Re-examining the comorbidity between borderline personality disorder and post-traumatic stress disorder: a systematic narrative review
Bibliographic record
Abstract
BACKGROUND: Borderline personality disorder (BPD) and post-traumatic stress disorder (PTSD) frequently co-occur, yet research on this comorbidity is limited. Recent advancements in this area have led to the emergence of new studies that provide insight into the relationship between these disorders, potential treatment interventions, and the ongoing debate surrounding the diagnosis of Complex PTSD. This review aims to examine these findings and evaluate whether they address key gaps identified in the review by Frías & Palma (Psychopathology 48(1):1–10, 2014). METHODS: A literature search was conducted using Medline and PsycINFO databases covering the period from 2014 and 2024, using the following descriptors: ‘post-traumatic stress disorder’, ‘posttraumatic stress disorder’, ‘PTSD’, ‘borderline personality disorder’, and ‘BPD’. RESULTS: A total of 27 studies met the inclusion criteria for examining this comorbidity, with the majority focusing on psychotherapy treatments. Consistent with previous findings, high comorbidity rates persist in clinical and community samples, and emotion dysregulation appears to be a core feature of BPD-PTSD. Contrary to common belief, a comorbid diagnosis of PTSD did not hinder treatment effectiveness, and individuals with a dual diagnosis showed improvements comparable to those with either disorder alone. Although some patients report increased distress or dysfunction, BPD-specific, trauma-focused, and integrated treatments are well-accepted in BPD-PTSD populations. While BPD-specific interventions are beneficial in managing BPD symptoms, evidence suggests that trauma-focused treatments are the most validated and central approaches for addressing this comorbidity. Incorporating emotion regulation techniques as strategies within or alongside trauma-focused treatments may further enhance outcomes for individuals with BPD-PTSD. CONCLUSIONS: Our review builds on evidence that this comorbidity is treatment responsive. Despite the expanding understanding of these co-occurring disorders, gaps in the literature prevail. Further research on the prevalence, course, and etiology is needed, as well as on the efficacy of psychopharmacology treatments and the underrepresentation of men in BPD-PTSD samples.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.045 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.005 |
| Bibliometrics | 0.015 | 0.012 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".