Associations between pain conditions and borderline personality disorder symptoms: findings from the National Comorbidity Survey Replication.

OBJECTIVES

Associations between 4 forms of pain (ie, arthritis, severe/frequent headaches, chronic spinal pain, and other chronic pain) and borderline personality disorder (BPD) symptoms were investigated in the general population.

METHODS

Data from part II of the National Comorbidity Survey Replication (N=5692) were used. Pain conditions were assessed with self-reports. Arthritis was assessed on a lifetime basis. For the other pain conditions, variables were created to identify those with a remitted condition and those experiencing the condition in the past year. BPD symptoms were assessed with items from the International Personality Disorder Examination Screening Questionnaire. Axis I disorders were assessed with the Composite International Diagnostic Interview.

RESULTS

Multiple regression analyses adjusting for sociodemographic variables and past-year psychiatric disorders indicated that those with a history of each pain condition (either remitted or past-year) had higher levels of BPD symptoms relative to those with a lifetime absence of the condition. For each condition, follow-up analyses indicated that those experiencing the condition in the past year had higher levels of BPD symptoms than those reporting a remitted condition. After adjusting for axis I psychiatric disorders, only the difference between the remitted and past-year severe/frequent headache groups remained significant.

DISCUSSION

This is the first study to demonstrate that BPD symptoms are positively associated with chronic spinal pain, severe/frequent headaches, and other chronic pain conditions in a sample representative of the general population. The findings also suggest that relationships between remitted pain conditions and BPD symptoms warrant additional study.