Trauma-related altered states of consciousness in women with BPD with or without co-occurring PTSD

People with borderline personality disorder (BPD) who also have posttraumatic stress disorder (PTSD) report dissociative trauma-related altered states of consciousness (TRASC) less often than normal waking consciousness (NWC) symptoms. TRASC are more strongly linked to dissociative experiences and childhood emotional neglect than NWC symptoms are, especially in those with both BPD and PTSD. The prediction that TRASC symptoms would be less intercorrelated than NWC symptoms was not supported. The 4-D model categorizes trauma symptoms across time, thought, body, and emotion, each possibly experienced as normal or dissociative.

Study at a glance

Abstract

Background A “4-D model” was recently described as a theoretical framework for categorizing trauma-related symptoms into four phenomenological dimensions (the experience of time, thought, body, and emotion) that can present either in the form of normal waking consciousness (NWC) or as dissociative experiences, that is, trauma-related altered states of consciousness (TRASC). Methods The present study examined the predictions of the 4-D model in 258 persons with borderline personality disorder (BPD) with (n=126) versus without (n=132) posttraumatic stress disorder (PTSD). Results As measured by the Borderline Symptom List, consistent with the predictions of the 4-D model, in comparison with symptom endorsements theorized to be associated with NWC, measures of TRASC were less frequent, and more strongly correlated with both Dissociative Experience Scale scores and severity of childhood emotional neglect, particularly in persons with both BPD and PTSD. Our prediction that symptoms of TRASC would be less intercorrelated in comparison with distress associated with NWC symptoms, however, was not supported. Conclusions Findings are discussed as they pertain to the symptomatology of BPD, PTSD, and dissociation.