title: Borderline personality disorder, exposure to interpersonal trauma, and psychiatric comorbidity in urban primary care patients.
abstract: OBJECTIVE
  Few data are available on interpersonal trauma as a risk factor for borderline personality disorder (BPD) and its psychiatric comorbidity in ethnic minority primary care populations. This study aimed to examine the relation between trauma exposure and BPD in low-income, predominantly Hispanic primary care patients.
  
  
  METHODS
  Logistic regression was used to analyze data from structured clinical interviews and self-report measures (n = 474). BPD was assessed with the McLean screening scale. Trauma exposure was assessed with the Life Events Checklist (LEC); posttraumatic stress disorder (PTSD) was assessed with the Lifetime Composite International Diagnostic Interview, other psychiatric disorders with the SCID-I, and functional impairment with items from the Sheehan Disability Scale and Social Adjustment Scale Self-Report (SAS-SR).
  
  
  RESULTS
  Of the 57 (14%) patients screening positive for BPD, 83% reported a history of interpersonally traumatic events such as sexual and physical assault or abuse. While interpersonal trauma experienced during adulthood was as strongly associated with BPD as interpersonal trauma experienced during childhood, noninterpersonal trauma was associated with BPD only if it had occurred during childhood. The majority (91%) of patients screening positive for BPD met criteria for at least one current DSM-IV Axis I diagnosis and exhibited significant levels of functional impairment.
  
  
  CONCLUSIONS
  Increased awareness of BPD in minority patients attending primary care clinics, high rates of exposure to interpersonal trauma, and elevated risk for psychiatric comorbidity in this population may enhance physicians' understanding, treatment, and referral of BPD patients.
authors.forename: Maren
authors.initials: M
authors.lastname: Westphal
authors.forename: Mark
authors.initials: M
authors.lastname: Olfson
authors.forename: Margarita
authors.initials: M
authors.lastname: Bravova
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Gameroff
authors.forename: Raz
authors.initials: R
authors.lastname: Gross
authors.forename: Priya
authors.initials: P
authors.lastname: Wickramaratne
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Pilowsky
authors.forename: Richard
authors.initials: R
authors.lastname: Neugebauer
authors.forename: Steven
authors.initials: S
authors.lastname: Shea
authors.forename: Rafael
authors.initials: R
authors.lastname: Lantigua
authors.forename: Myrna
authors.initials: M
authors.lastname: Weissman
authors.forename: Yuval
authors.initials: Y
authors.lastname: Neria
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001883:Borderline Personality Disorder / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004812:Epidemiologic Methods; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D007398:Interpersonal Relations; D007406:Interview, Psychological; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales; D012917:Social Adjustment; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data; D014754:Violence / Q000208:ethnology / Q000706:statistics & numerical data*; D055815:Young Adult