Please select the eligibility criteria that correspond to the clinical trial below.
Title: Treating PTSD in Patients With Borderline Personality Disorder
Brief Summary: Individuals with borderline personality disorder (BPD) are the quintessential multi-problem patients, often presenting to treatment with numerous dysfunctional behaviors and comorbid diagnoses. Dialectical Behavior Therapy (DBT) is a comprehensive, cognitive-behavioral treatment for BPD that has been shown effective in reducing the primary problems it is designed to treat; namely, the frequency and severity of self-injurious and suicidal behavior, maintenance in treatment, and severe problems in living. However, the DBT treatment manual does not currently include a protocol specifying when or how to treat posttraumatic stress disorder (PTSD), a comorbid diagnosis that is prevalent in BPD patients and may maintain or exacerbate BPD criterion behaviors. Similarly, many of the existing treatment outcome studies for PTSD have excluded suicidal, substance abusing, and multiply diagnosed patients, thereby making it difficult to determine the generalizability of these approaches to individuals with BPD. The research proposed here is focused on the development of a protocol based on Prolonged Exposure therapy to treat PTSD in BPD patients that can be integrated into standard DBT, as well as the initial evaluation of this protocol's feasibility, acceptability, and efficacy. The treatment development and pilot testing process will occur in two phases, including measure development and standardization of the treatment protocol via clinical pre-testing (Phase 1); and pilot and feasibility testing of the intervention via a randomized controlled trial (RCT) comparing standard DBT + PTSD Protocol to standard DBT Only (Phase 2). Information gathered during the pilot RCT will be used to inform the design and conduct of a subsequent full-scale RCT. This research has the potential to significantly expand and improve upon the most empirically supported treatment currently available for BPD, while also demonstrating that exposure treatments for PTSD can be implemented safely and effectively in a BPD population.


Options:
A: Inclusion Criteria:

* Meet DSM-IV criteria for BPD
* Between 18-60 years of age
* Have had two parasuicide episodes in the past five years with one occurring in the past 3 months
* Have had OHIP coverage for 1 year or more
* Literate in English
* Provide informed consent to participate in the study

Exclusion Criteria:

* Current active substance dependence disorder
* Psychotic disorder,bipolar I disorder, or dementia
* Evidence of an organic brain syndrome or mental retardation
* A chronic or serious physical health problem that will require hospitalization within the next year (e.g. cancer)
* A medical condition that would preclude the psychiatric medication regimen in the GPM condition
* Definite plans to leave the province in the next 2 years
* Currently engaged in DBT or GPM at St. Michael's Hospital
B: Inclusion Criteria:

* Female
* Age 18-60
* Meet criteria for borderline personality disorder
* Meet criteria for post-traumatic stress disorder
* Can clearly remember at least some part of the traumatic event(s)
* Recent and recurrent self-injurious behavior
* Lives within commuting distance of University of Washington, Seattle campus
* Consents to all research protocols

Exclusion Criteria:

* Male
* Court ordered to treatment
* Diagnosis of psychotic disorder, bipolar disorder, or seizure disorder requiring medication
* Less than 18 years of age or older than 60 years of age
* Problems which by their presence or severity preclude ability to attend or understand treatment and/or requires priority treatment
* Familial or domestic relationship with a current study participant
C: Inclusion Criteria:

* Patient has presented with an index episode of intentional self-harm at an eligible Emergency Department in Ontario, Canada.
* Patient is biologically male.
* Patient is 18 years of age or older.
* Patient has a valid OHIP number.

Exclusion Criteria:

* Patient has presented to the Emergency Department for a reason other than intentional self-harm at an eligible Emergency Department in Ontario, Canada.
* Patient is biologically female.
* Patient is under 18 years of age.
* Patient does not have a valid OHIP number.
D: Inclusion Criteria:

* Significant suicide ideation on Beck's Scale for Suicide Ideation (score 13 and above). Informed consent to participate.

Exclusion Criteria:

* Active psychosis, cognitive or physical impairment or other problems that preclude the ability to understand the study procedures and provide informed consent, non-Norwegian speaking subjects

Answer: B