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Pain and Pain Catastrophizing Among Internal Medicine Outpatients With Borderline Personality Symptomatology: A Cross-Sectional Self-Report Survey

Randy A. Sansone, MD; Daron A. Watts, MD; and Michael W. Wiederman, PhD

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ABSTRACT

Objective: The extant literature indicates that individuals with borderline personality disorder generally report higher levels of pain than individuals without this disorder. This study examined relationships between borderline personality symptomatology, pain, and pain catastrophizing (a related aspect of the pain experience).

Method: Using a cross-sectional consecutive sample of internal medicine outpatients (N = 238) and a self-report survey methodology, we examined relationships between borderline personality symptomatology as measured by the Personality Diagnostic Questionnaire–4 and the Self-Harm Inventory; pain levels “now,” “over the past week,” and “over the past year”; and scores on the Pain Catastrophizing Scale (PCS) and its subscales (rumination, magnification, helplessness). Data were collected during November 2012.

Results: Scores on both measures of borderline personality disorder individually exhibited statistically significant correlations with self-reported pain levels at the time of the survey, during the past week, and over the past year (P < .001), as well as with total scores on the PCS and each of its subscales (P < .001). Participants who were positive on both measures of borderline personality disorder (a conservative indicator of borderline personality disorder) also demonstrated statistically significantly higher pain ratings now, over the past week, and over the past year, as well as higher scores on the total PCS (P < .001) compared with those who were negative on both measures or scored positively on only 1 measure.

Conclusions: Regardless of the measure used, individuals with borderline personality disorder symptomatology consistently demonstrated higher pain scores at all time points, as well as higher levels of pain catastrophizing.

Prim Care Companion CNS Disord 2013;15(5):doi:10.4088/PCC.13m01536

Submitted: June 3, 2013; accepted June 28, 2013.

Published online: September 19, 2013.

Corresponding author: Randy A. Sansone, MD, Sycamore Primary Care Center, 2115 Leiter Rd, Miamisburg, OH 45342 (Randy.Sansone@khnetwork.org.).