Clinician bias in the diagnosis of posttraumatic stress disorder and borderline personality disorder.

Woodward, Halley E.; Taft, Casey T.; Gordon, Richard A.; Meis, Laura

doi:10.1037/a0017944

Cited by 19 publications

(9 citation statements)

References 14 publications

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“…Recently, Frías and Palma [ 1 ] summarized the overlap in psychopathological mechanisms of BPD and PTSD by referencing empirical support for the characterization that both disorders exhibit more dissociative symptoms than (a) healthy controls and/or (b) other mental disorders. Despite what seems to be a narrow phenomenological overlap between BPD and PTSD, the clinical presentation of these two disorders can be easily confused [ 11 , 12 ]. Furthermore, influential authors on the topic, Herman and van der Kolk [ 13 ], described apparent similarities of disturbance across BPD and PTSD in the core domains of affect regulation, impulse control, reality testing, interpersonal relationships, and self-integration.…”

Section: Comparing Bpd and Ptsdmentioning

confidence: 99%

The comorbidity of borderline personality disorder and posttraumatic stress disorder: revisiting the prevalence and associations in a general population sample

Scheiderer

Wood

Trull

2015

bord personal disord emot dysregul

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BackgroundThe comorbidity of borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) is frequent, yet not well understood. The influence of childhood sexual abuse (CSA) in the development of this comorbidity has been a focus of prior clinical studies, but empirical evidence to generalize this focus to the broader population is lacking. Primary aims of the present study included evaluation of: (a) the association of this comorbidity with decrements in health-related quality of life (HRQOL) and (b) the importance of CSA as a predictive factor for this comorbidity in a general population sample.MethodsWe utilized data from Wave 2 of the National Epidemiological Survey on Alcohol and Related Conditions, a nationally representative face-to-face survey evaluating mental health in the non-institutionalized adult population of the United States. Data from respondents who met criteria for BPD and/or PTSD were analyzed (N = 4104) to assess potential associations between and among lifetime BPD-PTSD comorbidity, CSA, gender, healthcare usage, and mental and physical HRQOL.ResultsLifetime comorbidity of BPD and PTSD was associated with more dysfunction than either individual disorder; and the factors of gender, age, and CSA exhibited significant effects in the prediction of this comorbidity and associated decrements in HRQOL.ConclusionsResults support the measured focus on CSA as an important, but not necessary, etiologic factor and emphasize this comorbidity as a source of greater suffering and public health burden than either BPD or PTSD alone. The differential impact of these disorders occurring alone versus in comorbid form highlights the importance of diagnosing both BPD and PTSD and attending to lifetime comorbidity.

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Section: Comparing Bpd and Ptsdmentioning

confidence: 99%

The comorbidity of borderline personality disorder and posttraumatic stress disorder: revisiting the prevalence and associations in a general population sample

Scheiderer

Wood

Trull

2015

bord personal disord emot dysregul

View full text Add to dashboard Cite

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“…However, the authors do not report on the closeness of the relationship to the perpetrator, so it is not possible to differentiate between the levels of betrayal present. A recent study by Woodward, Taft, Gordon, and Meis (2009) showed that clinicians, when evaluating ambiguous case vignettes of a person who experienced childhood sexual abuse that included symptoms of both BPD and PTSD, were not more likely to assign women the BPD diagnosis. Thus, clinicians were responding to the nature of the trauma, not the client's gender, when interpreting the case.…”

mentioning

confidence: 99%

Betrayal trauma and borderline personality characteristics: Gender differences.

Kaehler

Freyd

2012

Psychological Trauma: Theory, Research, Practice, and Policy

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Borderline Personality Disorder has been linked to both trauma and insecure attachment styles. Betrayal Trauma Theory proposes those who have experienced interpersonal trauma may remain unaware of betrayal in order to maintain a necessary attachment. This study attempts to replicate the association between self-reported betrayal trauma experiences and borderline personality characteristics found by Kaehler and Freyd (2009); however, this project includes participants from a community, rather than a college, sample. Using multiple regression, all three levels of betrayal (high, medium, and low) and gender were significant predictors of borderline personality characteristics. Separate regression analyses were conducted for both genders to explore the associations of betrayal trauma on these traits. For men, all three levels of betrayal trauma were significant predictors; for women, only high and medium betrayal traumas were significant. These findings suggest trauma may be a key factor of borderline personality disorder, with differential effects for betrayal and gender.

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“…High rates of CSA among psychiatric patients were also reported earlier by other authors (Herman, ; Read, ). Further, Herman () stated that this group of traumatised patients is frequently misdiagnosed and poorly treated in the mental health system, a view that is supported by Woodward, Taft, Gordon, and Meis (). If the aftermath of CSA is not acknowledged and treated, there is a risk that the health problems will remain.…”

Section: Introductionmentioning

confidence: 99%

Psychological distress among women who were sexually abused as children

2012

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One of the aims of the study was to investigate how participants in self‐help groups (SHG) for women (n = 87) who had been sexually abused in childhood rated their mental health and to what extent they were at risk of developing posttraumatic stress disorder (PTSD). A further aim was to investigate the relationship between the ratings of mental health, occurrence of PTSD, women's interpersonal relationships, reasons for participating in an SHG and characteristics of the childhood sexual abuse (CSA). The participants completed questionnaires regarding their personal relationships, reasons for joining a group, abuse characteristics, mental health (Symptom Checklist‐90‐Revised) and PTSD (Impact of Event Scale‐Revised). The women showed poor mental health, and more than half of them were at risk of developing PTSD. Lack of social support and feelings of shame correlated with poor mental health, whereas guilt did not. Relationships with female friends had a positive association. Further research is needed to determine whether participating in an SHG could provide adequate social support and reduce feelings of shame, thereby contributing to the healing process in the aftermath of CSA. Key Practitioner Message: • Child abuse is a significant component of the global burden of disease; • Both social workers and public health care providers meet sexually abused girls and it is important that they have knowledge about the subject; • An important clinical implication for adequate treatment would be to assess and recognise childhood sexual abuse and to link diagnosis to trauma.

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Clinician bias in the diagnosis of posttraumatic stress disorder and borderline personality disorder.

Cited by 19 publications

References 14 publications

The comorbidity of borderline personality disorder and posttraumatic stress disorder: revisiting the prevalence and associations in a general population sample

The comorbidity of borderline personality disorder and posttraumatic stress disorder: revisiting the prevalence and associations in a general population sample

Betrayal trauma and borderline personality characteristics: Gender differences.

Psychological distress among women who were sexually abused as children

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