Psychoanalysis.  2023 Apr;34(2):17-24. 10.18529/psychoanal.2023.34.2.17.

Charicterist Clinical Features Between Post-Traumatic Stress Disorder, Complex Post-Traumatic Disorder and Borderline Personality Disorder Based On Prevalence, Comorbidity and Symptoms

• Jin B
• Chung US

• KMID: 2542034
• DOI: http://doi.org/10.18529/psychoanal.2023.34.2.17

Abstract

It is important for the therapist to differentiate between the symptoms of childhood trauma-related disorders, such as post-traumatic stress disorder (PTSD), complex post-traumatic stress disorder (cPTSD), and borderline personality disorder (BPD), and to evaluate whether these disorders coexist. Instead of the diagnosis of BPD with general stigma, the diagnosis of cPTSD without BPD has less stigma with a more accurate evaluation and treatment plan for patients. The relationship between PTSD, cPTSD/ disturbance of self-organization (DSO), and BPD was evaluated in terms of prevalence, comorbidities, and clinical features. The comorbidity of BPD at diagnosis of cPTSD was higher than that of cPTSD at diagnosis of BPD. BPD symptoms tended to appear together with PTSD or cPTSD/DSO symptoms, rather than appearing separately, and in a subgroup with high severity of cPTSD. It suggested that the symptoms were more complex and aggravated during the transition from PTSD to cPTSD/DSO, and then followed by BPD after exposure to trauma. cPTSD/DSO symptoms were found to be distinct from PTSD and BPD symptoms; PTSD being fear-related intrusive memory, avoidance, and hypervigilance, and cPTSD/DSO being emotional numbness and emptiness, impaired self-perception, detachment from relationships, and BPD was characterized by emotional reactivity, impulsivity, emptiness, fear of abandonment, and a fragmented unstable sense of self. cPTSD/DSO was characterized by fear of getting close, avoidance, and unwillingness to make relationships, while BPD was characterized by intense, fleeting relational hostility and al-ternating excessive enmeshment in relationships. Cases with all BPD, PTSD, cPTSD/DSO symptoms were more strongly associated with accumulated more severe interpersonal trauma from childhood than those with cPTSD/DSO symptoms or PTSD without BPD symptoms.

Keyword

PTSD; Complex PTSD; Borderline personality disorder; Differential diagnosis; Symptoms; Comorbidity