title: Latent class analysis of personality disorders in adults with posttraumatic stress disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions.
abstract: OBJECTIVE
  To characterize predominant typologies of co-occurring personality disorders among adults with posttraumatic stress disorder (PTSD) and examine their relation to Axis I comorbidities, health-related quality of life, and course and treatment of PTSD.
  
  
  METHODS
  Latent class analysis was conducted on the 10 DSM-IV personality disorders in a nationally representative sample of 2,463 adults with a lifetime diagnosis of PTSD from Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions.
  
  
  RESULTS
  Three latent classes of personality disorders were identified: a borderline-dysregulated class (11.4%), an obsessive-paranoid class (13.1%), and a no/low personality disorders class (75.5%). The borderline-dysregulated and obsessive-paranoid classes were more likely than the no/low personality disorder class to have a broad range of comorbid Axis I diagnoses and to have ever attempted suicide (ORs = 1.50-8.01), and they reported lower mental health-related quality of life. The borderline-dysregulated class was less likely than the no/low personality disorder class to have experienced remission of their most recent episode of PTSD (OR = 0.54; 95% CI, 0.38-0.75) and was more likely to have been prescribed medication for PTSD (OR = 1.65; 95% CI, 1.20-2.28) and to have used alcohol and drugs to mitigate their PTSD symptoms (OR = 2.77; 95% CI, 1.62-4.74). The obsessive-paranoid class was more likely than the no/low personality disorders class to report sexual assault as their worst trauma (OR = 2.22; 95% CI, 1.36-3.61) and had an earlier age at onset of PTSD symptoms compared to the other 2 classes.
  
  
  CONCLUSIONS
  Among US adults with PTSD, the 10 DSM-IV personality disorders can be classified into 3 "person-based" typologies, which are differentially associated with comorbid Axis I disorders, mental health-related quality of life, and clinical and treatment characteristics of this disorder. These results suggest that comprehensive assessment of personality disorders may help inform etiologic models and treatment approaches for PTSD.
authors.affiliation: VA Connecticut Healthcare System, 950 Campbell Ave, 151D, West Haven, CT 06516 Jack.Tsai@yale.edu.
authors.forename: Jack
authors.initials: J
authors.lastname: Tsai
authors.forename: Ilan
authors.initials: I
authors.lastname: Harpaz-Rotem
authors.forename: Corey E
authors.initials: CE
authors.lastname: Pilver
authors.forename: Erika J
authors.initials: EJ
authors.lastname: Wolf
authors.forename: Rani A
authors.initials: RA
authors.lastname: Hoff
authors.forename: Kenneth N
authors.initials: KN
authors.lastname: Levy
authors.forename: Jitender
authors.initials: J
authors.lastname: Sareen
authors.forename: Robert H
authors.initials: RH
authors.lastname: Pietrzak
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology*; D001008:Anxiety Disorders / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology; D010554:Personality Disorders / Q000145:classification* / Q000453:epidemiology*; D011788:Quality of Life; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000209:etiology; D019966:Substance-Related Disorders / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult