I think one thing that keeps getting mixed up on this thread is the difference between different types of TRAUMA and different diagnosis of different conditions that can be linked to trauma. (Please, correct me if I am wrong on any of this.)
I think everyone can agree there is different types of trauma, right? And different severity of trauma.
Severity of trauma does not always equal severity of PTSD symptoms. (I'm trying to find the studies I have on this one, and I will have to post them later.)
But there is car accident trauma, childhood/dveleopmental trauma, war trauma… etc.
And there is a condition, PTSD, that *some* people who go through trauma develop. Not all people who go through trauma develop PTSD.
What seems to be (hotly) debated, is if the diagnosis of complex PTSD, PTSD, and DESNOS as a condition, are differing things, and what makes them different. There also seems to be real debate over if complex PTSD is a diagnosis of a condition (not a diagnosis of a type of trauma EVENT) that should be used without a clear standard of diagnostic criteria for all providers to go off of. Many different sources publish criteria for the condition of complex PTSD, but there isn't one standard to use to as a diagnostic tool for people as having that condition. There just isn't. If there is one, that all providers use, please point me to it.
One thing I am trying to point out is that I see people on this thread use complex PTSD where it might be more appropriate to say a history of complex trauma.
One car accident in one person can bring on very severe PTSD in one person, and no PTSD in others. Severe repeated trauma can sometimes lead to not very severe PTSD in one person, and much more severe PTSD in others. The amount and type of trauma is not the only factor in developing PTSD. (Again, I will post links later when I can find them.)
Having a trauma history is a criteria for the condition of PTSD, but it's not always a predictor of the severity of PTSD.
You've pretty much just described how my CPTSD developed. I don't care if people can't acknowledge there is a difference. I know from having four distinct "types" of PTSD there is a difference. in 1999 I had PTSD from a car accident. In 2001, I had PTSD from nearly dying during labour. In 2002 I had PTSD from a sexual assault. In 2002-2007 I also had complex PTSD from the psychiatric abuse I suffered when seeking help for the birth trauma and then later the sexual assault. Ultimately, all four "types" fall into the PTSD symptoms.
@Butterflywings – whoa, respectfully, I would disagree that you have "4 types of PTSD." You have 4 different kinds of TRAUMA, all of which have given you various symptoms of PTSD.
For example, if I had diabetes, 4 different types of food may trigger symptoms disease of diabetes. Some foods may set off hypoglycemia, some may set off hyperglycemia, one food may put me into a coma…. but it's all a part of the overall disease process of diabetes. It’s not various forms of diabetes.
Parsing it out into different forms of diabetes is making something overly complex when it doesn't need to be. A Diagnosis is a tools to help identify an overall disease process, not each individual symptom. Many symptoms can be a part of one diagnosis of one condition. i.e. One condition can cause many problems, but it doesn't mean each problem needs a separate diagnosis if they are all due to the same disease process. Am I making any sense?
Basically the way you've worded it "70% of those diagnosed with BPD meet the criteria for CPTSD" says it's all.
The studies show that 70% of people with BPD have TRAUMA histories. Having a trauma history does not always equal having any form of PTSD. From
http://www.aapel.org/bdp/BLptsdUS.html:
“* Sansone RA, Sansone, Wiederman M. - Department of Psychiatry, University of Oklahoma College of Medicine, Tulsa, the USA. 1995 Arch Fam Med - Trauma Prevalence and links with borderline personality disorder and self-destructive behaviors
Traumatic events were reported by 70.7% of the borderline subjects. (aapel: For 30% thus, the cause is different) Among them 25.8% sexual abuse, 36.4% physical abuses, 43.7% emotional abuses, 9.3% physical negligence and 43.0% witnesses of violence”
So 70% of people with BPD have been through traumatic events. This does not mean they have PTSD. They are much more likely than the general population to have PTSD, but it's not at 70%.
The number of people with BPD who also have the condition of PTSD is actually lower than 70% - it’s 26% to 57%. (
[DLMURL="http://ajp.psychiatryonline.org/article.aspx?articleID=176500"]http://ajp.psychiatryonline.org/article.aspx?articleID=176500[/DLMURL]) It’s actually not higher for Borderline Personaility Disorder than it is for other personality disorders. From that last linked study, “Compared to subjects without borderline personality disorder, subjects with borderline personality disorder had significantly higher rates of childhood/adolescent physical abuse (52.8% versus 34.3%) and were twice as likely to develop PTSD.”
In fact, the study goes further to compare BPD with rates of trauma and PTSD for other personaility disorders, and they found BPD isn't the highest.
“The associations with both trauma and PTSD were not unique to borderline personality disorder;
paranoid personality disorder subjects had an even higher rate of comorbid PTSD than subjects without paranoid personality disorder, as well as elevated rates of physical abuse and assault in childhood/adolescence and adulthood.”
