ICD-11 Complex Posttraumatic Stress Disorder and Subclasses of Borderline Personality Disorder in a Korean General Population Sample with Childhood Abuse Experiences: A Latent Class Analysis

Background: Complex posttraumatic stress disorder (CPTSD) and borderline personality disorder (BPD), which are distinctive diagnoses, share the common risk factor of childhood abuse experiences. However, additional evidence is needed to determine which factors contribute to the manifestation of different symptoms. Method: Participants were 499 Korean adults sampled from an online panel of a general population sample who reported experiences of childhood abuse. A latent class analysis (LCA) was conducted to identify the patterns of CPTSD and BPD symptoms. We adopted a three-step LCA to compare types of childhood abuse, invalidating environments, attachment styles, and pathological personality traits among different classes. Results: The LCA revealed four classes: a CPTSD and BPD “comorbid” class, an “externalizing BPD” class, an “avoidant BPD” class, and a low symptom class. The “comorbid” class showed the highest scores in all symptoms and risk factors. The “externalizing BPD” class was distinguished from the “avoidant BPD” class by the externalizing versus internalizing associated pathological personality traits. The “avoidant BPD” class experienced high emotional neglect in addition to other types of abuse and it also showed an additional avoidant attachment style. Conclusion: Childhood abuse may heighten the risk for high comorbidity of CPTSD and BPD as well as externalizing-internalizing subgroups of BPD. Beyond the identification of CPTSD and BPD, assessing attachment styles and pathological personality traits based on dimensional approaches would benefit the tailoring of effective treatment.