Exploring the links among borderline personality disorder symptoms, trauma, and pain in patients with chronic pain disorders
Chronic pain and borderline personality disorder (BPD) are commonly comorbid and jointly associated with increased symptoms of both disorders and clinical and functional impairment. Little is known, however, about specific links between these disorders. In a cross-sectional study of patients with ch...
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| Veröffentlicht in: | Journal of psychosomatic research 2020-08, Vol.135, p.110164-110164, Article 110164 |
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| creator | Johnson, Benjamin N. Lumley, Mark A. Cheavens, Jennifer S. McKernan, Lindsey C. |
| description | Chronic pain and borderline personality disorder (BPD) are commonly comorbid and jointly associated with increased symptoms of both disorders and clinical and functional impairment. Little is known, however, about specific links between these disorders. In a cross-sectional study of patients with chronic pain, we compared participants high or low on BPD symptoms on patterns of pain experience and types of child and adult traumas.
Adults (N = 181) with chronic pain completed self-reports of pain severity, dimensions of pain experiencing, body coverage of pain, and clinical indicators of central sensitization (i.e., chronic hypersensitivity of the central nervous system), as well as measures of child and adult physical abuse, sexual abuse, trauma, and neglect. Participants also completed the McLean Screening Instrument for BPD.
Participants with clinically significant BPD symptoms (n = 32) reported more childhood sexual trauma, punishment, and neglect, as well as adult physical/sexual trauma, than those without elevated BPD symptoms. Among participants with clinically significant BPD symptoms, affective pain and central sensitization were elevated, potentially explained by heightened negative affect in BPD.
BPD symptoms are associated with increased clinical severity among patients with chronic pain as well as a unique manifestation of pain experiencing (i.e., increased affective pain and central sensitization in particular). Childhood trauma of all types is associated with chronic pain and BPD co-occurrence. Researchers and clinicians should assess for BPD in people with chronic pain to enhance conceptual models of the transaction between these disorders and to improve clinical care.
•BPD symptoms are linked with affective pain in patients with chronic pain.•BPD symptoms are linked to central sensitization and fibromyalgia in chronic pain.•Negative affect mediates the link between BPD symptoms and pain experiencing.•Childhood trauma is associated with risk for BPD/chronic pain co-occurrence.•Assessing for BPD among patients with chronic pain is clinically recommended. |
| doi_str_mv | 10.1016/j.jpsychores.2020.110164 |
| format | Article |
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Adults (N = 181) with chronic pain completed self-reports of pain severity, dimensions of pain experiencing, body coverage of pain, and clinical indicators of central sensitization (i.e., chronic hypersensitivity of the central nervous system), as well as measures of child and adult physical abuse, sexual abuse, trauma, and neglect. Participants also completed the McLean Screening Instrument for BPD.
Participants with clinically significant BPD symptoms (n = 32) reported more childhood sexual trauma, punishment, and neglect, as well as adult physical/sexual trauma, than those without elevated BPD symptoms. Among participants with clinically significant BPD symptoms, affective pain and central sensitization were elevated, potentially explained by heightened negative affect in BPD.
BPD symptoms are associated with increased clinical severity among patients with chronic pain as well as a unique manifestation of pain experiencing (i.e., increased affective pain and central sensitization in particular). Childhood trauma of all types is associated with chronic pain and BPD co-occurrence. Researchers and clinicians should assess for BPD in people with chronic pain to enhance conceptual models of the transaction between these disorders and to improve clinical care.
