The similarities and differences between CPTSD and borderline personality disorder

What is it about?

Complex PTSD (CPTSD) is a newly defined disorder that presents very similarly to borderline personality disorder (BPD). The similarities in these disorders have raised questions as to whether they are distinct profiles or whether CPTSD is a subtype or even used as a replacement for the highly stigmatised BPD label. This paper systematically reviewed similarities and differences in symptom presentations of the two disorders. The majority of studies found CPTSD and BPD to be distinct profiles. CPTSD presented as trauma related thought avoidance, a negative sense of self, feelings of guilt and worthlessness, emotional numbing, nightmares and intrusive recollections whereas BPD presented as impulsiveness, temper outbursts, an unstable sense of self and identity disturbances, frantic behaviour to avoid abandonment, intense and unstable interpersonal relationships, self-harm and suicidal behaviour. CPTSD and BPD can present comorbidly, these individuals will have likely experienced earlier and more frequent interpersonal trauma and display greater functional impairment.

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Photo by Susan Wilkinson on Unsplash

Photo by Susan Wilkinson on Unsplash

Why is it important?

This review is important as it highlights the differences between the two disorders, supporting the ICD-11 diagnosis of CPTSD, separate from BPD and suggests the merger or replacement of BPD is inadvisable. Furthermore, it highlights the importance of the clinical assessment of the patient, which needs to accurately differentially diagnose presentations that may seem similar, as the recommended treatments for the conditions are different.

Perspectives