Co-morbidity of personality disorder, Axis I and trauma symptomatology
This study was designed to identify the nature and prevalence of personality disorder within a secondary care day service and, in addition, to investigate the extent to which personality disorder was co-morbid with both Axis I and trauma symptomatology. A cross sectional survey design was used, and a total of 51 participants completed the Millon Clinical Multiaxial Inventory III, the Trauma Symptom Inventory and the SCL-90-R. The results revealed that 55 per cent of the clinical population met the study's criteria for a personality disorder, a finding that is broadly line with previous research. When these data were collapsed into the three DSM IV personality clusters, 47 per cent met criteria for the Anxious-Fearful cluster, 22 per cent for the Dramatic-Erratic cluster and eight per cent for the Odd-Eccentric cluster. The results disconfirmed the study's first hypothesis which predicted that participants meeting personality disorder criteria would have a greater level of Axis I symptomatology than other participants. This finding indicates that the two diagnostic Axes may be independent, suggesting that personality disordered individuals have an additional set of distinct needs which may not be addressed adequately by a symptomfocused approach. The results supported the second hypothesis, demonstrating that participants with a personality disorder were significantly more likely to achieve caseness on the PTSD and Self-dysfunction TSI trauma scales. Of the three personality disorder clusters, only those in the Dramatic-Erratic group were found to be significantly more likely to achieve trauma caseness. These findings lend qualified support to previous research indicating that Borderline patients have particularly high levels of trauma history. The methodological limitations are discussed, as are the implications for future research and clinical practice.