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

Authors


  • This work was supported by Grant No. R34MH082143 from the National Institute of Mental Health to the first author. Portions of these data were presented at the 2011 convention of the Association of Behavioral and Cognitive Therapies, Toronto, CA.

  • We would like to thank the patients, therapists, assessors, and staff at the Behavioral Research and Therapy Clinics for their contributions to this research.

  • Dr. Harned is a trainer and consultant for Behavioral Tech, LLC.

  • Behavioral Research and Therapy Clinics, 3935 University Way NE, Box 355915, University of Washington, Seattle, WA, 98195-5915.

Please address correspondence to: Melanie S. Harned at the Behavioral Research and Therapy Clinics, 3935 University Way NE, Box 355915, University of Washington, Seattle, WA, 98195-5915. E-mail: mharned@u.washington.edu

Abstract

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.

Ancillary