Trauma, Diagnosis, and Borderline Personality Disorder: The Need for Conceptual Clarity

This paper explores the relationship between borderline personality disorder (BPD) and trauma, including the development of the construct of complex posttraumatic stress disorder (cPTSD). While trauma, particularly in childhood, is frequently associated with BPD, it is not a sufficient or necessary cause, suggesting a multi-causal model involving genetic vulnerability, environmental factors, and temperament. The paper examines the validity and clinical implications of cPTSD as introduced in the ICD-11, analyzing arguments that it either overlaps with, is a subtype of, or is distinct from BPD. Key issues in psychiatric diagnosis are addressed, including stigma, labeling, deliberate misdiagnosis, and ethical concerns in clinical practice. Through a review of empirical research and theoretical models, the paper concludes that while trauma may influence the development of BPD, it is not determinative, and accurate, nuanced diagnosis is essential for effective treatment planning and ethical social work practice.