{"id":{"repo_id":"oxford-brookes","oai_identifier":"tle:fa410a82-9abe-4069-b57f-3dea322f98fa:d6bd9758-527a-46cd-bfe2-c433766e8fca:1"},"canonical_url":"https://search.dev.ndltd.org/etd/oxford-brookes/tle:fa410a82-9abe-4069-b57f-3dea322f98fa:d6bd9758-527a-46cd-bfe2-c433766e8fca:1","repository":{"repo_id":"oxford-brookes","name":"Oxford Brookes University","base_url":"https://radar.brookes.ac.uk/radar/oai"},"display":{"title":"The under-recognition of trauma in the diagnosis of Borderline Personality Disorder (BPD)","abstract":"BPD is a complex condition presenting with a wide array of features, making it difficult to diagnose and treat. Controversially, there is also concern about BPD misdiagnosis due to under-recognition of trauma and PTSD/CPTSD (Complex PTSD) because of common aetiology. PTSD/CPTSD has a better track record of successful treatment; as typically BPD treatment focuses more on symptoms, while PTSD/CPTSD treats underlying traumatic causes. Aim: The research objective is to assess if early screening for traumatic exposure and PTSD/CPTSD symptoms will enhance BPD diagnosis, and lead to improved treatment. Methodology: Following clinical and academic reviews, two stages were completed. Stage 1: Initially medical records of BPD (N=60) patients in three UK Mental Health Hospitals were examined for evidence of BPD, trauma, PTSD and CPTSD. Stage 2: Separate BPD outpatients (N=40) were screened for trauma, PTSD/CPTSD using a new simple ‘BPD Trauma Exposure and Reactions Screen’ (BTERS). Reliability and validity was then assessed using recommended reference instruments (CAPS and SIDES). Results: Trauma was recorded in 47% of the stage 1 medical records, 100% in stage 2, 92.5% trauma in childhood. Sixty percent of stage 2 patients suffered distressing non-life-threatening trauma consistent with Adjustment Disorder. High trauma percentages in BPD are explained by a combination of life-threatening trauma, requiring specialist PTSD/CPTSD treatment, and non-life-threatening, which is treatable using similar techniques by BPD clinicians without specialist training. Conclusions: Although insufficient evidence for BPD misdiagnosis was found, an under-diagnosis of comorbid PTSD/CPTSD was confirmed. Without initial screening (BTERS) of BPD patients, clinicians are missing PTSD/CPTSD diagnoses, and hence are losing the opportunity for early treatment for a significant percentage of BPD patients, which could be critical to improved recovery and reduced suicide rates.","abstract_html":"BPD is a complex condition presenting with a wide array of features, making it difficult to diagnose and treat. Controversially, there is also concern about BPD misdiagnosis due to under-recognition of trauma and PTSD/CPTSD (Complex PTSD) because of common aetiology. PTSD/CPTSD has a better track record of successful treatment; as typically BPD treatment focuses more on symptoms, while PTSD/CPTSD treats underlying traumatic causes. Aim: The research objective is to assess if early screening for traumatic exposure and PTSD/CPTSD symptoms will enhance BPD diagnosis, and lead to improved treatment. Methodology: Following clinical and academic reviews, two stages were completed. Stage 1: Initially medical records of BPD (N=60) patients in three UK Mental Health Hospitals were examined for evidence of BPD, trauma, PTSD and CPTSD. Stage 2: Separate BPD outpatients (N=40) were screened for trauma, PTSD/CPTSD using a new simple ‘BPD Trauma Exposure and Reactions Screen’ (BTERS). Reliability and validity was then assessed using recommended reference instruments (CAPS and SIDES). Results: Trauma was recorded in 47% of the stage 1 medical records, 100% in stage 2, 92.5% trauma in childhood. Sixty percent of stage 2 patients suffered distressing non-life-threatening trauma consistent with Adjustment Disorder. High trauma percentages in BPD are explained by a combination of life-threatening trauma, requiring specialist PTSD/CPTSD treatment, and non-life-threatening, which is treatable using similar techniques by BPD clinicians without specialist training. Conclusions: Although insufficient evidence for BPD misdiagnosis was found, an under-diagnosis of comorbid PTSD/CPTSD was confirmed. Without initial screening (BTERS) of BPD patients, clinicians are missing PTSD/CPTSD diagnoses, and hence are losing the opportunity for early treatment for a significant percentage of BPD patients, which could be critical to improved recovery and reduced suicide rates.","abstract_has_math":false,"creators":["Tallon, Doris"],"institution":"Oxford Brookes University","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":["Wellman, Nigel","Coombes, Lindsey","Oskrochi, Reza"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2014,"date_issued":"2014","date_published":"2014","updated_at":"2026-07-24T03:42:46Z","subjects":[],"languages":["en"],"rights":["All rights reserved"],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://doi.org/10.24384/jk4g-v037","outbound_label":"DOI","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Tallon, Doris","Wellman, Nigel","Coombes, Lindsey","Oskrochi, Reza"]},{"key":"dc:creator","label":"Author","values":["Tallon, Doris"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2014"]},{"key":"dc:publisher","label":"Institution","values":["Oxford