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<p class="ltrs-br-ltr-br-title"><span class="bold">Driving Recklessly: Relationships With Borderline Personality Symptomatology</span></p>
<p class="ltrs-br-ltr-br-body-text"><span class="semibold">To the Editor:</span> In this study, we examine the relationship between reckless driving and borderline personality disorder (BPD)—a relationship that has been infrequently studied.</p>
<p class="ltrs-br-ltr-br-body-text"> </p>
<p class="ltrs-br-ltr-br-body-text"><span class="semibold-ital">Method.</span> Participants consisted of men and women, aged 18 years or older, recruited from an identical clinical setting (an internal medicine outpatient clinic that is staffed predominantly by resident providers) during 4 research projects that were undertaken over a 2-year period (2009–2011).<span class="htm-cite"><a href="#ref1">1–4</a></span> We compiled these cross-sectional datasets to maximize the current sample size for investigation. The resulting sample consisted of 1,102 patients: 353 men, 748 women, and 1 individual who did not indicate sex. Ages ranged from 18 to 97 years (mean<span class="thinspace"> </span>=<span class="thinspace"> </span>49.74, SD<span class="thinspace"> </span>=<span class="thinspace"> </span>15.35), and 87.1% of participants were white/Caucasian.</p>
<p class="ltrs-br-ltr-br-body-text">During clinic hours, each incoming patient was approached by a research assistant, who excluded individuals unable to successfully complete a survey (mostly due to severe illness and/or language difficulties). The recruiter reviewed the focus of the project with potential candidates and invited each to participate by completing a multipage survey. In addition to demographic queries, we examined, in the survey, borderline personality symptomatology through 2 self-report measures—the BPD scale of the Personality Diagnostic Questionnaire-4 (PDQ-4)<span class="htm-cite"><a href="#ref5">5</a></span> and the Self-Harm Inventory (SHI)<span class="htm-cite"><a href="#ref6">6</a>;</span> a score of 5 or higher on either scale indicates a diagnosis of BPD. As for inquiries about reckless driving, 1 PDQ-4 query states, “I have done things on impulse that can get me into trouble” and includes the item reckless driving. Likewise, SHI item 7 asks respondents whether they have ever “driven recklessly on purpose.” As the focus of the current investigation, these 2 items were not included in the total scoring of the PDQ-4 and SHI. To increase measurement reliability, we considered respondents who endorsed both items to have engaged in purposeful and problematic reckless driving.</p>
<p class="ltrs-br-ltr-br-body-text">These 4 projects were reviewed and exempted by the institutional review boards of both the community hospital and the university. Completion of the survey was assumed to function as implied consent, which was explicitly clarified on the cover page of the booklet.</p>
<p class="ltrs-br-ltr-br-body-text"><span class="semibold-ital">Results.</span> Of the 1,102 respondents, 77 (7.0%) endorsed both reckless driving items, with no statistically significant difference in the proportions of men (8.8%) and women (6.1%) (<span class="italic">χ</span><span class="superscript">2</span><span class="thinspace"> </span>=<span class="thinspace"> </span>2.55, <span class="italic">P</span><span class="thinspace"> </span><<span class="thinspace"> </span>.15). Point-biserial correlation coefficients revealed that those who endorsed both reckless driving items tended to be younger (<span class="italic">r</span><span class="thinspace"> </span>=<span class="thinspace"> </span>–0.17, <span class="italic">P</span><span class="thinspace"> </span><<span class="thinspace"> </span>.001) and scored higher on the PDQ-4 (<span class="italic">r</span><span class="thinspace"> </span>=<span class="thinspace"> 0</span>.38, <span class="italic">P</span><span class="thinspace"> </span><<span class="thinspace"> </span>.001) and the SHI (<span class="italic">r</span><span class="thinspace"> </span>=<span class="thinspace"> 0</span>.46, <span class="italic">P</span><span class="thinspace"> </span><<span class="thinspace"> </span>.001). Similarly, when compared to respondents who denied ever having driven recklessly, those who did were more likely to exceed the clinical cutoff score on the PDQ-4 (58.4% vs 13.5%, <span class="italic">χ</span><span class="superscript">2</span><span class="thinspace"> </span>=<span class="thinspace"> </span>104.62, <span class="italic">P</span><span class="thinspace"> </span><<span class="thinspace"> </span>.001) and the SHI (76.6% vs 15.0%, <span class="italic">χ</span><span class="superscript">2</span><span class="thinspace"> </span>=<span class="thinspace"> </span>174.12, <span class="italic">P</span><span class="thinspace"> </span><<span class="thinspace"> </span>.001).</p>
