A new study coming out of the University of Connecticut Health Center has taken the study of the intertwined relationship between PTSD, CPTSD and BPD to new levels. The article is a review summarizing recent empirical findings regarding BPD, PTSD, and cPTSD. The evaluation of the findings in research, not in a clinical setting, are explored. It is a massive article broken down into seven major areas of study.
The authors seek to evaluate the body of work regarding PTSD, Complex PTSD, and BPD. They look specifically at the
(1) prevalence and comorbidity; (below, Part 1)
(2) clinical phenomenology;
(3) traumatic antecedents;
(4) psychobiology;
(5) emotion dysregulation;
(6) dissociation; and
(7) empirically supported approaches to clinical assessment and psychotherapeutic treatment.
To avoid the TLDR I’ll put the conclusions they reached here.
They posit that PTSD, cPTSD, and BPD are distinct syndromes with a likelyhood of presenting together, they can be comorbid. They introduce the idea that the disorders while differentiated by unique traits, and combinations of traits, do in fact represent a continuum of the stress response.
In the main body of the report the researchers give a succinct history of the diagnosis of cPTSD. They cite both the inclusion in the ICD-11 and its absence in the DSM-V.
What follows is a quick summary of the multipart study. The article reviews recent findings regarding BPD, PTSD, and cPTSD across the seven areas mentioned above.
Section 1: prevalence and comorbidity OF CPTSD, BPD and PTSD
| Condition | % in General Pop | % in MH Patients |
|---|---|---|
| BPD | 0.7 – 3.5 | 9 – 18 |
| PTSD | 3.0 – 4.4 | 2 – 39 |
| CPTSD | 0.5 – 7.7 | 36 |
PTSD and BPD comorbidity
In the United States,
25–30% of adults with either PTSD or BPD also have the other disorder,
30–70% of adults with BPD had an episode of PTSD within their lifetime,
*A 10-year follow-up of adults with BPD found that while most (85%) who had PTSD, found relief but the BPD diagnosis persisted.
*Almost half of the remitted PTSD cases experienced a recurrence. Those who suffered childhood sexual abuse were the least likely to remit.
*More than one in four of the BPD cases had a new diagnosis of PTSD over the 10-year period, most often following a sexual assault.
CPTSD and BPD comorbidity
An analysis of patients from the Netherlands reported
Inpatients BPD was comorbid in 79% of cPTSD cases
and cPTSD was comorbid in 40.5% of BPD cases.
Outpatient treatment
ICD-11 defined cPTSD was 36%, while BPD was 8% and PTSD 8%
cPTSD was comorbid in 44% of the BPD cases,
BPD was comorbid in only 10% of the cPTSD cases
BPD was comorbid in only 8% of the PTSD cases.
A study of outpatient women who had experienced childhood abuse,
ICD-11 cPTSD was comorbid with ~50% of cases diagnosed with BPD,
while BPD was comorbid with ~ 8% of cases with cPTSD
The researchers make this summation – “BPD occurs more often when cPTSD is diagnosed than cPTSD occurs when BPD is diagnosed.”
I am going to end this report here. Not because there isn’t more to study, there is. And that is precisely why I am going to take a break here, to go study the article. Further entries will be linked from the list above.
Citation:
Ford, J.D., Courtois, C.A. Complex PTSD and borderline personality disorder. bord personal disord emot dysregul 8, 16 (2021).
https://doi.org/10.1186/s40479-021-00155-9