•BPD symptoms are linked with affective pain in patients with chronic pain.•BPD symptoms are linked to central sensitization and fibromyalgia in chronic pain.•Negative affect mediates the link between BPD symptoms and pain experiencing.•Childhood trauma is associated with risk for BPD/chronic pain co-occurrence.•Assessing for BPD among patients with chronic pain is clinically recommended.</description><identifier>ISSN: 0022-3999</identifier><identifier>EISSN: 1879-1360</identifier><identifier>DOI: 10.1016/j.jpsychores.2020.110164</identifier><identifier>PMID: 32569851</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject>Abused children ; Adult ; Adults ; Borderline personality disorder ; Borderline Personality Disorder - complications ; BPD ; Central nervous system ; Central sensitization ; Child ; Child abuse & neglect ; Childhood ; Children ; Chronic pain ; Chronic Pain - complications ; Chronic Pain - psychology ; Clinical indicators ; Clinical significance ; Comorbidity ; Conceptual models ; Cross-Sectional Studies ; Emotions ; Female ; Fibromyalgia ; Functional impairment ; Humans ; Hypersensitivity ; Male ; Medical screening ; Middle Aged ; Negative emotions ; Nervous system ; Pain ; Patients ; Personality ; Personality disorders ; Psychological trauma ; Psychological Trauma - complications ; Punishment ; Self Report ; Sensitization ; Sexual abuse ; Symptoms ; Tests ; Trauma</subject><ispartof>Journal of psychosomatic research, 2020-08, Vol.135, p.110164-110164, Article 110164</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Science Ltd. Aug 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c507t-fc3e169b65f0a255332f3014dcc52da1a7f56eeef308c9773ff9066ba8a2efab3</citedby><cites>FETCH-LOGICAL-c507t-fc3e169b65f0a255332f3014dcc52da1a7f56eeef308c9773ff9066ba8a2efab3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jpsychores.2020.110164$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3548,27922,27923,30997,33772,45993</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32569851$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Johnson, Benjamin N.</creatorcontrib><creatorcontrib>Lumley, Mark A.</creatorcontrib><creatorcontrib>Cheavens, Jennifer S.</creatorcontrib><creatorcontrib>McKernan, Lindsey C.</creatorcontrib><title>Exploring the links among borderline personality disorder symptoms, trauma, and pain in patients with chronic pain disorders</title><title>Journal of psychosomatic research</title><addtitle>J Psychosom Res</addtitle><description>Chronic pain and borderline personality disorder (BPD) are commonly comorbid and jointly associated with increased symptoms of both disorders and clinical and functional impairment. Little is known, however, about specific links between these disorders. In a cross-sectional study of patients with chronic pain, we compared participants high or low on BPD symptoms on patterns of pain experience and types of child and adult traumas.
Adults (N = 181) with chronic pain completed self-reports of pain severity, dimensions of pain experiencing, body coverage of pain, and clinical indicators of central sensitization (i.e., chronic hypersensitivity of the central nervous system), as well as measures of child and adult physical abuse, sexual abuse, trauma, and neglect. Participants also completed the McLean Screening Instrument for BPD.
Participants with clinically significant BPD symptoms (n = 32) reported more childhood sexual trauma, punishment, and neglect, as well as adult physical/sexual trauma, than those without elevated BPD symptoms. Among participants with clinically significant BPD symptoms, affective pain and central sensitization were elevated, potentially explained by heightened negative affect in BPD.
BPD symptoms are associated with increased clinical severity among patients with chronic pain as well as a unique manifestation of pain experiencing (i.e., increased affective pain and central sensitization in particular). Childhood trauma of all types is associated with chronic pain and BPD co-occurrence. Researchers and clinicians should assess for BPD in people with chronic pain to enhance conceptual models of the transaction between these disorders and to improve clinical care.
