Borderline Personality or Complex Posttraumatic Stress Disorder? An Update on the Controversy

Lewis, Kate L.; Grenyer, Brin F. S.

doi:10.3109/10673220903271848

Cited by 80 publications

(62 citation statements)

References 49 publications

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“…With regard to a specific association between PTSD and BPD, the taxonomic hypothesis most commonly advocated by ‘trauma models' is that both pathologies are part of a general spectrum of pathologies related to traumatic experiences [11,64,65,66]. Although this is a tentative approach, empirical findings show that the prevalence of PTSD and traumatic events in childhood is not consistently higher in subjects with BPD than in patients with other personality disorders [16].…”

Section: Nosological Status Of Comorbidity Between Ptsd and Bpdmentioning

confidence: 99%

Comorbidity between Post-Traumatic Stress Disorder and Borderline Personality Disorder: A Review

Frías

Palma

2014

Psychopathology

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Background: Traditionally, the presence of post-traumatic stress disorder (PTSD) in subjects diagnosed with borderline personality disorder (BPD) has been the object of scant empirical research. The clarification of issues related to the different areas of study for this comorbidity is not only significant from a theoretical point of view but also relevant for clinical practice. The aim of this review is to describe the main theoretical findings and research conclusions about the comorbidity between PTSD and BPD. Methods: A literature review was carried out via PubMed and PsycINFO for the period between 1990 and September 2013. The descriptors used were ‘post-traumatic stress disorder', ‘borderline personality disorder', ‘PTSD', ‘complex PTSD' and ‘BPD'. Results: Epidemiological studies show that the risk of PTSD among BPD subjects is not regularly higher than in subjects with other personality disorders. Furthermore, there is no conclusive evidence about the main aetiopathogenic mechanism of this comorbidity, either of one disorder being a risk factor for the other one or of common underlying variables. Concerning comparative studies, several studies with PTSD-BPD subjects have found a higher severity of psychopathology and psychosocial impairment than in BPD subjects. With regard to nosological status, the main focus of controversy is the validation of ‘complex PTSD', a clinical entity which may comprise a subgroup of PTSD-BPD subjects. With regard to treatment, there are preliminary evidences for the efficient treatment of psychopathology in both PTSD and BPD. Conclusions: These findings are remarkable for furthering the understanding of the link between PTSD and BPD and their implications for treatment. The results of this review are discussed, including methodological constraints that hinder external validity and consistency of referred findings.

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Section: Nosological Status Of Comorbidity Between Ptsd and Bpdmentioning

confidence: 99%

Comorbidity between Post-Traumatic Stress Disorder and Borderline Personality Disorder: A Review

Frías

Palma

2014

Psychopathology

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“…La perte de confiance envers les autres, l'irritabilité, la colère et l'instabilité affective sont communes aux deux diagnostics (Gunderson et Sabo, 1993 ;Lewis et Grenyer, 2009). Cependant les symptômes se développent sur un mode temporel différent.…”

Section: Dissociation Et Trouble De Personnalité Limiteunclassified

“…Le TSPT connaît une exacerbation symptomatique suite à un traumatisme avec rémission possible tandis que le développement du TPL est plus longitudinal (Horevitz et Braun, 1984). Heureusement, le pronostic des patients avec TPL qui vivent de la dissociation est favorable puisque les symptômes s'atténuent avec le temps (Zanarini et al, 2008 ;Lewis et Grenyer, 2009). …”

Section: Dissociation Et Trouble De Personnalité Limiteunclassified

“…Plus spécifiquement, il existe un lien entre la dissociation et une dysfonction maternelle, un attachement anxieux et un système de défense plus primitif (Simeon et al, 2002(Simeon et al, , 2003. Il faut donc être prudent avant de tirer des conclusions hâtives sur la relation de cause à effet entre toutes ces dimensions cliniques (Lewis et Grenyer, 2009), mais l'association entre stress, développement psychologique compromis et dissociation est avancée.…”

Section: Dissociation Et Trouble De Personnalité Limiteunclassified

“…Rinne et al (2002) rapportent néanmoins une augmentation de la réponse de l'axe hypothalamopituitairo-hypophysaire chez des sujets TPL abusés sur une longue période de temps. Selon les analyses statistiques, la suppression du cortisol semble plus reliée au TSPT qu'au TP (Shea, 1999 ;Lewis et Grenyer, 2009). Les données sont de ce fait difficiles à interpréter lorsqu'il s'agit de faire la part des choses entre l'influence du traumatisme ou d'une personnalité limite sur la réponse physiologique au stress (Flory et al, 2009 ;Zimmerman et Choi-Kain, 2009 Toujours dans le champ de recherche en neuro-imagerie, les sujets avec TPL ou TPST ont aussi des volumes réduits des noyaux de l'hippocampe et de l'amygdale en comparaison à des sujets normaux (Lewis et Grenyer, 2009 ;Wingenfeld et al, 2010).…”

Section: Constatations Neurophysiologiques Sur La Dissociationunclassified

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Comprendre la dissociation chez les patients avec un trouble de personnalité limite

