Lasting personality pathology following exposure to severe trauma in adulthood: retrospective cohort study
Abstract Background Early exposure to trauma is a known risk factor for personality disorder (PD), but evidence for late-onset personality pathology following trauma in adults is much less clear. We set out to investigate whether exposure to war trauma can lead to lasting personality pathology in ad...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-01-01
|
| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12888-018-1975-5 |
| _version_ | 1811310021005279232 |
|---|---|
| author | Jasna Munjiza Dolores Britvic Mike J. Crawford |
| author_facet | Jasna Munjiza Dolores Britvic Mike J. Crawford |
| author_sort | Jasna Munjiza |
| collection | DOAJ |
| description | Abstract Background Early exposure to trauma is a known risk factor for personality disorder (PD), but evidence for late-onset personality pathology following trauma in adults is much less clear. We set out to investigate whether exposure to war trauma can lead to lasting personality pathology in adults and to compare the mental health and social functioning of people with late–onset personality problems with those with PD. Methods We recruited patients who scored positively on the International Personality Disorder Examination (IPDE) in southern Croatia 15 years after the Croatian war of independence and used a semi-structured interview to establish when the person’s personality-related problems arose. All participants also completed Harvard Trauma Questionnaire, and measures of mental health and social functioning. Results Among 182 participants with probable personality disorder, 65 (35.7%) reported that these problems started after exposure to war-trauma as adults. The most prevalent personality problems among those with late-onset pathology were borderline, avoidant, schizotypal, schizoid and paranoid. Participants with late-onset personality pathology were more likely to have schizotypal (75.4% vs. 47.3%) and schizoid traits (73.8% vs. 41.1%) compared to those with PD. Participants with late-onset personality pathology were three times more likely to have complex personality pathology across all three DSM-IV clusters compared to those with PD (OR = 2.96, 95% CI 1.54 to 5.67) after adjusted for gender and marital status. The prevalence of depression and social dysfunction were as high among those with late-onset personality pathology as among those with personality disorder. Conclusion Retrospective accounts of people with significant personality pathology indicate that some develop these problems following exposure to severe trauma in adulthood. Personality-related problems which start in adulthood may be as severe as those that have an earlier onset. These findings highlight the long term impact of war trauma on the mental health and have implications for the way that personality pathology is classified and treated. |
| first_indexed | 2024-04-13T09:51:27Z |
| format | Article |
| id | doaj.art-e66f2006212748cd9c87691363ab36f6 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-04-13T09:51:27Z |
| publishDate | 2019-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-e66f2006212748cd9c87691363ab36f62022-12-22T02:51:34ZengBMCBMC Psychiatry1471-244X2019-01-011911910.1186/s12888-018-1975-5Lasting personality pathology following exposure to severe trauma in adulthood: retrospective cohort studyJasna Munjiza0Dolores Britvic1Mike J. Crawford2Centre for Psychiatry, Faculty of Medicine, Imperial College LondonDepartment of Psychiatry, School of Medicine Split, University of SplitCentre for Psychiatry, Faculty of Medicine, Imperial College LondonAbstract Background Early exposure to trauma is a known risk factor for personality disorder (PD), but evidence for late-onset personality pathology following trauma in adults is much less clear. We set out to investigate whether exposure to war trauma can lead to lasting personality pathology in adults and to compare the mental health and social functioning of people with late–onset personality problems with those with PD. Methods We recruited patients who scored positively on the International Personality Disorder Examination (IPDE) in southern Croatia 15 years after the Croatian war of independence and used a semi-structured interview to establish when the person’s personality-related problems arose. All participants also completed Harvard Trauma Questionnaire, and measures of mental health and social functioning. Results Among 182 participants with probable personality disorder, 65 (35.7%) reported that these problems started after exposure to war-trauma as adults. The most prevalent personality problems among those with late-onset pathology were borderline, avoidant, schizotypal, schizoid and paranoid. Participants with late-onset personality pathology were more likely to have schizotypal (75.4% vs. 47.3%) and schizoid traits (73.8% vs. 41.1%) compared to those with PD. Participants with late-onset personality pathology were three times more likely to have complex personality pathology across all three DSM-IV clusters compared to those with PD (OR = 2.96, 95% CI 1.54 to 5.67) after adjusted for gender and marital status. The prevalence of depression and social dysfunction were as high among those with late-onset personality pathology as among those with personality disorder. Conclusion Retrospective accounts of people with significant personality pathology indicate that some develop these problems following exposure to severe trauma in adulthood. Personality-related problems which start in adulthood may be as severe as those that have an earlier onset. These findings highlight the long term impact of war trauma on the mental health and have implications for the way that personality pathology is classified and treated.http://link.springer.com/article/10.1186/s12888-018-1975-5Late-onset personality pathologySevere traumaPTSDPersonality disorderWar |
| spellingShingle | Jasna Munjiza Dolores Britvic Mike J. Crawford Lasting personality pathology following exposure to severe trauma in adulthood: retrospective cohort study BMC Psychiatry Late-onset personality pathology Severe trauma PTSD Personality disorder War |
| title | Lasting personality pathology following exposure to severe trauma in adulthood: retrospective cohort study |
| title_full | Lasting personality pathology following exposure to severe trauma in adulthood: retrospective cohort study |
| title_fullStr | Lasting personality pathology following exposure to severe trauma in adulthood: retrospective cohort study |
| title_full_unstemmed | Lasting personality pathology following exposure to severe trauma in adulthood: retrospective cohort study |
| title_short | Lasting personality pathology following exposure to severe trauma in adulthood: retrospective cohort study |
| title_sort | lasting personality pathology following exposure to severe trauma in adulthood retrospective cohort study |
| topic | Late-onset personality pathology Severe trauma PTSD Personality disorder War |
| url | http://link.springer.com/article/10.1186/s12888-018-1975-5 |
| work_keys_str_mv | AT jasnamunjiza lastingpersonalitypathologyfollowingexposuretoseveretraumainadulthoodretrospectivecohortstudy AT doloresbritvic lastingpersonalitypathologyfollowingexposuretoseveretraumainadulthoodretrospectivecohortstudy AT mikejcrawford lastingpersonalitypathologyfollowingexposuretoseveretraumainadulthoodretrospectivecohortstudy |