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The association of posttraumatic stress disorder, complex posttraumatic stress disorder, and borderline personality disorder from a network analytical perspective
Abstract
Background Posttraumatic Stress Disorder (PTSD), Complex PTSD, and Borderline Personality Disorder (BPD) share etiological risk factors and an overlapping set of associated symptoms. Since the ICD-11 proposal for trauma-related disorders, the relationship of these disorders has to be clarified. A novel approach to psychopathology, network analysis, allows for a detailed analysis of comorbidity on symptom level.Methods Symptoms were assessed in adult survivors of childhood abuse (N=219) using the newly developed ICD-11 Trauma-Questionnaire and the SCID-II. The psychopathological network was analyzed using the network approach.Results PTSD and Complex PTSD symptoms were strongly connected within disorders and to a lesser degree between disorders. Symptoms of BPD were weakly connected to others. Re-experiencing and dissociation were the most central symptoms.Conclusions Mental disorders are no discrete entities, clear boundaries are unlikely to be found. The psychopathological network revealed central symptoms that might be important targets for specific first interventions.
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“On the other hand, BPD symptoms were only weakly inter-connected to one another, primarily centering on self-harm, chronic emotional emptiness, mood instability, and impulsivity.”
From Complex PTSD and borderline personality disorder (2021) · cites this paper as [95]
In the citing paper
“In addition, dissociative and DSO emotion dysregulation symptoms were most central and most strongly connected to PTSD symptoms.”
From Complex PTSD and borderline personality disorder (2021) · cites this paper as [95]
In the citing paper
“Furthermore, none of the BPD symptoms were more than weakly connected with either the PTSD or DSO symptoms, except to the PTSD symptom of reckless behavior.”
From Complex PTSD and borderline personality disorder (2021) · cites this paper as [95]
In the citing paper
“In a sample of adults with histories of institutional child abuse, network analyses showed that PTSD and DSO symptoms were moderately interconnected [95].”
From Complex PTSD and borderline personality disorder (2021) · cites this paper as [95]
In the citing paper
“Dissociation has been shown to be problematic for a sub-set of the individuals who are diagnosed with BPD, PTSD, and cPTSD, both as freestanding disorders and when comorbid with one another [95, 179, 180].”
From Complex PTSD and borderline personality disorder (2021) · cites this paper as [95]
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Metadata
- Authors
- Knefel, M., Tran, U. S., & Lueger-Schuster, B.
- Affiliations
- University of Vienna (AT)
- Corresponding author
- Knefel, Matthias
- Venue
- Journal of Anxiety Disorders
- Publisher
- Elsevier BV
- Published
- 2016-10
- Volume
- 43
- Pages
- 70-78
- ISSN
- 0887-6185 (ISSN-L)
- OpenAlex
- W2520302677
- Cited by
- 146
- References
- 44
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 14 · 2023: 13 · 2022: 14 · 2021: 23 · 2020: 23 · 2019: 14 · 2018: 13 · 2017: 7 · 2016: 3
- FWCI
- 16.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Anxiety Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Austrian Science Fund (P 26584)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- post-traumatic stress disorder, complex PTSD, borderline personality disorder, symptom networks, comorbidities, childhood abuse, re-experiencing, dissociation
- MeSH terms
- Adult, Aged, Aged, 80 and over, Borderline Personality Disorder, Dissociative Disorders, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Risk Factors, Stress Disorders, Post-Traumatic, Adult Survivors of Child Abuse, Symptom Assessment
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