Brookes University"]},{"key":"dc:type","label":"Dc Type","values":["thesis"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["en"]},{"key":"dc:rights","label":"Dc Rights","values":["All rights reserved"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://doi.org/10.24384/jk4g-v037","https://radar.brookes.ac.uk/radar/file/fa410a82-9abe-4069-b57f-3dea322f98fa/1/tallon2014under-recognition.pdf"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["BPD is a complex condition presenting with a wide array of features, making it difficult to diagnose and treat. Controversially, there is also concern about BPD misdiagnosis due to under-recognition of trauma and PTSD/CPTSD (Complex PTSD) because of common aetiology. PTSD/CPTSD has a better track record of successful treatment; as typically BPD treatment focuses more on symptoms, while PTSD/CPTSD treats underlying traumatic causes. Aim: The research objective is to assess if early screening for traumatic exposure and PTSD/CPTSD symptoms will enhance BPD diagnosis, and lead to improved treatment. Methodology: Following clinical and academic reviews, two stages were completed. Stage 1: Initially medical records of BPD (N=60) patients in three UK Mental Health Hospitals were examined for evidence of BPD, trauma, PTSD and CPTSD. Stage 2: Separate BPD outpatients (N=40) were screened for trauma, PTSD/CPTSD using a new simple ‘BPD Trauma Exposure and Reactions Screen’ (BTERS). Reliability and validity was then assessed using recommended reference instruments (CAPS and SIDES). Results: Trauma was recorded in 47% of the stage 1 medical records, 100% in stage 2, 92.5% trauma in childhood. Sixty percent of stage 2 patients suffered distressing non-life-threatening trauma consistent with Adjustment Disorder. High trauma percentages in BPD are explained by a combination of life-threatening trauma, requiring specialist PTSD/CPTSD treatment, and non-life-threatening, which is treatable using similar techniques by BPD clinicians without specialist training. Conclusions: Although insufficient evidence for BPD misdiagnosis was found, an under-diagnosis of comorbid PTSD/CPTSD was confirmed. Without initial screening (BTERS) of BPD patients, clinicians are missing PTSD/CPTSD diagnoses, and hence are losing the opportunity for early treatment for a significant percentage of BPD patients, which could be critical to improved recovery and reduced suicide rates."]},{"key":"dc:format","label":"Dc Format","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["The under-recognition of trauma in the diagnosis of Borderline Personality Disorder (BPD)"]}]}],"canonical_facts":{"dc:contributor":["Tallon, Doris","Wellman, Nigel","Coombes, Lindsey","Oskrochi, Reza"],"dc:creator":["Tallon, Doris"],"dc:date":["2014"],"dc:description":["BPD is a complex condition presenting with a wide array of features, making it difficult to diagnose and treat. Controversially, there is also concern about BPD misdiagnosis due to under-recognition of trauma and PTSD/CPTSD (Complex PTSD) because of common aetiology. PTSD/CPTSD has a better track record of successful treatment; as typically BPD treatment focuses more on symptoms, while PTSD/CPTSD treats underlying traumatic causes. Aim: The research objective is to assess if early screening for traumatic exposure and PTSD/CPTSD symptoms will enhance BPD diagnosis, and lead to improved treatment. Methodology: Following clinical and academic reviews, two stages were completed. Stage 1: Initially medical records of BPD (N=60) patients in three UK Mental Health Hospitals were examined for evidence of BPD, trauma, PTSD and CPTSD. Stage 2: Separate BPD outpatients (N=40) were screened for trauma, PTSD/CPTSD using a new simple ‘BPD Trauma Exposure and Reactions Screen’ (BTERS). Reliability and validity was then assessed using recommended reference instruments (CAPS and SIDES). Results: Trauma was recorded in 47% of the stage 1 medical records, 100% in stage 2, 92.5% trauma in childhood. Sixty percent of stage 2 patients suffered distressing non-life-threatening trauma consistent with Adjustment Disorder. High trauma percentages in BPD are explained by a combination of life-threatening trauma, requiring specialist PTSD/CPTSD treatment, and non-life-threatening, which is treatable using similar techniques by BPD clinicians without specialist training. Conclusions: Although insufficient evidence for BPD misdiagnosis was found, an under-diagnosis of comorbid PTSD/CPTSD was confirmed. Without initial screening (BTERS) of BPD patients, clinicians are missing PTSD/CPTSD diagnoses, and hence are losing the opportunity for early treatment for a significant percentage of BPD patients, which could be critical to improved recovery and reduced suicide rates."],"dc:format":["application/pdf"],"dc:identifier":["https://doi.org/10.24384/jk4g-v037","https://radar.brookes.ac.uk/radar/file/fa410a82-9abe-4069-b57f-3dea322f98fa/1/tallon2014under-recognition.pdf"],"dc:language":["en"],"dc:publisher":["Oxford Brookes University"],"dc:rights":["All rights reserved"],"dc:title":["The under-recognition of trauma in the diagnosis of Borderline Personality Disorder (BPD)"],"dc:type":["thesis"]},"updated_at":"2026-07-24T03:42:46Z"}