Personality disorders associated with full and partial posttraumatic stress disorder in the U.S. population: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions

Abstract

Background While it is well known that personality disorders are associated with trauma exposure and PTSD, limited nationally representative data are available on DSM-IV personality disorders that co-occur with posttraumatic stress disorder (PTSD) and partial PTSD. Methods Face-to-face interviews were conducted with 34,653 adults participating in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression analyses controlling for sociodemographics and additional psychiatric comorbidity evaluated associations of PTSD and partial PTSD with personality disorders. Results Prevalence rates of lifetime PTSD and partial PTSD were 6.4% and 6.6%, respectively. After adjustment for sociodemographic characteristics and additional psychiatric comorbidity, respondents with full PTSD were more likely than trauma controls to meet criteria for schizotypal, narcissistic, and borderline personality disorders (ORs=2.1–2.5); and respondents with partial PTSD were more likely than trauma controls to meet diagnostic criteria for borderline (OR=2.0), schizotypal (OR=1.8), and narcissistic (OR=1.6) PDs. Women with PTSD were more likely than controls to have obsessive-compulsive PD. Women with partial PTSD were more likely than controls to have antisocial PD; and men with partial PTSD were less likely than women with partial PTSD to have avoidant PD. Conclusions PTSD and partial PTSD are associated with borderline, schizotypal, and narcissistic personality disorders. Modestly higher rates of obsessive-compulsive PD were observed among women with full PTSD, and of antisocial PD among women with partial PTSD.

Comorbidity of personality disorders in anxiety disorders: A meta-analysis of 30 years of research

“…A connection between PTSD and the axis II disorders avoidant (Ansell et al, 2011), obsessive-compulsive (Pietrzak et al, 2011) and borderline PDs have been established (Bienvenu and Stein, 2003b;Pagura et al, 2010;Shea et al, 1999), but also with paranoid and schizotypal PDs (Crepulja and Franciskovic, 2010;Pietrzak et al, 2011). Paranoid traits are understandable as PTSD patients often feel a constant need to be vigilant and on guard.…”

Comorbidity between Post-Traumatic Stress Disorder and Borderline Personality Disorder: A Review

“…With regard to studies in community samples, some of the main research in the general adult population showed that the prevalence of PTSD ranges from 3 to 6% [4,5,6]. Specifically, when data are from subjects diagnosed with BPD, the range of people with PTSD increases to 30-70% [7,8,9].…”

“…Specifically, when data are from subjects diagnosed with BPD, the range of people with PTSD increases to 30-70% [7,8,9]. Likewise, results from subjects with a primary diagnosis of PTSD also point out that BPD comorbidity is estimated to occur in 22-24% [6,7]. Despite this high comorbidity, different comparative studies have found no conclusive evidence about a higher relative prevalence of PTSD in subjects diagnosed with BPD than in people with other personality disorders [6,10]…”

Posttraumatic Stress Disorder

“…For example, in the NCS, Kessler, Sonnega, et al (1995) found that PTSD was associated with an increased odds of being diagnosed with a mood disorder, an anxiety disorder, alcohol/drug abuse or dependence, and conduct disorders. The mood disorder most commonly comorbid with PTSD is consistently found to be major depressive disorder (MDD; Brown et al, 2001;Pietrzak, Goldstein, Southwick, & Grant, 2011). The most common comorbid anxiety disorder tends to vary by sample, ranging from generalized anxiety disorder (e.g., Brown et al, 2001) to specific phobia (e.g., Pietrzak et al, 2011).…”

“…The mood disorder most commonly comorbid with PTSD is consistently found to be major depressive disorder (MDD; Brown et al, 2001;Pietrzak, Goldstein, Southwick, & Grant, 2011). The most common comorbid anxiety disorder tends to vary by sample, ranging from generalized anxiety disorder (e.g., Brown et al, 2001) to specific phobia (e.g., Pietrzak et al, 2011). Alcohol and drug abuse and dependence are consistently found to be highly comorbid with PTSD as well (Brown et al, 2001;Pietrzak et al, 2011).…”