Borderline Personality Disorder Features Are Associated with Concurrent Pain-Related Disability in a Chronic Pain...

To determine whether core features of borderline personality disorder are associated with increased rates of being on disability benefits due to chronic pain conditions.

A total of 147 patients currently in treatment for chronic pain at a multimodal chronic pain clinic.

We tested for a concurrent relationship between borderline personality disorder features and employment status using self-report measures.

Borderline personality disorder features were associated with increased likelihood of currently being on disability due to pain conditions (odds ratio [OR] = 23.13, 95% confidence interval [CI] = 1.68-318.73), on disability due to other conditions (OR = 33.65, 95% CI = 2.15-526.13), and unemployed (OR = 20.14, 95% CI = 1.38-294.93), even while controlling for pain severity and interference, depression, and trait anxiety. A follow-up analysis revealed that these associations were due to the negative relationships facet of borderline personality disorder features.

Borderline personality disorder features, particularly negative relationships, are associated with increased rates of pain disability, general disability, and unemployment in a chronic pain sample. Future research should examine mechanisms by which the maladaptive interpersonal behaviors and cognitions of borderline personality disorder might result in worse long-term employment outcomes of chronic pain.