Self-identified trauma study
Research type
Research Study
Full title
Experiences of therapeutic services for people with histories of complex trauma: a mixed-methods study.
IRAS ID
317599
Contact name
Jessica Atkinson
Contact email
Sponsor organisation
Queen Mary University of London
Duration of Study in the UK
1 years, 8 months, 0 days
Research summary
Summary of Research
Complex PTSD (CPTSD) is a newly-identified disorder linked to adverse childhood experiences. CPTSD is categorised by traumatic memory in which the individual has difficulty organising their emotions, particularly around others after exposure to traumatic interpersonal victimisation. CPTSD symptomology includes affect dysregulation, identity dissociation and relational impairments, consistent negative self-image and risky behaviour. These difficulties are also displayed in individuals with a diagnosis of borderline personality disorder (BPD); a serious mental disorder characterised by a pervasive pattern of instability in interpersonal relationships, self-image, impulse control and affect regulation. Patients with BPD report high prevalence rates of negative childhood events such as neglect or childhood sexual abuse.
Similarities between these disorders have made them hard to distinguish, with this in mind, we will not try to differentiate between the disorders but focus on how the patient identifies with their diagnosis, and whether this influences their treatment. The stigma behind a BPD diagnosis could lead to individuals having a preference over diagnostic terms. Therefore, do individuals who have experienced trauma have a more beneficial treatment journey if they identify with their given diagnosis? And does stigma exists behind certain labels?
We will be recruiting adults through three personality disorder services, participants will be asked to complete a set of questionnaires investigating trauma, symptoms and functioning when they start their treatment and repeat some of these after 8 months. Additionally, some participants will be interviewed about their understanding of their diagnosis, their progress, how their identity has changed throughout therapy and any stigma they have faced. Clinicians will also be interviewed to gain an understanding on how both diagnoses fit within their values and remit of their service.
The study is funded by the ESRC through a LISS-DTP studentship.
Summary of Results
Complex PTSD (CPTSD) and borderline personality disorder (BPD) both stem from early relational trauma and display similar presentations; relationship impairments, affect dysregulation and disruption in self-awareness. With BPD being one of the most stigmatised mental health diagnoses, CPTSD could provide individuals with a less-stigmatised diagnosis that better reflects their experience. This study aimed to investigate how individuals who self-define as having experienced trauma identify with their given mental health diagnosis and understand the role of past trauma in their presenting difficulties. Additionally, it aimed to uncover whether patients believe stigma exists behind certain labels and how CPTSD fits within the remit of personality disorder services. The study adopted a mixed method research approach for collecting and analysing data which started with a quantitative phase followed by a qualitative phase. 23 service users from three different personality disorder services completed the online questionnaire, ten of which went on to be interviewed along with four clinicians. The findings showed CPTSD and BPD to be distinct clinical concepts. Most patients identified with their diagnosis of BPD and understood their presenting difficulties to be a result of trauma. However, the stigma attached to the BPD label impacted how individuals identified with it. CPTSD was found to be a less-stigmatised label that for some, represented their experiences better and felt less victim-blaming. Identity towards diagnosis was shown to be important as it helped individuals to be seen, understand themselves better and feel motivated for treatment. Clinicians should not avoid disclosing a BPD diagnosis but take time to describe the diagnosis in the context of a person’s life and experiences and provide them with reliable information they can share with their friends and family.
REC name
Social Care REC
REC reference
23/IEC08/0002
Date of REC Opinion
31 Mar 2023
REC opinion
Further Information Favourable Opinion