Pugliese Erica, Visco-Comandini Federica, Papa Carolina, Ciringione Luciana, Cornacchia Lucia, Gino Fabiana, Cannito Loreta, Fadda Stefania, Mancini Francesco
Associazione di Psicologia Cognitiva APC e Scuola di Psicoterapia Cognitiva SPC, 00185 Roma, Italy.
Department of Psychology, Sapienza University of Rome, 00185 Roma, Italy.
Brain Sci. 2024 Aug 25;14(9):856. doi: 10.3390/brainsci14090856.
This work aims to shed light on the differential diagnosis of complex post-traumatic stress disorder (cPTSD), post-traumatic stress disorder (PTSD), and borderline personality disorder (BPD) within the context of intimate partner violence (IPV), which represents a highly innovative field of clinical research. To this end, a critical review of the literature was conducted to identify and compare the clinical patterns and symptomatic overlaps among cPTSD, PTSD, and BPD, with an emphasis on their manifestation in both IPV victims and offenders. The results show that despite some symptomatic similarities, cPTSD, PTSD, and BPD have distinct clinical patterns of interpersonal violence. Specifically, disturbances in self-organization (DSO) are more commonly found in offenders, while the diagnosis of cPTSD seems more aligned with the psychological functioning of victims. In addition, cPTSD and specific characteristics of BPD, such as fear of rejection and instability of identity, constitute risk factors for IPV victimization. cPTSD is shown as a predisposing factor not only for IPV victims but also for offenders, while PTSD emerges as a consequential factor. The specific pathways linking PTSD, cPTSD, and BPD with IPV have significant implications for clinical practice. Further research is needed to understand these profiles and the mechanisms linking trauma-related features to IPV, which is crucial for implementing effective violence prevention programs.
这项工作旨在阐明亲密伴侣暴力(IPV)背景下复杂创伤后应激障碍(cPTSD)、创伤后应激障碍(PTSD)和边缘性人格障碍(BPD)的鉴别诊断,这是一个极具创新性的临床研究领域。为此,对文献进行了批判性综述,以识别和比较cPTSD、PTSD和BPD之间的临床模式和症状重叠,重点关注它们在IPV受害者和施暴者中的表现。结果表明,尽管存在一些症状相似性,但cPTSD、PTSD和BPD在人际暴力方面具有不同的临床模式。具体而言,自我组织障碍(DSO)在施暴者中更为常见,而cPTSD的诊断似乎与受害者的心理功能更为相符。此外,cPTSD和BPD的特定特征,如害怕被拒绝和身份不稳定,构成了IPV受害的风险因素。cPTSD不仅被证明是IPV受害者的一个诱发因素,也是施暴者的诱发因素,而PTSD则是一个结果因素。将PTSD、cPTSD和BPD与IPV联系起来的具体途径对临床实践具有重要意义。需要进一步研究以了解这些特征以及将创伤相关特征与IPV联系起来的机制,这对于实施有效的暴力预防计划至关重要。