus, M., Kleindienst, N., Hahn, C., Müller-Engelmann, M., Ludäscher, P., Steil, R., Fydrich, T., Kuehner, C., Resick, P. A., Stiglmayr, C., et al. (2020) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2020.2148 · Cited by 265 · see citing works
Comorbidity of personality disorders in anxiety disorders: A meta-analysis of 30 years of research
Friborg, O., Martinussen, M., Kaiser, S., Øvergård, K. T., & Rosenvinge, J. H. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.07.004 · Cited by 251 · see citing works
Examining potential contraindications for prolonged exposure therapy for PTSD
van Minnen, A., Harned, M. S., Zoellner, L., & Mills, K. (2012) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v3i0.18805 · Cited by 248 · see citing works
Borderline Personality Disorder
Leichsenring, F., Heim, N., Leweke, F., Spitzer, C., Steinert, C., & Kernberg, O. F. (2023) · JAMA · doi:10.1001/jama.2023.0589 · Cited by 225 · see citing works
Messman‐Moore, T. L., & Bhuptani, P. H. (2017) · Clinical Psychology Science and Practice · doi:10.1111/cpsp.12193 · Cited by 209 · see citing works
Complex PTSD, affect dysregulation, and borderline personality disorder
Ford, J. D., & Courtois, C. A. (2014) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/2051-6673-1-9 · Cited by 182 · see citing works
Cattane, N., Rossi, R., Lanfredi, M., & Cattaneo, A. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1383-2 · Cited by 177 · see citing works
Sareen, J., Henriksen, C. A., Bolton, S.-L., Afifi, T. O., Stein, M. B., & Asmundson, G. J. G. (2013) · Psychological Medicine · doi:10.1017/s003329171200102x · Cited by 163 · see citing works
Self-citationRISK FACTORS FOR POST-INJURY MENTAL HEALTH PROBLEMS
Sareen, J., ERICKSON, J. D., Medved, M. I., Asmundson, G. J. G., Enns, M. W., Stein, M. B., Leslie, W. D., Doupe, M. B., & Logsetty, S. (2013) · Depression and Anxiety · doi:10.1002/da.22077 · Cited by 170 · see citing works
Self-citationWedig, M. M., Silverman, M. H., Frankenburg, F. R., Reich, D. B., Fitzmaurice, G., & Zanarini, M. C. (2012) · Psychological Medicine · doi:10.1017/s0033291712000517 · Cited by 137 · see citing works
Adverse childhood experiences and suicidal behavior of adolescent psychiatric inpatients
Isohookana, R., Riala, K., Hakko, H. H., & Räsänen, P. K. (2012) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-012-0311-8 · Cited by 132 · see citing works
Farina, B., Liotti, M., & Imperatori, C. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.00933 · Cited by 111 · see citing works
Comorbidity between Post-Traumatic Stress Disorder and Borderline Personality Disorder: A Review
Frías, Á., & Palma, C. (2015) · Psychopathology · doi:10.1159/000363145 · Cited by 114 · see citing works
Matthies, S. D., & Philipsen, A. (2014) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/2051-6673-1-3 · Cited by 110 · see citing works
Schulze, L., Schulze, A., Renneberg, B., Schmahl, C., & Niedtfeld, I. (2019) · Biological Psychiatry: Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2018.11.004 · Cited by 102 · see citing works
MacIntosh, H. B., Godbout, N., & Dubash, N. (2015) · Canadian Psychology/Psychologie canadienne · doi:10.1037/cap0000028 · Cited by 100 · see citing works
The Role of Trauma Symptoms in Nonsuicidal Self-Injury
Smith, N. B., Kouros, C. D., & Meuret, A. E. (2013) · Trauma Violence & Abuse · doi:10.1177/1524838013496332 · Cited by 95 · see citing works
Bohus, M., Schmahl, C. G., Fydrich, T., Steil, R., Müller‐Engelmann, M., Herzog, J., Ludäscher, P., Kleindienst, N., & Priebe, K. (2019) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-019-0099-y · Cited by 92 · see citing works
Scheiderer, E. M., Wood, P. K., & Trull, T. J. (2015) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-015-0032-y · Cited by 90 · see citing works
Hyland, P., Karatzias, T., Shevlin, M., & Cloitre, M. (2019) · Journal of Traumatic Stress · doi:10.1002/jts.22444 · Cited by 89 · see citing works
Neacsiu, A. D., Lungu, A., Harned, M. S., Rizvi, S. L., & Linehan, M. M. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2013.12.004 · Cited by 80 · see citing works
“Comorbid anxiety disorders (Pagura et al., 2010; Sareen, 2011) and heightened aggression (Evren, Cınar, Evren, & Celik, 2011) increase the odds for suicidal behavior in a variety of clinical presentations, including BPD.”
