Borderline Personality Disorder (BPD) and Complex Posttraumatic Stress Disorder (CPTSD): A Network Analysis in a Highly Traumatized Clinical Sample

Abstract

Whether complex posttraumatic stress disorder (CPTSD) and borderline personality disorder (BPD) diagnoses differ substantially enough to warrant separate diagnostic classifications has been a subject of controversy for years. To contribute to the nomological network of cumulative evidence, the main goal of the present study was to explore, using network analysis, how the symptoms of ICD-11 PTSD and disturbances in self-organization (DSO) are interconnected with BPD in a clinical sample of polytraumatized individuals (N = 330). Participants completed measures of life events, CPTSD, and BPD. Overall, our study suggests that BPD and CPTSD are largely separated. The bridges between BPD and CPTSD symptom clusters were scarce, with “Affective Dysregulation” items being the only items related to BPD. The present study contributes to the growing literature on discriminant validity of CPTSD and supports its distinctiveness from BPD. Implications for treatment are discussed.

Is it possible to differentiate ICD‐11 complex PTSD from symptoms of borderline personality disorder?

“…Diagnostic items related to affect dysregulation are often equal ly endorsed across the disorders, and in network analyses these symptoms appear to be common in both CPTSD and BPD 3 . How ever, BPD is associated with high rates of impulsivity and suicidal and self injurious behaviours, while in CPTSD these characteris tics may be present, but do not occur as frequently as other CPTSD symptoms, nor as often as in BPD 4 .…”

“…Thanos Karatzias 1,2 , Martin Bohus 3,4 , Mark Shevlin 5 , Philip Hyland 6 , Jonathan I. Bisson 7 , Neil P. Roberts 7,8 , Marylène Cloitre 9,10 Of the many protocols drafted and discussed during the meet ings, very few survived the criticisms of the group members and were proposed to external bodies for funding. The first very suc cessful initiative was the European First Episode Schizophre nia Trial (EUFEST), the largest randomized trial comparing the clinical effectiveness of second vs. first generation (haloperidol below 5 mg/day) antipsychotics in first episode schizophrenia spectrum patients 1 .…”

“…However, after a couple of years, the EGRIS decided to return to its previous autonomy and working style. Part of the group also remained in the ECNP Schizo phrenia Network, and, under my leadership, the Network included new members, who had never been EGRIS members, and focused on research on negative symptoms of schizophrenia 3,4 .…”

Distinguishing between ICD-11 complex post-traumatic stress disorder and borderline personality disorder: clinical guide and recommendations for future research

“…16 Diagnostic items related to affect dysregulation are often equally endorsed across the disorders and in network analyses appear to link CPTSD and BPD. 15 However, BPD is associated with high rates of impulsive, suicidal and self-injurious behaviours, whereas in CPTSD these characteristics may be present but do not occur as frequently as other CPTSD symptoms nor as markedly or persistently as those seen in BPD. 11 Indeed, addressing suicidal and self-injurious behaviours has been viewed as the defining concern and primary treatment target in BPD.…”

“…To date there have been seven studies exploring the association between BPD and ICD-11 CPTSD using disorder-specific measures. These studies have been conducted in general population samples as well as in clinical samples of traumatised individuals and they include factor analysis, 9,10 latent class analysis [11][12][13] and network analysis 14,15 designs. All these studies concluded that there is a group of individuals who endorse criteria of both conditions, but CPTSD and BPD were generally found to be distinct disorders.…”