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Other Overlap of PTSD with personality disorders

Rose White

I read something yesterday about the overlap of gender identity disorder with NPD and BPD. There is a similar overlap with autism and NPD (not sure about BPD.). And there are overlaps with PTSD and Autism.

I used to think I had autism and BPD. My dad had signs of having NPD. My ego was enmeshed with his. I see signs of NPD in myself and maybe BPD to a very small extent but used to be greater.

I learned that the old way of thinking that BPD is mostly caused by trauma is falling out of favor. Likely something similar for NPD.

Side note I also read a study on addiction to internet trolling (bullying online) and found out that the idea that someone who bullies has low self esteem is simply not true. Maybe about half of them do. About half actually have good self esteem. Which was kind of a lightbulb moment for me as a teacher who witnesses bullying—some of the bullies have high or average self esteem.

Which, back to my question, I don’t think that all people with NPD and BPD get it from low self esteem and trauma. I believe there is a theory that a person is genetically vulnerable to the condition and then events can set it off.

So having PTSD may not even be the cause for someone having BPD or NPD or the another PD.

Anyway, we have casually talked about on here how people with PTSD are more selfish than people without PTSD, broadly speaking.

So I’m curious how many with PTSD have a personality disorder or suspect they have one.
So having PTSD may not even be the cause for someone having BPD or NPD or the another PD.
Never will.

TRAUMA causes one whole helluva lotta possible variations/reactions… with PTSD just being one of many.

So I’m curious how many with PTSD have a personality disorder or suspect they have one.
I have transitory traits from half a dozen different personality disorders. But??? Zero childhood trauma & the fact that they’re transitory, means I am disallowed… twice… from any kind of PD Dx.

That’s actually super common with complex trauma histories.

The same way, ish, that’s super common with drug abuse histories. (And also why drugs disqualify a person from those diagnoses. Because those symptoms are drug induced, rather than innate, or enduring and persistent).

Ish… because when people sober up, with drug abuse histories, they cease exhibiting symptoms. But with complex trauma? Those symptoms are as cyclic and reactive as PTSD symptoms are cyclic and reactive… if and only if… they also have a PTSD diagnosis. If they have another DX aside from PTSD? Those PD symptoms tend to emulate the same course their pre-existing disorder does. Like people with OCD tend to exhibit ABC, whilst people with GAD tend to exhibit XYZ, etc.

So… NOPE! No PD, here. But? I do have traits of several. Off & on.

I’m okay with that.

I have PTSD.
I have ADHD.
I have a few things “beyond the scope” of either… that are absurdly common amongst “my people”, so much so as to be the expected end result. Shrug. Psych is a soft science.
Never will.

TRAUMA causes one whole helluva lotta possible variations/reactions
Good catch. Interesting about the childhood trauma; my understanding is that the idea that ACES are a requirement for the development of PD’s is changing. Makes sense that the presence of addiction would obfuscate any PD Dx. My understanding is that the same is true for diagnosing children and especially teens with PD’s. It’s common and even typical for them to have a grandiose (younger age) or unstable (teen age) sense of self, so it’s not helpful to give a Dx of PD until their development is complete.

I found your global approach to explaining helpful.
my understanding is that the idea that ACES are a requirement for the development of PD’s is changing.
Can you elaborate on this?

My understanding is that there’s pretty strong evidence that while ACEs is a sloppy way to measure, there’s pretty persuasive evidence that trauma in childhood is very strongly linked to personality disorders (with a very strong link in BPD).

Research is increasingly being directed to the neurological changes caused by traumatic experiences in childhood which might explain why this happens, and also what role genetics have (for example, genes that predispose a person to PDs).

I’m very interested to read about it more if that’s not the case.
what role genetics have (for example, genes that predispose a person to PDs).
Basically this. That someone with a genetic predisposition would be vulnerable to developing it and ACES are an environmental condition that switches those genes on but that people with a genetic predisposition can develop it without ACES as well.

“Normal personality traits have a heritability in the 30-60% range.” The genetic epidemiology of personality disorders

“Findings from twin and adoption studies suggest that personality disorders are moderately to strongly heritable (heritability estimates between 30% and 80%)”

“Current research supports the theory that there is a large genetic component to whether a person develops BPD. Two genes—DPYD and PKP4—have been identified as increasing a person's risk of developing BPD. However, these genes are linked to schizophrenia and bipolar disorder risk, too.“

“childhood trauma is one of several risks for BPD, but is by no means the main etiological factor accounting for the development of this disorder.”
Yes, personality disorders aren't caused by PTSD. They're caused by genetic and environmental factors (just like PTSD is). They're often comorbid with PTSD because the factors that can cause them both often overlap, but you do not need a criterion A trauma as defined by PTSD, to develop a personality disorder. (And all a personality disorder really is is impairments in one's fixed/stable traits that interfere with socialization, so it's quite broad).

I think this is a case where people conflate trauma with PTSD, but they aren't interchangeable words. Nor does all trauma rise to the definition of criterion A. Most people who experience trauma do not go on to develop PTSD or a PD, which is why they're disorders - they're not the norm. Essentially they occur because the individual in question has failed to develop sufficient resiliency (in the scientific sense) to their circumstances, or their circumstances were genuinely insurmountable. Whether due to genetics, other neurodivergence, temperament, or overwhelming psychiatric injury beyond reasonable mechanisms of coping.

My family has at least 4 people with schizophrenia-spectrum illnesses and at least two with autism including my mom. I wound up with RAD, which is quite rare even in the most severe cases of abuse - it's clear that this has a genetic component, if most people who endure the same experiences don't end up with the disorder. Since my symptoms persisted past childhood, they have become my fixed/stable traits, hence personality disorder (SZPD) - but I have always been like this, from as early as I can recall, even before I was trafficked. That this disorder is on the schizophrenia spectrum makes perfect sense, considering my family history.

Think of it a little like cancer: your risk of developing lung cancer goes up if you smoke, but not all smokers will develop lung cancer - in fact, most smokers don't (the lifetime prevalence is highest in men, at 14.8%, sometimes rounded up to 20%, which means even at its highest, ~80% of smokers don't develop lung cancer). But, it's very obvious that there is a link between cancer and smoking, if 20% of smokers get cancer. Those 20% were more vulnerable to developing disease after being exposed to a risk factor, due to their physiological composition.
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