BackgroundFrost, R., Hyland, P., Shevlin, M., & Murphy, J. (2020) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2018.08.004 · Cited by 76 · see citing works
Parlar, M. E., Frewen, P., Nazarov, A., Oremus, C., MacQUEEN, G. M., Lanius, R. A., & McKinnon, M. C. (2014) · Brain and Behavior · doi:10.1002/brb3.215 · Cited by 75 · see citing works
Borderline Personality Disorder
Brüne, M. (2016) · Evolution Medicine and Public Health · doi:10.1093/emph/eow002 · Cited by 73 · see citing works
Brewerton, T. D. (2022) · Journal of Eating Disorders · doi:10.1186/s40337-022-00696-6 · Cited by 71 · see citing works
Attentional Bias for Emotional Stimuli in Borderline Personality Disorder: A Meta-Analysis
Kaiser, D., Jacob, G. A., Domes, G., & Arntz, A. R. (2016) · Psychopathology · doi:10.1159/000448624 · Cited by 63 · see citing works
Tull, M. T., Berghoff, C. R., Wheeless, L. E., Cohen, R. T., & Gratz, K. L. (2017) · Behavior Therapy · doi:10.1016/j.beth.2017.05.005 · Cited by 63 · see citing works
Pietrzak, R. H., Goldstein, R. B., Southwick, S. M., & Grant, B. F. (2010) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2010.09.013 · Cited by 61 · see citing works
Self-citationPowers, A. D., Petri, J. M., Sleep, C. E., Mekawi, Y., Lathan, E. C., Shebuski, K., Bradley, B., & Fani, N. (2021) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2022.102558 · Cited by 61 · see citing works
Self-injurious behaviors in posttraumatic stress disorder: An examination of potential moderators
Dixon-Gordon, K. L., Tull, M. T., & Gratz, K. L. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.05.033 · Cited by 59 · see citing works
Jowett, S., Karatzias, T., & Albert, I. (2020) · Psychology and Psychotherapy: Theory, Research and Practice · doi:10.1111/papt.12248 · Cited by 55 · see citing works
Lotfinia, S., Soorgi, Z., Mertens, Y., & Daniels, J. (2020) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.05.006 · Cited by 53 · see citing works
Dysregulation between emotion and theory of mind networks in borderline personality disorder
O’Neill, A., D’Souza, A., Samson, A. C., Carballedo, A., Kerskens, C., & Frodl, T. (2014) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2014.11.002 · Cited by 55 · see citing works
How Do Stress Exposure and Stress Regulation Relate to Borderline Personality Disorder?
Bourvis, N., Aouidad, A., Cabelguen, C., Cohen, D., & Xavier, J. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.02054 · Cited by 48 · see citing works
People with a borderline personality disorder diagnosis describe discriminatory experiences
Veysey, S. A. (2014) · Kōtuitui New Zealand Journal of Social Sciences Online · doi:10.1080/1177083x.2013.871303 · Cited by 42 · see citing works
Gratz, K. L., Dixon-Gordon, K. L., & Tull, M. T. (2014) · Personality Disorders: Theory, Research, and Treatment · doi:10.1037/per0000062 · Cited by 51 · see citing works
Body-Related Emotions in Posttraumatic Stress Disorder Following Childhood Sexual Abuse
Dyer, A. S., Feldmann, R. E., & Borgmann, E. (2015) · Journal of Child Sexual Abuse · doi:10.1080/10538712.2015.1057666 · Cited by 48 · see citing works
Riffer, F., Farkas, M., Streibl, L. E., Kaiser, E., & Sprung, M. S. (2019) · International Journal of Psychiatry in Clinical Practice · doi:10.1080/13651501.2019.1576904 · Cited by 48 · see citing works
Anxiety disorders and risk for suicide: why such controversy?
