Posttraumatic stress disorder, dissociation, and self-destructive behaviorin borderline patients

We studied traumatic childhood experiences, comorbid posttraumatic stress d isorders (PTSD), dissociation and self-destructive behavior in 30 inpatient s with a borderline personality disorder. A standardized interview for the assessment of PTSD, the Dissociative Experience Scale and the Symptom-Check list were administered. Results were compared to a control of inpatients wi th neurotic disorders matched for gender and age. Borderline patients showe d significantly more childhood sexual and physical abuse as well as emotion al neglect than the control patients. Of the borderline patients, 67% met c riteria for PTSD and only 13% of the control group. Dissociative symptoms w ere significantly more frequent in borderline patients and predicted in com bination with PTSD symptoms self-destructive behavior. We discuss our findi ngs with respect to their etiological and clinical significance and propose a model for self-destruction in borderline patients which focusses on diss ociation and trauma.