Elsevier

Behavior Therapy

Volume 39, Issue 1, March 2008, Pages 72-78
Behavior Therapy

Borderline Personality Characteristics and Treatment Outcome in Cognitive-Behavioral Treatments for PTSD in Female Rape Victims

https://doi.org/10.1016/j.beth.2007.05.002Get rights and content

Abstract

Many studies report that comorbid borderline personality pathology is associated with poorer outcomes in the treatment of Axis I disorders. Given the high rates of comorbidity between borderline personality pathology and posttraumatic stress disorder (PTSD), it is essential to determine whether borderline symptomatology affects PTSD treatment outcome. This study examined the effects of borderline personality characteristics (BPC) on 131 female rape victims receiving cognitive-behavioral treatment for PTSD. Higher BPC scores were associated with greater pretreatment PTSD severity; however, individuals with higher levels of BPC were just as likely to complete treatment and also as likely to show significant treatment response on several outcome measures. There were no significant interactions between type of treatment and BPC on the outcome variables. Findings suggest that women with borderline pathology may be able to benefit significantly from cognitive-behavioral treatment for PTSD.

Section snippets

Participants

Participants were part of a larger study designed to compare the efficacy of cognitive processing therapy (CPT), prolonged exposure (PE), and a waitlist control for the treatment of PTSD in female rape survivors (Resick et al., 2002). All participants included in this larger study experienced at least one completed rape 3 or more months prior to study participation and met full diagnostic criteria for PTSD according to the DSM-IV (American Psychiatric Association, 1994). Exclusion criteria

Results

On the borderline personality dimensional scale of the SNAP, the participants had a mean BPC score of 11.83 (SD = 4.98), with scores ranging from 1 to 23. Thirty-nine women (25.2%) had scores of 15 or greater, indicative of a clinical level of psychopathology according to the SNAP manual (Clark, 1996). The BPC score was significantly correlated with pretreatment scores on the CAPS (r = .29, p = .001) and BDI (r = .33, p < .001), indicating that higher BPC scores were associated with higher levels of PTSD

Discussion

This study adds to the growing body of literature on borderline personality characteristics and PTSD. By utilizing a larger sample of women with PTSD as well as more comprehensive analytic techniques, this study improves upon previous research in this area and suggests that women with borderline personality characteristics can benefit from CBT treatment for PTSD. Specifically, although women with higher BPC scores were likely to begin treatment with more severe scores on a number of variables,

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    1

    Shireen L. Rizvi is now at the New School for Social Research.

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