<p class="ltrs-br-ltr-br-body-text"> </p>
<p class="ltrs-br-ltr-br-body-text">While the potential limitations of this study include the self-report nature of the data, including the borderline personality measures, and possible participant overlap in the 4 databases, findings in this large and consecutive sampling of 4 studies indicate clear relationships between reckless driving and BPD.</p>
<p class="ltrs-br-ltr-br-references-head"><span class="smallcaps">References</span></p>
<p class="references-references-text-1-9"><a name="ref1"></a>1. Sansone RA, Farukhi S, Wiederman MW. Disruptive behaviors in the medical setting and borderline personality. <span class="italic">Int J Psychiatry Med</span>. 2011;41(4):355–363. <span class="pubmed-crossref"><a href="
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=22238840&dopt=Abstract">PubMed</a> <a href="
http://dx.doi.org/10.2190/PM.41.4.e">doi:10.2190/PM.41.4.e</a></span></p>
<p class="references-references-text-1-9"><a name="ref2"></a>2. Sansone RA, Lam C, Wiederman MW. Borderline personality disorder and reckless driving. <span class="italic">J Clin Psychiatry</span>. 2010;71(4):507. <span class="pubmed-crossref"><a href="
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=20409451&dopt=Abstract">PubMed</a> <a href="
http://dx.doi.org/10.4088/JCP.09l05494gre">doi:10.4088/JCP.09l05494gre</a></span></p>
<p class="references-references-text-1-9"><a name="ref3"></a>3. Sansone RA, Lam C, Wiederman MW. The relationship between illegal behaviors and borderline personality symptoms among internal medicine outpatients. <span class="italic">Compr Psychiatry</span>. 2012;53(2):176–180. <span class="pubmed-crossref"><a href="
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=21550032&dopt=Abstract">PubMed</a> <a href="
http://dx.doi.org/10.1016/j.comppsych.2011.03.006">doi:10.1016/j.comppsych.2011.03.006</a></span></p>
<p class="references-references-text-1-9"><a name="ref4"></a>4. Sansone RA, Leung JS, Wiederman MW. Litigious history and borderline personality symptomatology. <span class="italic">Prim Care Companion CNS Disord</span>. In press.</p>
<p class="references-references-text-1-9"><a name="ref5"></a>5. Hyler SE. <span class="italic">Personality Diagnostic Questionniare-4</span>. New York, NY: New York State Psychiatric Institute 1994.</p>
<p class="references-references-text-1-9"><a name="ref6"></a>6. Sansone RA, Wiederman MW, Sansone LA. The Self-Harm Inventory (SHI): development of a scale for identifying self-destructive behaviors and borderline personality disorder. <span class="italic">J Clin Psychol</span>. 1998;54(7):973–983. <span class="pubmed-crossref"><a href="
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9811134&dopt=Abstract">PubMed</a> <a href="
http://dx.doi.org/10.1002/(SICI)1097-4679(199811)54:7%3C973::AID-JCLP11%3E3.0.CO;2-H">doi:10.1002/(SICI)1097-4679(199811)54:7<973::AID-JCLP11>3.0.CO;2-H</a></span></p>
<p class="ltrs-br-ltr-br-author"><span class="bold">Randy A. Sansone, MD</span></p>
<p class="ltrs-br-ltr-br-author"><a href="
mailto:Randy.sansone@khnetwork.org">
Randy.sansone@khnetwork.org</a></p>
<p class="ltrs-br-ltr-br-author"><span class="bold">Michael W. Wiederman, PhD</span></p>
<p class="ltrs-br-ltr-br-endmatter-fieldnotes"><span class="semibold-ital">Author affiliations:</span> Departments of Psychiatry and Internal Medicine, Wright State University School of Medicine, Dayton, and Department of Psychiatry Education, Kettering Medical Center, Kettering, Ohio (Dr Sansone); and Department of Psychology, Columbia College, Columbia, South Carolina (Dr Wiederman).</p>
<p class="ltrs-br-ltr-br-endmatter-fieldnotes"><span class="semibold-ital">Potential conflicts of interest:</span> None reported.</p>
<p class="ltrs-br-ltr-br-endmatter-fieldnotes"><span class="semibold-ital">Funding/support:</span> None reported.</p>
<p class="ltrs-br-ltr-br-endmatter-fieldnotes"><span class="semibold-ital">Published online:</span> January 3, 2013.</p>
<p class="ltrs-br-ltr-br-copyright-doi"><span class="italic">Prim Care Companion CNS Disord 2013;15(1):</span><span class="doi">doi:10.4088/PCC.12l01379</span></p>
<p class="ltrs-br-ltr-br-copyright-doi"><span class="italic">© Copyright 2013 Physicians Postgraduate Press, Inc.</span></p>
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