Ealing Recovery Team East.
School of Health and Social Care, Edinburgh Napier University.
Personal Disord. 2020 Jan;11(1):36-45. doi: 10.1037/per0000346. Epub 2019 Jul 1.
Complex posttraumatic stress disorder (CPTSD) has been included as a diagnostic category in the International Classification of Diseases, 11th Edition, consisting of six symptom clusters: the three PTSD criteria of reexperiencing, avoidance, and hypervigilance, in addition to three disturbances of self-organization (DSO) symptoms defined as emotional dysregulation, interpersonal difficulties, and negative self-concept. As borderline personality disorder (BPD) shares similar features to DSO presentations and is commonly associated with PTSD, there is debate as to whether and how CPTSD is distinct from PTSD comorbid with BPD. This article aimed to identify groups with distinct profiles of self-reported CPTSD and BPD symptoms and associated trauma history characteristics. A latent class analysis (LCA) using CPTSD and BPD symptom variables was conducted on a sample of 195 treatment-seeking adults at a specialist trauma service. The classes were then compared on demographic and clinical characteristics using a series of analysis of variance and χ2 tests. The latent class analysis determined three distinct classes: a CPTSD/High BPD class characterized by high symptom endorsement across both conditions, a CPTSD/Moderate BPD class characterized by high PTSD and DSO symptom endorsement and moderate BPD, and a PTSD/Low BPD class characterized by PTSD symptoms and low DSO and BPD symptom endorsement. The two CPTSD classes were associated with greater exposure to multiple, interpersonal traumas earlier in life and exhibited higher functional impairment. Findings support the construct of a CPTSD diagnosis as a separate entity although BPD features seem to overlap greatly with CPTSD symptoms in this highly traumatized clinical sample. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
复杂性创伤后应激障碍(CPTSD)已被纳入国际疾病分类第 11 版的诊断类别,由六个症状群组成:重新体验、回避和过度警觉的三个创伤后应激障碍标准,以及三个自我组织障碍(DSO)症状,定义为情绪失调、人际关系困难和消极自我概念。由于边缘型人格障碍(BPD)与 DSO 表现具有相似特征,并且通常与 PTSD 相关,因此存在 CPTSD 是否与 PTSD 合并 BPD 存在区别以及如何区别的争议。本文旨在确定具有不同 CPTSD 和 BPD 症状报告和相关创伤史特征的患者群体。使用 CPTSD 和 BPD 症状变量对在专科创伤服务机构接受治疗的 195 名成年患者进行潜在类别分析(LCA)。然后使用一系列方差分析和 χ2 检验比较这些类别的人口统计学和临床特征。潜在类别分析确定了三个不同的类别:一个 CPTSD/高 BPD 类,其特征是两种疾病均有较高的症状表现;一个 CPTSD/中 BPD 类,其特征是 PTSD 和 DSO 症状表现高且 BPD 中度;一个 PTSD/低 BPD 类,其特征是 PTSD 症状和低 DSO 和 BPD 症状表现。这两个 CPTSD 类与生命早期更多的、人际间创伤暴露有关,并表现出更高的功能障碍。研究结果支持将 CPTSD 诊断作为一个独立实体的概念,尽管在这个高度创伤化的临床样本中,BPD 特征似乎与 CPTSD 症状有很大的重叠。