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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0304

Between trauma and personality: Diagnostic challenges in PTSD, complex PTSD, and borderline personality disorder

BETWEEN TRAUMA AND PERSONALITY: DIAGNOSTIC CHALLENGES IN PTSD, COMPLEX PTSD AND BORDERLINE PERSONALITY DISORDER

PTSD, complex PTSD, and borderline personality disorder can be distinguished by their core symptoms, trauma history, and course; because accurate differential diagnosis determines treatment selection, trauma-informed and longitudinal assessment is necessary.

The aim of this study is to review the key differences and overlaps among post-traumatic stress disorder (PTSD), complex PTSD (C-PTSD), introduced in ICD-11, and borderline personality disorder (BPD), and to discuss their implications for diagnosis and treatment. A narrative review focusing on diagnostic criteria, clinical features, and theoretical models was conducted, examining relevant studies and international classification systems to identify distinguishing features and areas of overlap. The comparison table lists the core features of PTSD as re-experiencing, avoidance, and hyperarousal; the features of BPD as emotional instability, instability in interpersonal relationships, identity disturbance, and impulsivity; and the features of C-PTSD as core PTSD symptoms accompanied by disturbances in self-organization (difficulties in affect regulation, negative self-concept, and interpersonal difficulties). Trauma history is characterized by a single or time-limited event in PTSD, frequently occurring early trauma in BPD (not required for diagnosis), and prolonged or repeated events in C-PTSD. In terms of course, PTSD symptoms emerge following the traumatic event, whereas BPD involves a pervasive pattern beginning in adolescence or early adulthood, and C-PTSD follows a course of chronic symptoms after prolonged trauma. Trauma exposure is common in all three conditions but differs in type, chronicity, and developmental timing. Treatment also differs: trauma-focused psychotherapy is recommended as the first-line treatment for PTSD, a phase-based and trauma-focused approach for C-PTSD, and specialized psychotherapies such as dialectical behavior therapy or mentalization-based therapy for BPD. In conclusion, because misdiagnosis may lead to inappropriate treatment, trauma-informed and longitudinal assessment is considered critical for improving diagnostic accuracy and guiding individualized interventions.

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