Renaud

2011

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Cet article examine la dissociation, un concept psychiatrique controversé qui se rencontre dans le quotidien du clinicien. À partir d’une recherche sur Pubmed/Ovid avec les mots clés dissociation et trouble de personnalité limite et d’autres références, l’auteure décrit le phénomène dissociatif dans ses aspects cliniques chez les sujets atteints du trouble de personnalité limite (TPL). L’article discute des hypothèses psychodynamiques et des données neurophysiologiques pour expliquer la dissociation. Certains validateurs neurophysiologiques et neuro-anatomiques produits grâce à l’imagerie cérébrale, et des études du métabolisme de neurotransmetteurs sont étudiés pour étayer les énoncés hypothétiques. L’auteure conclut sur un modèle de mécanisme de défense dans un contexte de prédisposition biologique, de carence du développement psychologique ou d’une sensibilisation post-traumatique et suggère des pistes thérapeutiques.Dissociation is a disturbing psychiatric concept fraught with controversy. It is however encountered in clinical contexts and has to be understood by clinicians. This article based on a Pubmed/Ovid on line research with key words dissociation and borderline personality disorder and other references, describes the clinical aspects of the dissociative phenomena in patients with borderline personality disorder. Psychodynamic hypotheses and neurophysiological data are examined to explain dissociation. Neurophysiological and neuroanatomical variables provided by cerebral imagery controlled studies support hypotheses brought forward. The article concludes with a defence mechanism developed within a context of biological predisposition, deprived psychological development and in reaction to trauma. In conclusion, emerging psychotherapeutic solutions are summarized.Este artículo examina la disociación, concepto psiquiátrico controversial, con la que el clínico se encuentra cotidianamente. A partir de una búsqueda en Pubmed/Ovid con las palabras clave disociación y trastorno de la personalidad límite y otras referencias, la autora describe el fenómeno disociativo, en sus aspectos clínicos, en las personas que sufren de un trastorno de la personalidad límite (TPL). El artículo discute las hipótesis psicodinámicas y los datos neurofisiológicos para explicar la disociación. Se estudian ciertos validadores neurofisiológicos y neuroanatómicos producidos gracias a neuroimágenes, así como estudios del metabolismo de neurotransmisores, con el fin de apoyar los enunciados hipotéticos. La autora concluye con un modelo de mecanismo de defensa en un contexto de predisposición biológica, de carencia del desarrollo psicológico o de una sensibilización postraumática, y sugiere pistas terapéuticas.Este artigo examina a dissociação, um conceito psiquiátrico controverso que encontra-se no cotidiano do clínico. A partir de uma pesquisa sobre o Pubmed/Ovid com as palavras-chave dissociação e transtorno de personalidade limite e outras referências, a autora descreve o fenômeno dissociativo em seus aspectos clínicos nos paciente...

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Overlap of autism spectrum disorder and borderline personality disorder: A systematic review and meta‐analysis

May

Pilkington

Younan³

et al. 2021

Autism Research

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Autism spectrum disorder (ASD) and borderline personality Disorder (BPD) share features, including social and emotion regulation difficulties. The evidence for the overlap in prevalence and clinical characteristics was systematically reviewed. Ovid Medline, PsycInfo, and PubMed were searched until November 30, 2020 using keywords relating to BPD and ASD. Studies that reported on the overlap of ASD and BPD diagnoses or traits and used a case, cohort, or casecontrolled design were included. Of 1633 screened studies, 19 were included, of which 12 reported data suitable for meta-analysis. Most samples were of small, clinically ascertained groups, with 11 having high risk of bias. The pooled prevalence of BPD in ASD was 4% [95% CI 0%-9%] and of ASD in BPD, 3% [95% CI 1%-8%]. There were inconsistent findings across clinical areas. The prevalence of a dual diagnosis of BPD in ASD cohorts and of ASD in BPD cohorts was within population prevalence estimates of each disorder. Based on this data we were not able to assess whether there is misdiagnosis of one in favor of the other. Neurocognitive differences may underlie similar behavioral symptoms, but further research using larger, well-validated samples is needed. Lay SummaryAutism spectrum disorder (ASD) and borderline personality disorder (BPD) have overlaps in their symptoms. The overlap in how frequently they co-occur and their presentation was systematically reviewed. We searched the key databases and including all studies that reported on the overlap of ASD and BPD diagnoses or traits and used a case, cohort or case-controlled design. Of 1633 studies, 19 were included, of which 12 reported data suitable for pooling. Most samples were of small, clinical groups, with 11 having high risk of bias. The pooled prevalence of BPD in ASD was 4% [95% CI 0%-9%] and of ASD in BPD, 3% [95% CI 1%-8%]. There were inconsistent findings across studies comparing ASD and BPD related symptoms and problems. The prevalence of a dual diagnosis of BPD in ASD cohorts and of ASD in BPD cohorts was similar to the population prevalence of each disorder. Further research using larger, well-validated samples is needed.

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Borderline Personality or Complex Posttraumatic Stress Disorder? An Update on the Controversy

Cited by 80 publications

References 49 publications

Comorbidity between Post-Traumatic Stress Disorder and Borderline Personality Disorder: A Review

Comorbidity between Post-Traumatic Stress Disorder and Borderline Personality Disorder: A Review

Comprendre la dissociation chez les patients avec un trouble de personnalité limite

Overlap of autism spectrum disorder and borderline personality disorder: A systematic review and meta‐analysis

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