Multiple and interpersonal trauma are risk factors for both post‐traumatic stress disorder and borderline personality disorder: A systematic review on the traumatic backgrounds and clinical characteristics of comorbid post‐traumatic stress disorder/borderline personality disorder groups versus single‐disorder groups

Jowett, Sally; Karatzias, Thanos; Albert, Idit

Abstract

Background: Both BPD and PTSD are associated with exposure to traumatic events and are highly comorbid. No review to date has addressed the clinical presentations and traumatic backgrounds associated with these disorders although this work is essential for the development of effective interventions.

Objectives: To systematically explore similarities and differences in traumatic history and clinical presentation in comorbid BPD and PTSD as compared to PTSD or BPD alone.

Method: The Web of Science, Cochrane Library, PsychInfo, Medline, and PILOTS databases were searched systematically. Eligible studies included adult populations, compared comorbid BPD/PTSD to a single disorder, and published in English.

Results: 10,147 cases across 33 studies were included; 2057 comorbid BPD/PTSD, 2648 BPD only, and 5442 PTSD only. The comorbid group overall reported greater exposure to multiple and interpersonal trauma and elevated emotion dysregulation compared to both single disorder groups. In terms of methodological quality, most papers achieved a Fair rating with improvements required in minimising bias through recruiting adequate and representative samples, and reporting on traumatic exposure.

Conclusion: Multiple and interpersonal trauma might have a unique role in the development of comorbid BPD/PTSD features, particularly so for emotion dysregulation. Future research is required to unravel the unique characteristics of interpersonal trauma that can generate BPD and PTSD symptoms.

Practitioner Points
• Practitioners should routinely assess for interpersonal trauma considering its impact
• Tackling emotional regulation difficulties might promote recovery from both PTSD and BPD symptoms
• Presence of self-injury might be used to discriminate between PTSD and BPD and offer suitable interventions

Citation

Jowett, S., Karatzias, T., & Albert, I. (2020). Multiple and interpersonal trauma are risk factors for both post‐traumatic stress disorder and borderline personality disorder: A systematic review on the traumatic backgrounds and clinical characteristics of comorbid post‐traumatic stress disorder/borderline personality disorder groups versus single‐disorder groups. Psychology and Psychotherapy: Theory, Research and Practice, 93(3), 621-638. https://doi.org/10.1111/papt.12248

• Journal Article Type: Article
• Acceptance Date: Jul 12, 2019
• Online Publication Date: Aug 24, 2019
• Publication Date: 2020-09
• Deposit Date: Jul 22, 2019
• Publicly Available Date: Aug 25, 2020
• Electronic ISSN: 2044-8341
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 93
• Issue: 3
• Pages: 621-638
• DOI: https://doi.org/10.1111/papt.12248
• Keywords: Post Traumatic Stress Disorder; PTSD; Borderline Personality Disorder; BPD; trauma; comorbidity; emotion dysregulation
• Public URL: http://researchrepository.napier.ac.uk/Output/1985892
• Contract Date: Jul 22, 2019