Distinguishing Among Symptoms of Posttraumatic Stress Disorder, Complex Posttraumatic Stress Disorder, and Borderline Personality Disorder in a Community Sample of Women

Abstract

The diagnosis of complex posttraumatic stress disorder (CPTSD) was included in the ICD-11 in 2018. Debates are still ongoing in the scientific community regarding the conceptual distinction between CPTSD symptoms and those of comorbid PTSD and borderline personality disorder (BPD). The present study aimed to determine whether (a) patterns of symptoms reported by women in a community sample would reveal a CPTSD profile distinct from PTSD and BPD profiles and (b) the resulting profiles could be compared on measures of cumulative childhood trauma exposure, dissociation, and life satisfaction. Women who reported at least one potentially traumatic experience (N = 438) completed questionnaires assessing PTSD, CPTSD, and BPD symptoms. We performed latent profile analyses testing seven models, with the five-profile model emerging as the most appropriate solution. The profiles were characterized as "high PTSD symptoms" (12.0%), "high CPTSD symptoms" (7.6%), "high BPD symptoms" (9.9%), "high CPTSD and BPD symptoms" (3.8%), and "low symptoms" (66.7%). Group comparisons revealed that the profiles characterized by high CPTSD symptoms, high BPD symptoms, and high CPTSD and BPD symptoms tended to include participants with higher levels of cumulative childhood trauma exposure and symptoms of dissociation and lower ratings of life satisfaction compared to the profiles characterized by high PTSD symptoms and low symptoms, ds = 0.55-1.06. These findings support the distinction between ICD-11 CPTSD symptoms and those of PTSD and BPD, promoting an integrative approach to understanding trauma sequelae, diagnosis, and treatment.