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Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis
Open accessAbstract
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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“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]
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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 [19].”
From Complex PTSD and borderline personality disorder (2021) · cites this paper as [19]
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“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]
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In the citing paper
“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]
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“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]
In the citing paper
“there are higher rates of childhood abuse in people with complex PTSD than in those with PTSD 13,14,17 .”
From Post‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges (2019) · cites this paper as [14]
In the citing paper
“latent class analyses have consistently documented that there is a class of individuals with high PTSD symptoms and high disturbances in self-organization, and another class with high PTSD symptoms and low disturbances in self-organization 12-16 .”
From Post‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges (2019) · cites this paper as [14]
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“there is also evidence that complex PTSD identifies a distinct class from borderline personality disorder 14 .”
From Post‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges (2019) · cites this paper as [14]
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Metadata
- 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)
- Venue
- European Journal of Psychotraumatology
- Publisher
- Informa UK Limited
- Published
- 2014-09-15
- Volume
- 5
- Issue
- 1
- ISSN
- 2000-8066 (ISSN-L)
- 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
- gold
- doi.org
- 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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