OBJECTIVE: Many patients with posttraumatic stress disorder (PTSD)
appear to have co-occurring symptoms of character pathology; however, to
date there have been no empirical studies of comorbid clinician- rated axis
II personality disorders in war veterans with chronic PTSD. The authors'
objective was to assess DSM-III-R personality disorders in
treatment-seeking combat veterans with PTSD. METHOD: They used the
Personality Disorder Examination, a standardized diagnostic interview for
DSM-III-R axis II disorders, to assess DSM-III-R personality disorders in
34 patients with PTSD; 18 of the subjects were inpatients and 16 were
outpatients. RESULTS: A high rate of character pathology was observed in
both inpatient and outpatient groups. The most frequent disorders for which
criteria were met were borderline, obsessive- compulsive, avoidant, and
paranoid personality disorders. Inpatients had a higher rate of nearly
every personality disorder than did outpatients. Inpatients were
significantly more likely to meet diagnostic criteria for paranoid,
schizotypal, avoidant, and self- defeating personality disorders.
CONCLUSIONS: War-related PTSD in treatment-seeking Vietnam veterans is
often accompanied by diffuse, debilitating, and enduring impairments in
character. Subtyping patients with PTSD on the basis of specific axis II
profiles may aid in the selection of more specific and effective
treatments.
Abstract Teaser