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Cited by 15Personality Disorders and PsychopathologyPersonality Traits and PsychologyPosttraumatic Stress Disorder Research

Lasting personality pathology following exposure to severe trauma in adulthood: retrospective cohort study

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Munjiza, Jasna, Britvic, Dolores, Crawford, Mike J.·2019·BMC Psychiatry
DOI 10.1186/s12888-018-1975-5PMC PMC6318845
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Abstract

BACKGROUND: Early exposure to trauma is a known risk factor for personality disorder (PD), but evidence for late-onset personality pathology following trauma in adults is much less clear. We set out to investigate whether exposure to war trauma can lead to lasting personality pathology in adults and to compare the mental health and social functioning of people with late-onset personality problems with those with PD. METHODS: We recruited patients who scored positively on the International Personality Disorder Examination (IPDE) in southern Croatia 15 years after the Croatian war of independence and used a semi-structured interview to establish when the person's personality-related problems arose. All participants also completed Harvard Trauma Questionnaire, and measures of mental health and social functioning. RESULTS: Among 182 participants with probable personality disorder, 65 (35.7%) reported that these problems started after exposure to war-trauma as adults. The most prevalent personality problems among those with late-onset pathology were borderline, avoidant, schizotypal, schizoid and paranoid. Participants with late-onset personality pathology were more likely to have schizotypal (75.4% vs. 47.3%) and schizoid traits (73.8% vs. 41.1%) compared to those with PD. Participants with late-onset personality pathology were three times more likely to have complex personality pathology across all three DSM-IV clusters compared to those with PD (OR = 2.96, 95% CI 1.54 to 5.67) after adjusted for gender and marital status. The prevalence of depression and social dysfunction were as high among those with late-onset personality pathology as among those with personality disorder. CONCLUSION: Retrospective accounts of people with significant personality pathology indicate that some develop these problems following exposure to severe trauma in adulthood. Personality-related problems which start in adulthood may be as severe as those that have an earlier onset. These findings highlight the long term impact of war trauma on the mental health and have implications for the way that personality pathology is classified and treated.

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  • Extreme interpersonal trauma in adulthood also has been shown to be associated with severe personality disorders including BPD.

    “Extreme interpersonal trauma in adulthood (e.g., civilian exposure to war trauma, torture, sex trafficking, or genocide) also has been shown to be associated with severe personality disorders including BPD [120].”

    From Complex PTSD and borderline personality disorder (2021) · cites this paper as [120]

    The Discussion reports that personality problems followed severe war trauma in adulthood and that 86.2% of the late-onset group met the screening threshold for borderline traits. The study assessed personality pathology and traits, not confirmed BPD diagnoses; it also does not establish the association for torture, sex trafficking, or genocide specifically. (LLM, conf=0.87)

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Authors
Munjiza, J., Britvic, D., & Crawford, M. J.
Affiliations
Central and North West London NHS Foundation Trust (GB)
Corresponding author
Munjiza, Jasna
ORCID
Venue
BMC Psychiatry
Publisher
Springer Science and Business Media LLC
Published
2019-01-03
Volume
19
Issue
1
Pages
3-3
ISSN
1471-244X (ISSN-L)
DOI
10.1186/s12888-018-1975-5
PMC
PMC6318845
OpenAlex
W2927095280
Cited by
15
References
36
Citations by year
2026: 3 · 2025: 2 · 2024: 3 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 2
FWCI
1.46
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Psychiatry (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Spiral (Imperial College London) (submittedVersion, other-oa)
Funders
  • NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust/Institute of Cancer Research
  • National Institute for Health and Care Research
Topics
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Keywords
war trauma, Croatian War of Independence, personality disorders, schizotypal personality, schizoid personality disorder, borderline personality, avoidant personality, paranoid personality, depression, social dysfunction
MeSH terms
Late Onset Disorders, Armed Conflicts, Adult, Depression, Female, Humans, Male, Middle Aged, Personality Disorders, Surveys and Questionnaires, Retrospective Studies, Risk Factors, Wounds and Injuries, Prevalence, Croatia, Diagnostic and Statistical Manual of Mental Disorders, Young Adult

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