•BPD symptoms are linked with affective pain in patients with chronic pain.•BPD symptoms are linked to central sensitization and fibromyalgia in chronic pain.•Negative affect mediates the link between BPD symptoms and pain experiencing.•Childhood trauma is associated with risk for BPD/chronic pain co-occurrence.•Assessing for BPD among patients with chronic pain is clinically recommended.</description><subject>Abused children</subject><subject>Adult</subject><subject>Adults</subject><subject>Borderline personality disorder</subject><subject>Borderline Personality Disorder - complications</subject><subject>BPD</subject><subject>Central nervous system</subject><subject>Central sensitization</subject><subject>Child</subject><subject>Child abuse & neglect</subject><subject>Childhood</subject><subject>Children</subject><subject>Chronic pain</subject><subject>Chronic Pain - complications</subject><subject>Chronic Pain - psychology</subject><subject>Clinical indicators</subject><subject>Clinical significance</subject><subject>Comorbidity</subject><subject>Conceptual models</subject><subject>Cross-Sectional Studies</subject><subject>Emotions</subject><subject>Female</subject><subject>Fibromyalgia</subject><subject>Functional impairment</subject><subject>Humans</subject><subject>Hypersensitivity</subject><subject>Male</subject><subject>Medical screening</subject><subject>Middle Aged</subject><subject>Negative emotions</subject><subject>Nervous system</subject><subject>Pain</subject><subject>Patients</subject><subject>Personality</subject><subject>Personality disorders</subject><subject>Psychological trauma</subject><subject>Psychological Trauma - complications</subject><subject>Punishment</subject><subject>Self Report</subject><subject>Sensitization</subject><subject>Sexual abuse</subject><subject>Symptoms</subject><subject>Tests</subject><subject>Trauma</subject><issn>0022-3999</issn><issn>1879-1360</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>BHHNA</sourceid><recordid>eNqFkUtv1TAQhS0EopfCX0CW2LBoLn7ETrxBolV5SJXYwNpynEnjkMTBdgpX4sfjS9ry2CBZsnzm8_F4DkKYkj0lVL4a9sMSD7b3AeKeEZblo14-QDtaV6qgXJKHaEcIYwVXSp2gJzEOhBCpmHiMTjgTUtWC7tCPy-_L6IObr3HqAY9u_hKxmXw-Nz60ELICeIEQ_WxGlw64dfFXAcfDtCQ_xTOcglknc4bN3OLFuBnntZjkYE4Rf3Opx7YPfnZ2q945xKfoUWfGCM9u91P0-e3lp4v3xdXHdx8u3lwVVpAqFZ3lQKVqpOiIYUJwzjpOaNlaK1hrqKk6IQEgi7VVVcW7ThEpG1MbBp1p-Cl6vfkuazNBa3NfwYx6CW4y4aC9cfrvyux6fe1vdFUyRuo6G7y8NQj-6wox6clFC-NoZvBr1KykklWCE5nRF_-gg19Dnt2RKkuluJIqU_VG2eBjDNDdN0OJPkapB_07Yn2MWG8R56vP__zM_cW7TDNwvgGQR3rjIOhocxQWWhfAJt169_9XfgIaf8FS</recordid><startdate>20200801</startdate><enddate>20200801</enddate><creator>Johnson, Benjamin N.</creator><creator>Lumley, Mark A.</creator><creator>Cheavens, Jennifer S.</creator><creator>McKernan, Lindsey C.</creator><general>Elsevier Inc</general><general>Elsevier Science Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7TK</scope><scope>7U3</scope><scope>BHHNA</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200801</creationdate><title>Exploring the links among borderline personality disorder symptoms, trauma, and pain in patients with chronic pain disorders</title><author>Johnson, Benjamin N. ; Lumley, Mark A. ; Cheavens, Jennifer S. ; McKernan, Lindsey C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c507t-fc3e169b65f0a255332f3014dcc52da1a7f56eeef308c9773ff9066ba8a2efab3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abused children</topic><topic>Adult</topic><topic>Adults</topic><topic>Borderline personality disorder</topic><topic>Borderline Personality Disorder - complications</topic><topic>BPD</topic><topic>Central nervous system</topic><topic>Central sensitization</topic><topic>Child</topic><topic>Child abuse & neglect</topic><topic>Childhood</topic><topic>Children</topic><topic>Chronic pain</topic><topic>Chronic Pain - complications</topic><topic>Chronic Pain - psychology</topic><topic>Clinical indicators</topic><topic>Clinical significance</topic><topic>Comorbidity</topic><topic>Conceptual models</topic><topic>Cross-Sectional Studies</topic><topic>Emotions</topic><topic>Female</topic><topic>Fibromyalgia</topic><topic>Functional impairment</topic><topic>Humans</topic><topic>Hypersensitivity</topic><topic>Male</topic><topic>Medical screening</topic><topic>Middle Aged</topic><topic>Negative emotions</topic><topic>Nervous system</topic><topic>Pain</topic><topic>Patients</topic><topic>Personality</topic><topic>Personality disorders</topic><topic>Psychological trauma</topic><topic>Psychological Trauma - complications</topic><topic>Punishment</topic><topic>Self Report</topic><topic>Sensitization</topic><topic>Sexual abuse</topic><topic>Symptoms</topic><topic>Tests</topic><topic>Trauma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Johnson, Benjamin N.