Treatment Preference among Suicidal and Self-Injuring Women with Borderline Personality Disorder and PTSD

• Published in: Journal of clinical psychology 2013-07, Vol.69 (7), p.749-761
• Main Authors: Harned, Melanie S., Tkachuck, Mathew A., Youngberg, Kelly A.
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Anxiety disorders. Neuroses; Behavior Therapy - methods; Behavior therapy. Cognitive therapy; Biological and medical sciences; borderline personality disorder; Borderline Personality Disorder - epidemiology; Borderline Personality Disorder - therapy; Comorbidity; dialectical behavior therapy; Female; Humans; Implosive Therapy; Logistic Models; Medical sciences; Mental health care; Middle Aged; Patient Preference; Personality disorders; Post traumatic stress disorder; Preferences; prolonged exposure; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotherapy; PTSD; Self-Injurious Behavior - epidemiology; Self-Injurious Behavior - therapy; Stress Disorders, Post-Traumatic - epidemiology; Stress Disorders, Post-Traumatic - therapy; suicidal behavior; Suicide; Suicide Prevention; Suicides & suicide attempts; treatment preference; Treatments; United States; Women
• ISSN: 0021-9762; 1097-4679
• DOI: 10.1002/jclp.21943

Objectives This study examined treatment preferences among suicidal and self‐injuring women with borderline personality disorder (BPD) and PTSD. Method Women (N = 42, Mage = 34) with BPD, PTSD and recent intentional self‐injury were evaluated upon entry into a psychotherapy outcome study. Results The majority preferred a combined dialectical behavior therapy (DBT) and prolonged exposure (PE) treatment (73.8%), followed by DBT alone (26.2%), and PE alone (0%). Women who preferred the combined treatment were more likely to report a desire to obtain relief from PTSD and to receive specific DBT and PE treatment components as reasons underlying this preference. Few women (21.4%) reported concerns about PE, but those who did were more likely to prefer DBT alone. More severe PTSD re‐experiencing symptoms, a childhood index trauma, and less reduction in positive affect after a trauma interview predicted a preference for the combined treatment. Conclusions These results may help to inform treatment for these complex patients.