Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder Using Exploratory Structural Equation Modeling in a Trauma-Exposed Urban Sample

Borderline Personality Disorder (BPD) and Complex Posttraumatic Stress Disorder (CPTSD): A Network Analysis in a Highly Traumatized Clinical Sample

“…Hyland et al, 2019), where statistically significant cross-loadings were observed for both AD items with AD1 being more predictive of BPD than DSO in exploratory structural equation modelling analysis. Powers et al (2022) also suggest that AD1 presented salient cross loading with BPD. The present study reinforces this finding considering that the network model obtained provided no bridges between AD1 and other DSO, and indeed PTSD, nodes.…”

“…However, our results also suggest that two symptoms of CPTSD, namely, "When I am upset, it takes me a long time to calm down." (AD1) and "I feel numb or emotionally shut down" (AD2), were the only symptoms connecting the BPD with CPTSD constructs and potentially contribute to the overlap of the two conditions (Powers et al, 2022;Frost et al, 2020). Both AD1 and AD2 are part of the "Affective Dysregulation" (AD) symptom cluster of the CPTSD.…”

“…Despite the high interrelatedness of symptoms of PTSD, CPTSD and BPD, as exemplified in both substantial factor analysis cross loadings (Powers et al, 2022), and latent class analysis results showing high occurrence of BPD and CPTSD symptoms together (Frost et al, 2020;Jowett et al, 2020), there is currently only one study that investigated symptoms of PTSD, CPTSD and BPD using network analysis (Knefel et al, 2016). The network analysis approach is fitting in the case of contested validity of mental disorder classification as it assumes a bottom-up approach as opposed to a predefined approach by examining the interaction of symptoms as constituting a mental disorder.…”

“…Others have supported the notion that PTSD, CPTSD and BPD symptoms only occur together with no distinct BPD class (Saraiya et al, 2021) and others proposed that CPTSD is the by-product of comorbid BPD and PTSD (Kulkarni, 2017). Furthermore, Powers et al (2022), by using exploratory structural equation models, compared the diagnosis of BPD and PTSD using DSM-5 criteria and BPD and CPTSD using the ICD-11 criteria. They concluded that under DSM-5 classifications, the overlap between BPD and PTSD is substantial.…”