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.