Treatment Preference among Suicidal and Self‐Injuring Women with Borderline Personality Disorder and PTSD

OBJECTIVES: This study examined treatment preferences among suicidal and self-injuring women with borderline personality disorder (BPD) and PTSD. METHOD: Women (N = 42, M(age) = 34) with BPD, PTSD and recent intentional self-injury were evaluated upon entry into a psychotherapy outcome study. RESULTS: The majority preferred a combined dialectical behavior therapy (DBT) and prolonged exposure (PE) treatment (73.8%), followed by DBT alone (26.2%), and PE alone (0%). Women who preferred the combined treatment were more likely to report a desire to obtain relief from PTSD and to receive specific DBT and PE treatment components as reasons underlying this preference. Few women (21.4%) reported concerns about PE, but those who did were more likely to prefer DBT alone. More severe PTSD re-experiencing symptoms, a childhood index trauma, and less reduction in positive affect after a trauma interview predicted a preference for the combined treatment. CONCLUSIONS: These results may help to inform treatment for these complex patients.