Traumatic life events, temperament and character in patients with borderline personality disorder and complex posttraumatic stress disorder

Background: Traumatic life events are especially prevalent in persons with borderline personality disorder (BPD). Therefore, it has been assumed that many of those patients also suffer from a complex posttraumatic disorder (complex PTSD). In the current study we investigated the prevalence of complex PTSD among patients with BPD. Furthermore, we explored if BPD patients without complex PTSD differ from those with complex PTSD with respect to the kind of trauma experienced, age of first traumatization, temperament and character configuration. Patients and Methods: We investigated 51 inpatients with a BPD diagnosis (age: 26.5 +/- 7.57 years) who were treated at the University of Greifswald Hospital. These patients were assessed with regards to temperament and character, prevalence and kind of traumatic life events, and existing complex PTSD. Results: Out of these patients, 41 (80.4%) reported to have experienced at least one traumatic event in their life, and 31.4% met criteria for complex PTSD in addition to BPD. In comparison to BPD patients without complex PTSD, inpatients with BPD and complex PTSD were characterized by a significantly higher rate of type-II-trauma. Regarding the four dimensions of temperament assessed ( novelty seeking, harm avoidance, reward dependence and persistence) we found significantly higher levels of harm avoidance in BPD patients with complex PTSD compared to those without. Conclusions: Concerning subsequent development of complex PTSD, our findings underline the importance of dispositional conditions, such as increased behavioral inhibition, and traumatic life-experiences. When considering treatment and adequate differential diagnosis, our results indicate that patients with BPD and complex PTSD need modified treatment that takes into account the severity of the disorder as well as the meaning of traumatization.