Sareen, J. (2011) · Depression and Anxiety · doi:10.1002/da.20906 · Cited by 46 · see citing works
Self-citationEmotions and Memory in Borderline Personality Disorder
Winter, D., Elzinga, B., & Schmahl, C. (2013) · Psychopathology · doi:10.1159/000356360 · Cited by 50 · see citing works
Interpersonal violence in posttraumatic women: brain networks triggered by trauma-related pictures
Neumeister, P., Feldker, K., Heitmann, C. Y., Helmich, R., Gathmann, B., Becker, M. P. I., & Straube, T. (2016) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsw165 · Cited by 47 · see citing works
Patterns of comorbidity associated with ICD-11 PTSD among older adults in the United States
Fox, R. J., Hyland, P., Power, J. M., & Coogan, A. N. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113171 · Cited by 45 · see citing works
Steuwe, C., Rullkötter, N., Ertl, V., Berg, M., Neuner, F., Beblo, T., & Drießen, M. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0969-4 · Cited by 44 · see citing works
Meyers, L. L., Voller, E. K., McCallum, E. B., THURAS, P. D., Shallcross, S. L., Velasquez, T. L., & Meis, L. A. (2017) · Journal of Traumatic Stress · doi:10.1002/jts.22174 · Cited by 45 · see citing works
Markowitz, J. C., Petkova, E., Biyanova, T., Ding, K., Suh, E. J., & Neria, Y. (2015) · Depression and Anxiety · doi:10.1002/da.22436 · Cited by 44 · see citing works
Yuan, Y., Lee, H., Eack, S. M., & Newhill, C. E. (2023) · Journal of Personality Disorders · doi:10.1521/pedi.2023.37.1.16 · Cited by 46 · see citing works
Marshall‐Berenz, E. C., Morrison, J. A., Schumacher, J. A., & Coffey, S. F. (2011) · Depression and Anxiety · doi:10.1002/da.20798 · Cited by 44 · see citing works
Morandotti, N., Dima, D., Jogia, J., Frangou, S., Sala, M., Vidovich, G. Z. D., Lazzaretti, M., Gambini, F., Marraffini, E., d'Allio, G., et al. (2013) · Psychiatry Research · doi:10.1016/j.pscychresns.2013.02.002 · Cited by 49 · see citing works
Snoek, A., Beekman, A. T. F., Dekker, J., Aarts, I., van Grootheest, G., Blankers, M., Vriend, C., van den Heuvel, O., & Thomaes, K. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02713-x · Cited by 44 · see citing works
A critical review of negative affect and the application of CBT for PTSD
Brown, W. J., Dewey, D., Bunnell, B. E., Boyd, S. J., Wilkerson, A. K., Mitchell, M. A., & Bruce, S. E. (2018) · Trauma, Violence, & Abuse · doi:10.1177/1524838016650188 · Cited by 43 · see citing works
Slotema, C. W., Wilhelmus, B., Arends, L. R., & Franken, I. H. A. (2020) · European Journal of Psychotraumatology · doi:10.1080/20008198.2020.1796188 · Cited by 43 · see citing works
Slotema, C. W., van den Berg, D. P. G., Driessen, A., Wilhelmus, B., & Franken, I. H. A. (2019) · European Journal of Psychotraumatology · doi:10.1080/20008198.2019.1614822 · Cited by 42 · see citing works
Barnicot, K., & Priebe, S. (2013) · Personality and Mental Health · doi:10.1002/pmh.1227 · Cited by 31 · see citing works
Krause-Utz, A., Walther, J.-C., Lis, S., Schmahl, C., & Bohus, M. (2019) · Psychological Medicine · doi:10.1017/s0033291718002489 · Cited by 38 · see citing works
Sexuality‐related issues in borderline personality disorder: A comprehensive review
Frías, Á., Palma, C., Farriols, N., & González, L. (2016) · Personality and Mental Health · doi:10.1002/pmh.1330 · Cited by 37 · see citing works
Kaster, T. S., Goldbloom, D. S., Daskalakis, Z. J., Mulsant, B. H., & Blumberger, D. M. (2017) · Brain stimulation · doi:10.1016/j.brs.2017.10.009 · Cited by 37 · see citing works
Barnicot, K., & Crawford, M. J. (2018) · Journal of Traumatic Stress · doi:10.1002/jts.22340 · Cited by 30 · see citing works
Weiss, N. H., Tull, M. T., Borne, M. E. R., & Gratz, K. L. (2013) · AIDS Care · doi:10.1080/09540121.2013.764381 · Cited by 37 · see citing works
