title: Borderline Personality Disorder and Military Sexual Trauma: Analysis of Previous Traumatization and Current Psychiatric Presentation.
abstract: Military sexual trauma (MST) increases vulnerability for posttraumatic stress disorder (PTSD). Sexual trauma is also associated with increased risk for developing borderline personality disorder (BPD). Research has also documented a significant link between PTSD and BPD; however, there is a paucity of information examining this relationship among veterans with MST-related PTSD. In particular, we sought to examine whether comorbid BPD-PTSD compared with veterans with PTSD and no BPD resulted in increased PTSD and depression symptomatology. We also examined psychiatric, previous sexual trauma, and demographic factors to determine what-if any-factors were associated with comorbid BPD diagnosis. Using data from a recently conducted randomized clinical trial, we examined electronic medical records of the local Veterans Affairs Medical Center. Data from 90 veterans with MST-related PTSD were obtained. More than 22% ( n = 20) of the sample had a historical diagnosis of BPD. Participants were administered measures to assess psychiatric symptomatology (PTSD and depression), trauma-related negative cognitions (NCs), and previous sexual traumatization (e.g., childhood and civilian sexual exposure). An analysis of variance was conducted, which found that veterans with comorbid MST-related PTSD and BPD had significantly greater PTSD criterion B (avoidance) symptoms, depressive symptomatology, and NC scores than participants without comorbid BPD. In addition, a binary stepwise logistic regression found that veterans' BPD was also positively associated with NCs about self and the world; however, self-blame, depression, PTSD, sociodemographic variables (e.g., gender, age), and previous sexual traumatizations were not significant predictors. Implications are discussed with regard to clinical care and future research directions.
authors.affiliation: 1 Veterans Affairs North Texas Health Care System, Dallas, TX, USA.|2 University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Rush
authors.initials: R
authors.lastname: Williams
authors.affiliation: 1 Veterans Affairs North Texas Health Care System, Dallas, TX, USA.|2 University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Holliday
authors.affiliation: 2 University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Clem
authors.affiliation: 2 University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Anderson
authors.affiliation: 1 Veterans Affairs North Texas Health Care System, Dallas, TX, USA.
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Morris
authors.affiliation: 1 Veterans Affairs North Texas Health Care System, Dallas, TX, USA.|2 University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Alina
authors.initials: A
authors.lastname: Surís
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology; D001883:Borderline Personality Disorder / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D003469:Culture; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D010043:Outcome and Process Assessment, Health Care; D012307:Risk Factors; D012742:Sex Offenses / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D014728:Veterans / Q000523:psychology*
keywords: borderline personality disorder; depression; military sexual trauma; negative cognitions; posttraumatic stress disorder