Exploring the links among borderline personality disorder symptoms, trauma, and pain in patients with chronic pain disorders
Open accessAbstract
Objective Chronic pain and borderline personality disorder (BPD) are commonly comorbid and jointly associated with increased symptoms of both disorders and clinical and functional impairment. Little is known, however, about specific links between these disorders. In a cross-sectional study of patients with chronic pain, we compared participants high or low on BPD symptoms on patterns of pain experience and types of child and adult traumas.Methods Adults (N = 181) with chronic pain completed self-reports of pain severity, dimensions of pain experiencing, body coverage of pain, and clinical indicators of central sensitization (i.e., chronic hypersensitivity of the central nervous system), as well as measures of child and adult physical abuse, sexual abuse, trauma, and neglect. Participants also completed the McLean Screening Instrument for BPD.Results Participants with clinically significant BPD symptoms (n = 32) reported more childhood sexual trauma, punishment, and neglect, as well as adult physical/sexual trauma, than those without elevated BPD symptoms. Among participants with clinically significant BPD symptoms, affective pain and central sensitization were elevated, potentially explained by heightened negative affect in BPD.Conclusion BPD symptoms are associated with increased clinical severity among patients with chronic pain as well as a unique manifestation of pain experiencing (i.e., increased affective pain and central sensitization in particular). Childhood trauma of all types is associated with chronic pain and BPD co-occurrence. Researchers and clinicians should assess for BPD in people with chronic pain to enhance conceptual models of the transaction between these disorders and to improve clinical care.
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“However, among patients in treatment for chronic pain, BPD was associated with a history of childhood maltreatment and both acute hypersensitivity to emotionrelated pain and chronic central nervous system hypersensitivity [82], consistent with increased attempts to selfmedicate through the use of analgesic medications…”
Background
- Authors
- Johnson, B. N., Lumley, M. A., Cheavens, J. S., & McKernan, L. C.
- Affiliations
- Pennsylvania State University (US)
- Wayne State University (US)
- The Ohio State University (US)
- Vanderbilt University Medical Center (US)
- Corresponding author
- Johnson, Benjamin N.
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 2020-08
- Volume
- 135
- Pages
- 110164
- ISSN
- 0022-3999 (ISSN-L)
- PMC
- PMC7422088
- OpenAlex
- W3033679445
- Cited by
- 32
- References
- 81
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 6 · 2023: 4 · 2022: 5 · 2021: 5 · 2020: 1
- FWCI
- 1.50
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Advancing Translational Sciences
- Agency for Healthcare Research and Quality
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- borderline personality disorder, chronic pain, childhood trauma, adult trauma, central sensitization, affective pain, pain experience, child sexual abuse, child neglect, physical abuse, comorbidities
- MeSH terms
- Psychological Trauma, Adult, Borderline Personality Disorder, Child, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Self Report, Chronic Pain
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