Blonigen, D. M., Sullivan, E., Hicks, B. M., & Patrick, C. J. (2012) · Personality Disorders Theory Research and Treatment · doi:10.1037/a0026184 · Cited by 37 · see citing works
Snoek, A., Nederstigt, J., Čihařová, M., Sijbrandij, M., Lok, A., Cuijpers, P. J., & Thomaes, K. (2021) · European Journal of Psychotraumatology · doi:10.1080/20008198.2021.1929753 · Cited by 34 · see citing works
Smits, M. L., de Vos, J., Rüfenacht, E., Nijssens, L., Shaverin, L., Nolte, T., Luyten, P., Fonagy, P., & BATEMAN, A. W. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1426092 · Cited by 40 · see citing works
Kaiser, D., Jacob, G. A., van Zutphen, L., Siep, N., Sprenger, A., Tuschen‐Caffier, B., Senft, A., Arntz, A. R., & Domes, G. (2019) · Journal of Personality Disorders · doi:10.1521/pedi_2019_33_363 · Cited by 32 · see citing works
Zeifman, R. J., Landy, M. S. H., Liebman, R. E., Fitzpatrick, S., & Monson, C. M. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2021.102030 · Cited by 32 · see citing works
Deuter, C., Duesenberg, M., Hellmann-Regen, J., Metz, S., Roepke, S., Wolf, O. T., Otte, C., & Wingenfeld, K. (2021) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-021-00145-x · Cited by 28 · see citing works
Scheiderer, E. M., Wang, T., Tomko, R. L., Wood, P. K., & Trull, T. J. (2015) · Clinical Psychological Science · doi:10.1177/2167702615573214 · Cited by 31 · see citing works
Classification of Posttraumatic Stress Disorder
Ball, T. M., & Stein, M. B. (2012) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780195399066.013.0004 · Cited by 31 · see citing works
Self-citationHarned, M. S., Gallop, R. J., & Valenstein-Mah, H. R. (2018) · Psychotherapy Research · doi:10.1080/10503307.2016.1252865 · Cited by 30 · see citing works
de-Almeida, C. P., Wenzel, A. E., de-Carvalho, C. S., Powell, V. B., Araújo‐Neto, C. A., Quarantini, L. C., & de-Oliveira, I. R. (2012) · CNS Spectrums · doi:10.1017/s1092852912000466 · Cited by 30 · see citing works
Alarcón, R. D., & Palmer, B. A. (2020) · doi:10.1093/med/9780198713005.003.0119 · Cited by 29 · see citing works
Labudda, K., Kreisel, S. H., Beblo, T., Mertens, M., Kurlandchikov, O., Bien, C. G., Drießen, M., & Woermann, F. G. (2013) · PLoS ONE · doi:10.1371/journal.pone.0083677 · Cited by 29 · see citing works
Psychotherapy for PTSD: An evidence-based guide to a theranostic approach to treatment
Goodnight, J. R. M., Ragsdale, K. A., Rauch, S. A. M., & Rothbaum, B. O. (2019) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2018.05.006 · Cited by 28 · see citing works
Examining the Evidence for Complex Posttraumatic Stress Disorder as a Clinical Diagnosis
Landy, M. S. H., Wagner, A. C., Brown‐Bowers, A., & Monson, C. M. (2015) · Journal of Aggression Maltreatment & Trauma · doi:10.1080/10926771.2015.1002649 · Cited by 28 · see citing works
Rosenthal, M. Z., Neacsiu, A. D., Geiger, P. J., Fang, C. M., Ahn, R. R., & Larrauri, J. (2016) · Cognitive Therapy and Research · doi:10.1007/s10608-015-9736-y · Cited by 28 · see citing works
Complex trauma, dissociation and Borderline Personality Disorder: Working with integration failures
Mosquera, D., & Steele, K. (2017) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2017.01.010 · Cited by 26 · see citing works
Sommer, J. L., Blaney, C., Mota, N. P., Bilevicius, E., Beatie, B. E., Kilborn, K., Chang, U., Sareen, J., & El-Gabalawy, R. M. (2021) · Journal of Traumatic Stress · doi:10.1002/jts.22726 · Cited by 28 · see citing works
Self-citation“Hidden” and diverse long-term impacts of exposure to war and violence
Drožđek, B., Rodenburg, J., & Moyene-Jansen, A. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00975 · Cited by 29 · see citing works
Complex PTSD in ICD-11: A Case Report on a New Diagnosis
Rosenfield, P., Stratyner, A. G., Tufekcioglu, S., KARABELL, S., McKelvey, J. S., & Litt, L. C. (2018) · Journal of Psychiatric Practice · doi:10.1097/pra.0000000000000327 · Cited by 24 · see citing works