</creatorcontrib><creatorcontrib>Lumley, Mark A.</creatorcontrib><creatorcontrib>Cheavens, Jennifer S.</creatorcontrib><creatorcontrib>McKernan, Lindsey C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Neurosciences Abstracts</collection><collection>Social Services Abstracts</collection><collection>Sociological Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of psychosomatic research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Johnson, Benjamin N.</au><au>Lumley, Mark A.</au><au>Cheavens, Jennifer S.</au><au>McKernan, Lindsey C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Exploring the links among borderline personality disorder symptoms, trauma, and pain in patients with chronic pain disorders</atitle><jtitle>Journal of psychosomatic research</jtitle><addtitle>J Psychosom Res</addtitle><date>2020-08-01</date><risdate>2020</risdate><volume>135</volume><spage>110164</spage><epage>110164</epage><pages>110164-110164</pages><artnum>110164</artnum><issn>0022-3999</issn><eissn>1879-1360</eissn><abstract>Chronic pain and borderline personality disorder (BPD) are commonly comorbid and jointly associated with increased symptoms of both disorders and clinical and functional impairment. Little is known, however, about specific links between these disorders. In a cross-sectional study of patients with chronic pain, we compared participants high or low on BPD symptoms on patterns of pain experience and types of child and adult traumas.
Adults (N = 181) with chronic pain completed self-reports of pain severity, dimensions of pain experiencing, body coverage of pain, and clinical indicators of central sensitization (i.e., chronic hypersensitivity of the central nervous system), as well as measures of child and adult physical abuse, sexual abuse, trauma, and neglect. Participants also completed the McLean Screening Instrument for BPD.
Participants with clinically significant BPD symptoms (n = 32) reported more childhood sexual trauma, punishment, and neglect, as well as adult physical/sexual trauma, than those without elevated BPD symptoms. Among participants with clinically significant BPD symptoms, affective pain and central sensitization were elevated, potentially explained by heightened negative affect in BPD.
BPD symptoms are associated with increased clinical severity among patients with chronic pain as well as a unique manifestation of pain experiencing (i.e., increased affective pain and central sensitization in particular). Childhood trauma of all types is associated with chronic pain and BPD co-occurrence. Researchers and clinicians should assess for BPD in people with chronic pain to enhance conceptual models of the transaction between these disorders and to improve clinical care.
•BPD symptoms are linked with affective pain in patients with chronic pain.•BPD symptoms are linked to central sensitization and fibromyalgia in chronic pain.•Negative affect mediates the link between BPD symptoms and pain experiencing.•Childhood trauma is associated with risk for BPD/chronic pain co-occurrence.•Assessing for BPD among patients with chronic pain is clinically recommended.</abstract><cop>England</cop><pub>Elsevier Inc</pub><pmid>32569851</pmid><doi>10.1016/j.jpsychores.2020.110164</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Sociological Abstracts; Applied Social Sciences Index & Abstracts (ASSIA); ScienceDirect Journals (5 years ago - present) |
| subjects | Abused children Adult Adults Borderline personality disorder Borderline Personality Disorder - complications BPD Central nervous system Central sensitization Child Child abuse & neglect Childhood Children Chronic pain Chronic Pain - complications Chronic Pain - psychology Clinical indicators Clinical significance Comorbidity Conceptual models Cross-Sectional Studies Emotions Female Fibromyalgia Functional impairment Humans Hypersensitivity Male Medical screening Middle Aged Negative emotions Nervous system Pain Patients Personality Personality disorders Psychological trauma Psychological Trauma - complications Punishment Self Report Sensitization Sexual abuse Symptoms Tests Trauma |
| title | Exploring the links among borderline personality disorder symptoms, trauma, and pain in patients with chronic pain disorders |
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