School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia.
Harv Rev Psychiatry. 2009;17(5):322-8. doi: 10.3109/10673220903271848.
There remains controversy surrounding the nature of the relationship between borderline personality disorder and posttraumatic stress disorder, with strong arguments that it would be more accurate and less stigmatizing for the former to be considered a trauma spectrum disorder. This article reviews the major criticisms of the DSM-IV diagnosis of borderline personality disorder that have fueled this controversy, including the absence of an etiology for the disorder, which is widely believed to be associated with early traumatic experiences. Also reviewed are recent attempts to redefine the disorder as a trauma spectrum variant based on the apparent overlap in symptomatology, rates of diagnostic comorbidity, and the prevalence of early trauma in individuals with a borderline diagnosis. The conceptual and theoretical problems for these reformulations are discussed, with particular reference to discrepancies in theoretical orientation, confusion of risk with causation, and the different foci of interventions for borderline personality disorder and posttraumatic stress disorder.
围绕边缘型人格障碍和创伤后应激障碍之间的关系性质仍存在争议，强有力的观点认为，将前者视为创伤谱系障碍更为准确，也更少污名化。本文回顾了推动这一争议的 DSM-IV 边缘型人格障碍诊断的主要批评意见，包括该障碍的病因缺失，人们普遍认为该障碍与早期创伤经历有关。本文还回顾了最近根据症状表现、诊断共病率以及边缘型人格障碍个体中早期创伤的发生率明显重叠，尝试将该障碍重新定义为创伤谱系变异的尝试。本文讨论了这些重新制定的概念和理论问题，特别提到了理论取向的差异、风险与因果关系的混淆，以及边缘型人格障碍和创伤后应激障碍干预的不同重点。
