The comorbidity of borderline personality disorder and posttraumatic stress disorder: revisiting the prevalence and associations in a general population sample
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BACKGROUND: The comorbidity of borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) is frequent, yet not well understood. The influence of childhood sexual abuse (CSA) in the development of this comorbidity has been a focus of prior clinical studies, but empirical evidence to generalize this focus to the broader population is lacking. Primary aims of the present study included evaluation of: (a) the association of this comorbidity with decrements in health-related quality of life (HRQOL) and (b) the importance of CSA as a predictive factor for this comorbidity in a general population sample. METHODS: We utilized data from Wave 2 of the National Epidemiological Survey on Alcohol and Related Conditions, a nationally representative face-to-face survey evaluating mental health in the non-institutionalized adult population of the United States. Data from respondents who met criteria for BPD and/or PTSD were analyzed (N = 4104) to assess potential associations between and among lifetime BPD-PTSD comorbidity, CSA, gender, healthcare usage, and mental and physical HRQOL. RESULTS: Lifetime comorbidity of BPD and PTSD was associated with more dysfunction than either individual disorder; and the factors of gender, age, and CSA exhibited significant effects in the prediction of this comorbidity and associated decrements in HRQOL. CONCLUSIONS: Results support the measured focus on CSA as an important, but not necessary, etiologic factor and emphasize this comorbidity as a source of greater suffering and public health burden than either BPD or PTSD alone. The differential impact of these disorders occurring alone versus in comorbid form highlights the importance of diagnosing both BPD and PTSD and attending to lifetime comorbidity.
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The revised PTSD criteria in DSM-5 include new symptoms of pervasive negative changes in cognition, mood, and behavior that parallel other BPD criteria.
“the revised PTSD criteria in the DSM-5 [3] include new symptoms of pervasive negative changes in cognition, mood, and behavior that parallel other BPD criteria (i.e., identity disturbance, interpersonal mistrust, dysphoric affective instability, impulsivity, self-harm) [148].”
From Complex PTSD and borderline personality disorder (2021) · cites this paper as [148]
In “Comparing BPD and PTSD” (page not provided), the paper says that under DSM-5 the disorders appear quite different, with dissociative symptoms as their apparent similarity. It does not describe the new PTSD symptoms as paralleling the listed BPD criteria; its characterization of the diagnostic criteria is contrary to that attribution. (LLM, conf=0.82)
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- Authors
- Scheiderer, E. M., Wood, P. K., & Trull, T. J.
- Affiliations
- University of Missouri (US)
- Corresponding author
- Scheiderer, Emily M.
- Trull, Timothy J.
- Venue
- Borderline Personality Disorder and Emotion Dysregulation
- Published
- 2015-07-24
- Volume
- 2
- Issue
- 1
- Pages
- 11-11
- ISSN
- 2051-6673 (ISSN-L)
- PMC
- PMC4579516
- OpenAlex
- W1522280805
- Cited by
- 90
- References
- 56
- Citations by year
- 2026: 5 · 2025: 14 · 2024: 6 · 2023: 11 · 2022: 22 · 2021: 7 · 2020: 6 · 2019: 3 · 2018: 6 · 2017: 5 · 2016: 3 · 2014: 1
- FWCI
- 5.79
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Borderline Personality Disorder and Emotion Dysregulation (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute on Alcohol Abuse and Alcoholism (R01AA016392)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- borderline personality disorder, post-traumatic stress disorder, comorbidities, child sexual abuse, health-related quality of life, general population, gender differences, health care utilization, public health burden
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