# Complex PTSD, affect dysregulation, and borderline personality disorder

## TL;DR

This paper explores the relationship between complex PTSD and borderline personality disorder, highlighting their overlapping symptoms and the role of trauma.

## Contribution

The paper provides a nuanced understanding of how trauma influences both complex PTSD and BPD, suggesting they are distinct but related conditions.

## Key findings

- BPD and complex PTSD share significant overlap but are not interchangeable diagnoses.
- Childhood victimization and affect dysregulation are key factors in both disorders.
- A differentiated view of these disorders can improve clinical practice and research.

## Abstract

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.