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Given considerable symptom comorbidity and overlap in etiology between borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD), this study investigated whether BPD Compass holds promise as an integrated approach to simultaneously treating co\u2010occurring BPD features and PTSD symptoms. Participants included 84 trauma\u2010exposed adults who participated in a two\u2010phase clinical trial (Phase 1: randomized controlled trial of BPD Compass vs. waitlist [<jats:italic>n<\/jats:italic> = 43]; Phase 2: open trial of BPD Compass [<jats:italic>n =<\/jats:italic> 41]). Compared to waitlist, BPD Compass led to medium\u2010to\u2010large\u2013sized, significant improvements in BPD features, \u03b2s = \u2212.57 \u2212.44, and facets of neuroticism, \u03b2s &lt; \u2212.55\u2013\u2212.73, as well as small, nonsignificant improvements in self\u2010reported, \u03b2 = \u2212.20, and clinician\u2010rated PTSD symptom severity, \u03b2 = \u2212.19. During treatment, within\u2010person improvements in PTSD symptoms predicted subsequent improvements in BPD features, \u03b2 =\u00a0.13, but not vice versa, \u03b2 =\u00a0.07. Within\u2010person PTSD symptom reduction also predicted subsequent improvement in all personality dimensions, whereas only within\u2010person improvement in despondence, \u03b2 =\u00a0.12, affective dysregulation, \u03b2 =\u00a0.11, and dissociative tendencies, \u03b2 =\u00a0.12, predicted PTSD symptom reductions. Findings offer preliminary support for the potential of BPD Compass to target BPD features and aspects of neuroticism and agreeableness among trauma\u2010exposed adults. Moreover, PTSD symptom change predicting subsequent improvement in BPD features runs counter to current stage\u2010based treatment models that emphasize BPD feature stabilization before engaging in trauma\u2010focused therapy.<\/jats:p>","DOI":"10.1002\/jts.23024","type":"journal-article","created":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T15:23:35Z","timestamp":1710861815000},"page":"422-432","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["BPD Compass: Using a dimensional model of psychopathology to treat co\u2010occurring borderline personality disorder and posttraumatic stress symptoms"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4147-5366","authenticated-orcid":false,"given":"Caitlyn O.","family":"Hood","sequence":"first","affiliation":[{"name":"Department of Psychiatry University of Kentucky  Lexington Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5888-2769","authenticated-orcid":false,"given":"Matthew W.","family":"Southward","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Kentucky  Lexington Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9985-8418","authenticated-orcid":false,"given":"Christal L.","family":"Badour","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Kentucky  Lexington Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7322-983X","authenticated-orcid":false,"given":"Shannon","family":"Sauer\u2010Zavala","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Kentucky  Lexington Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/15299732.2020.1760410"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1037\/pas0000523"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/cpsp.12278"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2007.05.002"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000837"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1073191115581475"},{"key":"e_1_2_7_9_1","volume-title":"User's guide for the SCID\u20105\u2010PD (Structured Clinical Interview for DSM\u20105 Personality Disorder)","author":"First M.","year":"2015"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.copsyc.2016.12.002"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22478"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0024252"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2022.102177"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph182111729"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/15325024.2011.572035"},{"key":"e_1_2_7_16_1","unstructured":"IBM Corp. 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