The Molecular Relationship between Stress and Insomnia
Birch, J., & Vanderheyden, W. M. (2022) · Advanced Biology · doi:10.1002/adbi.202101203 · Cited by 24 · see citing works
Stephens, T. N., & Aparicio, E. M. (2016) · Children and Youth Services Review · doi:10.1016/j.childyouth.2016.11.035 · Cited by 23 · see citing works
Holder, N. D., Holliday, R. P., Pai, A. V., & Surís, A. (2017) · Behavioral Medicine · doi:10.1080/08964289.2016.1276430 · Cited by 23 · see citing works
Estric, C., Calati, R., & López‐Castromán, J. (2022) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000344 · Cited by 26 · see citing works
Boritz, T. Z., Barnhart, R., & McMain, S. (2015) · Journal of Personality Disorders · doi:10.1521/pedi_2015_29_207 · Cited by 24 · see citing works
Worthington, M., Mandavia, A. D., & Richardson-Vejlgaard, R. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02933-1 · Cited by 23 · see citing works
Harned, M. S., Tkachuck, M. A., & Youngberg, K. A. (2013) · Journal of Clinical Psychology · doi:10.1002/jclp.21943 · Cited by 22 · see citing works
Williams, R. C., Holliday, R. P., Clem, M. A., Anderson, E. H., Morris, E. E., & Surís, A. (2015) · Journal of Interpersonal Violence · doi:10.1177/0886260515596149 · Cited by 22 · see citing works
Treatment of borderline personality disorder and co-occurring anxiety disorders
Harned, M., & Valenstein, H. (2013) · F1000Prime Reports · doi:10.12703/p5-15 · Cited by 20 · see citing works
The Response to September 11: A Disaster Case Study
Crane, M. A., Levy‐Carrick, N. C., Crowley, L. E., Barnhart, S., Dudas, M. M., Onuoha, U., Globina, Y., Haile, W., Shukla, G., & Özbay, F. (2014) · Annals of Global Health · doi:10.1016/j.aogh.2014.08.215 · Cited by 23 · see citing works
Houston, E., Sandfort, T., Watson, K. T., & Caton, C. (2012) · Journal of Health Psychology · doi:10.1177/1359105312464674 · Cited by 15 · see citing works
Childhood trauma and borderline personality disorder traits: A discordant twin study.
Skaug, E., Czajkowski, N. O., Waaktaar, T., & Torgersen, S. O. (2022) · Journal of Psychopathology and Clinical Science · doi:10.1037/abn0000755 · Cited by 20 · see citing works
- Authors
- Pagura, J., Stein, M. B., Bolton, J. M., Cox, B. J., Grant, B., & Sareen, J.
- Affiliations
- University of Manitoba (CA)
- University of California San Diego (US)
- National Institutes of Health (US)
- Corresponding author
- Sareen, Jitender
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2010-12
- Volume
- 44
- Issue
- 16
- Pages
- 1190-1198
- ISSN
- 0022-3956 (ISSN-L)
- PMC
- PMC4209725
- OpenAlex
- W2111282764
- Cited by
- 330
- References
- 57
- Citations by year
- 2026: 14 · 2025: 20 · 2024: 22 · 2023: 38 · 2022: 34 · 2021: 25 · 2020: 23 · 2019: 18 · 2018: 15 · 2017: 16 · 2016: 19 · 2015: 20 · 2014: 23 · 2013: 19 · 2012: 15
- FWCI
- 14.80
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- Canadian Institutes of Health Research (82894)
- National Institute on Alcohol Abuse and Alcoholism (Z01AA000449)
- National Institute of Mental Health (MH-64122, K24MH064122)
- National Institute on Drug Abuse
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- borderline personality disorder, post-traumatic stress disorder, comorbidities, trauma exposure, childhood trauma, health-related quality of life, suicide attempts, lifetime prevalence, psychopathology, NESARC
- MeSH terms
- Adult, Aged, Borderline Personality Disorder, Data Collection, Female, Health Surveys, Humans, Longitudinal Studies, Male, Middle Aged, Psychiatric Status Rating Scales, Quality of Life, Severity of Illness Index, Stress Disorders, Post-Traumatic, Suicide, Attempted, United States, Comorbidity, Prevalence, Age of Onset, Young Adult
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