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Complex PTSD, affect dysregulation, and borderline personality disorder
Open accessAbstract
Complex PTSD (cPTSD) was formulated to include, in addition to the core PTSD symptoms, dysregulation in three psychobiological areas: (1) emotion processing, (2) self-organization (including bodily integrity), and (3) relational security. The overlap of diagnostic criteria for cPTSD and borderline personality disorder (BPD) raises questions about the scientific integrity and clinical utility of the cPTSD construct/diagnosis, as well as opportunities to achieve an increasingly nuanced understanding of the role of psychological trauma in BPD. We review clinical and scientific findings regarding comorbidity, clinical phenomenology and neurobiology of BPD, PTSD, and cPTSD, and the role of traumatic victimization (in general and specific to primary caregivers), dissociation, and affect dysregulation. Findings suggest that BPD may involve heterogeneity related to psychological trauma that includes, but extends beyond, comorbidity with PTSD and potentially involves childhood victimization-related dissociation and affect dysregulation consistent with cPTSD. Although BPD and cPTSD overlap substantially, it is unwarranted to conceptualize cPTSD either as a replacement for BPD, or simply as a sub-type of BPD. We conclude with implications for clinical practice and scientific research based on a better differentiated view of cPTSD, BPD and PTSD.
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Metadata
- Authors
- Ford, J. D., & Courtois, C. A.
- Venue
- Borderline Personality Disorder and Emotion Dysregulation
- Published
- 2014
- Volume
- 1
- Issue
- 1
- Pages
- 9
- ISSN
- 2051-6673 (ISSN-L)
- PMC
- PMC4579513
- OpenAlex
- W2161813267
- Cited by
- 182
- References
- 225
- Citations by year
- 2026: 15 · 2025: 11 · 2024: 15 · 2023: 22 · 2022: 19 · 2021: 17 · 2020: 18 · 2019: 15 · 2018: 11 · 2017: 16 · 2016: 8 · 2015: 11 · 2014: 2
- FWCI
- 1.88
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Borderline Personality Disorder and Emotion Dysregulation (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Substance Abuse and Mental Health Services Administration
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- complex PTSD, borderline personality disorder, affect dysregulation, post-traumatic stress disorder, comorbidities, dissociation, childhood trauma, primary caregivers, emotional processing, self-organization, relational security, diagnostic validity
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