“The associations of personality disorder with early trauma and PTSD were evident, but modest, in borderline personality disorder and were not unique to this type of personality disorder. The results do not appear substantial or distinct enough to support singling out borderline personality disorder from the other personality disorders as a trauma-spectrum disorder or variant of PTSD.”
“Borderline personality disorder was initially conceptualized as a mild form of schizophrenia, later as a variant of an affective disorder, and more recently as a variant of a traumatic stress disorder. The present findings of a relatively high rate of childhood physical abuse in persons with borderline personality disorder are largely consistent with the literature suggesting that trauma often precedes the development of borderline personality disorder. However, in light of these subjects’ high base rates of childhood trauma and PTSD, which were modestly and not uniquely associated with borderline personality disorder, the data do not support the idea that borderline personality disorder should be singled out from the other personality disorders as a trauma-spectrum disorder or variant of PTSD.”
Another summary about the data regarding possible causes of BPD is found at:
http://www.nimh.nih.gov/health/publications/borderline-personality-disorder/index.shtml From this article:
“Research on the possible causes and risk factors for borderline personality disorder is still at a very early stage. However, scientists generally agree that genetic and environmental factors are likely to be involved.”
“Studies on twins with borderline personality disorder suggest that the illness is strongly inherited.16,17 Another study shows that a person can inherit his or her temperament and specific personality traits, particularly impulsiveness and aggression.18 Scientists are studying genes that help regulate emotions and impulse control for possible links to the disorder.19 “
“Social or cultural factors may increase the risk for borderline personality disorder. For example, being part of a community or culture in which unstable family relationships are common may increase a person's risk for the disorder.1 Impulsiveness, poor judgment in lifestyle choices, and other consequences of BPD may lead individuals to risky situations. Adults with borderline personality disorder are considerably more likely to be the victim of violence, including rape and other crimes.”
And, going back to the ability to get better with BPD, this article later on states:
“Some symptoms of borderline personality disorder may come and go, but the core symptoms of highly changeable moods, intense anger, and impulsiveness tend to be more persistent.34 People whose symptoms improve may continue to face issues related to co-occurring disorders, such as depression or post-traumatic stress disorder.4 However, encouraging research suggests that relapse, or the recurrence of full-blown symptoms after remission, is rare. In one study, 6 percent of people with borderline personality disorder had a relapse after remission.4”
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Aspergers individuals never recover and they are actually much more frustrating to deal with than traums survivors- they do not have thick skin they have an inability to empathize. Many people believe jeffrey dahmer was an aspergers sufferer. I knew someone with aspergers who burned a cat"accidentally" on his stove top and put it in a garbage bag to dispose of it. Ihe then bought another cat to "keep him company and it died too. He worked but everyone knew there was something seriously wrong with him except for him-most people thought he was developmentally disabled due to his lack of hygeine and non concern for his offputting self. I asked him not to get any more animals because of his incompetence but due to his overestimation of himself he failed to comprehend it. I tried to explain decency to him such as respect for a creature who gave him comfort and the need for burial or cremation which was lost on him. I ended contact because I really cannot see the difference between a psychopath and him
@junglegirl - can you explain what you mean further? It seems like you are equating Aspergers to people with no moral compass - or maybe you are equating it more to psychopathy, not Aspergers. I actually don't quite follow you very well here.
It is true that many people do believe Dahmer had Asperger's. Bringing in Jeffery Dahmer is a little extreme and unclear of a comparison - he was a psychopath. Most of all, he was a cannibal and serial killer. It is a little dangerous to use such a horrible person to explain a condition many people have that are not violent - Aspergers. It's also not a clear comparision because Dahmer had other mental health issues. So does the other person you speak of above. Developmental delays are something that are separate from Aspergers. (It is possible to have one with or without the other.) There could be so many reasons why he did what he did to the cat, I'm not sure I would stick it to having Aspergers, but Psychopathy - which you did mention.
One of the biggest animal rights advocates out there is Temple Grandin, who has Austim, which is similar to but not Aspergers, but it is commonly believed people with austim can't empathtize either, and yet some do! She was my professor as an undergrad, and she is one of the most compassionate people I have known.
@Butterflywings, Grandin changes her mind quite often. So do other people I know with Aspergers or Austim. It's not a trait of the condition to "never" change their minds.
That all being said, it is dangerous when any of us a group of people and characterizing them on the basis of their worst or best examples. It's like if someone said all people with PTSD are violent, because a couple of people with PTSD have killed others. That kind of statement would probably upset most everyone here. (And here I am making generalizations myself!)
Hmmm, perhaps I have confused the topics all the more?
Aspergers and BPD are two very different things. So are BPD and PTSD.
