Latent Profile Analysis of Posttraumatic Stress Disorder, Complex Posttraumatic Stress Disorder, and Borderline Personality Disorder: A Replication and Extension

Abstract

The distinction between posttraumatic stress disorder (PTSD), complex PTSD (CPTSD), and borderline personality disorder (BPD) remains a subject of scientific debate, particularly in trauma-exposed populations where symptom overlap may be more frequent. This dissertation presents the findings of a latent profile analysis (LPA) that replicates and extends existing research on the discriminative validity of PTSD, CPTSD, and BPD symptoms. Participants were 509 undergraduate students with mixed-trauma exposure who completed measures of PTSD, CPTSD, BPD, and other trauma-related and clinical features. Results of the LPA indicated that a four-profile model revealed the best fit to the data and theoretical interpretability. The model included a “Comorbid” profile, characterized by high endorsement of all symptoms; a “High PTSD” profile, characterized by high levels of PTSD symptoms and comparatively lower levels of disturbances in self-organization (DSO) and BPD symptoms; a “High DSO and BPD” profile, characterized by low levels of PTSD symptoms and relatively higher levels of DSO and BPD symptoms; and a “Low Symptom” profile, characterized by low endorsement of all symptoms. Profiles were compared on multiple external correlates, including childhood maltreatment, trauma- and BPD-related features, clinical and personality pathology, and trauma history characteristics. Pairwise comparisons showed that the High PTSD and High DSO and BPD profiles are each related to external risk factors, but in distinct ways. The co-occurrence of PTSD and self-other dysfunction, as reflected in the Comorbid profile, appears to be associated with the highest levels of associated distress and impairment. Overall, PTSD symptoms appeared distinguishable from CPTSD and BPD symptoms; however, CPTSD and BPD symptoms exhibited a high degree of clinical and conceptual overlap. Findings highlight the need for continued refinement of CPTSD and BPD diagnostic frameworks.