Most with PTSD already border personality aspects, ie. the symptoms already cross-over, so you can't apply yourself into those streams, because meeting symptoms is not what a diagnosis is about, it goes further than that. Part of PTSD is dissociation and paranoia... but when these become more transitional and independent outside of PTSD, that is when physicians start looking in more depth and with focus at a specific element as being unique vs. being part of a normal PTSD symptom.
Those with complex trauma however; the definition of complex trauma means there IS without question a dissociative and/or personality disorder present, which is how complex trauma effects are defined. Whilst you may suffer abuse long term, it does not make it complex trauma if the end result is just PTSD. If you do however state your trauma is complex, ie. diagnosed as complex, then you fit smack within this range and do have a dissociative and/or personality disorder as well which must be managed and dealt with.
Both dissociative and personality disorders are all treatable, removable even... ie. remission, without question, just like PTSD, but it tends to take more time, longer duration treatment plan due to the complexities these disorders bring. Dissociation... not too bad, personality... all bad for treatment and often the people can be quite destructive.
Whilst I have always allowed those with a personality disorder here, there are some members who's disorders simply are too destructive, and often those members get removed, because it comes across the forum quite distinctly, just as it would to someone who was a friend of the person... they would have little to no friends, as relationships by others would be extremely difficult to handle, regardless of PTSD itself... the personality disorder would be chaotic if untreated via medication, and even then... still uniquely individual.
The Axis II disorders have three clusters, A, B & C. A is worst, B next level down, C the least issue... just more annoying, but usually not destructive, ie:
- Cluster A: Paranoid, Schizoid & Schizotypal (All Severe)
- Cluster B: Antisocial, Borderline, Histrionic & Narcissistic (Moderate to Severe)
- Cluster C: Avoidant, Dependent & Obsessive-Compulsive (Annoying, Not as Destructive)
There is obviously also a NOS for when it falls within the larger category cluster, but not specific to one or more.
Here is the broadest range in which a personality disorder is present, before a physician gets specific:
General diagnostic criteria for a Personality Disorder
A. An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture. This pattern is manifested in two (or more) of the following areas:
(1) cognition (i.e., ways of perceiving and interpreting self, other people, and events)
(2) affectivity (i.e., the range, intensity, lability, and appropriateness of emotional response)
(3) interpersonal functioning
(4) impulse control
B. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations.
C. The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.
D. The pattern is stable and of long duration and its onset can be traced back at least to adolescence or early adulthood.
E. The enduring pattern is not better accounted for as a manifestation or consequence of another mental disorder.
F. The enduring pattern is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., head trauma).
You can already read some cross-over with PTSD, so those aspects must obviously be evaluated at what is the primary disorder, usually PTSD wins, and then an Axis II becomes comorbid and/or Axis I dissociative does so, with PTSD, for those with complex trauma.
You can endure trauma for 10 years and just have PTSD, but that means your trauma is not complex, you just suffered trauma for a long time, that's it. The defined parameters for trauma becoming complex is the manifestation of protective measures the brain develops to endure the trauma, hence trauma has now become complex trauma, as you are no longer just dealing with the effects of trauma, you are dealing with substantial protection mechanisms, whether dissociative or personality based, both even, to also get past.