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Cited by 468Posttraumatic Stress Disorder ResearchPersonality Disorders and PsychopathologyChild Abuse and Trauma

Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis

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Cloitre, Marylène, Garvert, Donn W., Weiss, Brandon, Carlson, Eve B., Bryant, Richard A.·2014·European Journal of Psychotraumatology
DOI 10.3402/ejpt.v5.25097PMC PMC4165723
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Abstract

BACKGROUND: There has been debate regarding whether Complex Posttraumatic Stress Disorder (Complex PTSD) is distinct from Borderline Personality Disorder (BPD) when the latter is comorbid with PTSD. OBJECTIVE: To determine whether the patterns of symptoms endorsed by women seeking treatment for childhood abuse form classes that are consistent with diagnostic criteria for PTSD, Complex PTSD, and BPD. METHOD: A latent class analysis (LCA) was conducted on an archival dataset of 280 women with histories of childhood abuse assessed for enrollment in a clinical trial for PTSD. RESULTS: THE LCA REVEALED FOUR DISTINCT CLASSES OF INDIVIDUALS: a Low Symptom class characterized by low endorsements on all symptoms; a PTSD class characterized by elevated symptoms of PTSD but low endorsement of symptoms that define the Complex PTSD and BPD diagnoses; a Complex PTSD class characterized by elevated symptoms of PTSD and self-organization symptoms that defined the Complex PTSD diagnosis but low on the symptoms of BPD; and a BPD class characterized by symptoms of BPD. Four BPD symptoms were found to greatly increase the odds of being in the BPD compared to the Complex PTSD class: frantic efforts to avoid abandonment, unstable sense of self, unstable and intense interpersonal relationships, and impulsiveness. CONCLUSIONS: Findings supported the construct validity of Complex PTSD as distinguishable from BPD. Key symptoms that distinguished between the disorders were identified, which may aid in differential diagnosis and treatment planning.

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  • When BPD symptoms were endorsed they were consistently accompanied by PTSD and cPTSD/DSO symptoms.

    “However, when BPD symptoms were endorsed they were consistently accompanied by PTSD and cPTSD/DSO symptoms.”

    From Complex PTSD and borderline personality disorder (2021) · cites this paper as [19]

    The Results report that no one in the Low Symptom class met criteria for PTSD or CPTSD, while 12% met criteria for BPD. They also state that BPD-class members did not consistently endorse symptoms across all three disturbances in self-organization. These findings contradict the claim of consistent accompaniment. (LLM, conf=0.90)

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  • In an outpatient treatment-seeking sample of women with histories of childhood abuse, ICD-11 cPTSD was comorbid with approximately half of cases diagnosed with BPD, while BPD was comorbid with only approximately 8% of cases diagnosed with cPTSD.

    “in an outpatient treatment-seeking sample of women with histories of childhood abuse, ICD-11 cPTSD was comorbid with approximately half of cases diagnosed with BPD, while BPD was comorbid with only approximately 8% of cases diagnosed with cPTSD [19].”

    From Complex PTSD and borderline personality disorder (2021) · cites this paper as [19]

    Split into 2 atoms — 0 confirmed, 1 partially supported, 1 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

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  • In a sample of outpatient treatment-seeking women with childhood abuse histories, three sub-groups were identified: PTSD with minimal DSO and BPD symptoms except interpersonal detachment; cPTSD with both PTSD and DSO symptoms and minimal BPD symptoms except emotional emptiness; and BPD plus all PTSD and DSO symptoms except avoidance.

    “In a sample of outpatient treatment-seeking women with childhood abuse histories [19], three sub-groups were identified that were characterized by: (1) PTSD with minimal DSO and BPD symptoms except for interpersonal detachment; (2) cPTSD with both PTSD and DSO symptoms and minimal BPD symptoms except emotional emptiness; and (3) BPD plus all PTSD and DSO symptoms except for avoidance.”

    From Complex PTSD and borderline personality disorder (2021) · cites this paper as [19]

    Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

    Experimental — accuracy not yet measured

  • Dissociation, temper outbursts, self-harm, and mood instability were twice as likely to occur in the BPD class as in the cPTSD class.

    “although dissociation, temper outbursts, self-harm, and mood instability also were twice as likely to occur in the BPD class as in the cPTSD class.”

    From Complex PTSD and borderline personality disorder (2021) · cites this paper as [19]

    The Results (Table 4; page unavailable) show all four symptoms were more frequently endorsed in the BPD class than in the CPTSD class. But self-harm occurred in 48.7% versus 14.3%, and temper symptoms in 59.5% versus 15.6%—more than three times as often, not twice. The approximately twofold figures in Results Table 5 measure the risk of BPD-class membership associated with each symptom, rather than how often the symptoms occurred in each class. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Terror of abandonment, unstable sense of self and relationships, and impulsiveness best distinguished the "BPD" versus cPTSD sub-groups.

    “Terror of abandonment, unstable sense of self and relationships, and impulsiveness best distinguished the “BPD” versus cPTSD sub-groups”

    From Complex PTSD and borderline personality disorder (2021) · cites this paper as [19]

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1 of the 27 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Cloitre M Cohen L Koenan K Treating survivors of childhood abuse: psychotherapy for the interrupted life 2006 New York Guilford Press

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Related

Authors
Cloitre, M., Garvert, D. W., Weiss, B., Carlson, E. B., & Bryant, R. A.
Affiliations
  • National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
  • VA Palo Alto Health Care System (US)
  • UNSW Sydney (AU)
ORCID
Venue
European Journal of Psychotraumatology
Publisher
Informa UK Limited
Published
2014-09-15
Volume
5
Issue
1
ISSN
2000-8066 (ISSN-L)
DOI
10.3402/ejpt.v5.25097
PMC
PMC4165723
OpenAlex
W2059428488
Cited by
468
References
27
Citations by year
2026: 32 · 2025: 51 · 2024: 53 · 2023: 40 · 2022: 46 · 2021: 70 · 2020: 53 · 2019: 40 · 2018: 27 · 2017: 25 · 2016: 15 · 2015: 15
FWCI
21.70
Type
journal article
Language
en
Open access
Licence
Locations
  • European Journal of Psychotraumatology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
  • Minerva Access (University of Melbourne) (submittedVersion, cc-by)
  • Figshare (cc-by)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Keywords
complex PTSD, borderline personality disorder, post-traumatic stress disorder, childhood abuse, differential diagnosis, construct validity, symptom profiles, women, interpersonal relationships, impulsivity

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