I think that BPD is a distinctly different dx than CPTSD; they should therefore NOT be used interchangeably.

That said, I also think that BPD and all the other PD's (e.g., antisocial, histrionic, narcissistic, avoidant, schizotypal, obsessive-compulsive, etc.) should be changed to a different name. --What that name is, I don't know, but something that is more in line with its etiology. For instance, BPD often stems from childhood neglect and childhood emotional abuse, more so than anything else, but often in conjunction with childhood sexual abuse. Such childhood trauma profiles point to certain sequelae that exact an unresolved developmental trauma disorder for both males and females and those who do not identify as binary. That said, not everyone with childhood trauma winds up with the same symptoms in adulthood. More recently, neuroscience is advancing research in this area and finding neurological differences between those with BPD and other disorders. It may be that BPD is a neurological disorder that gets activated through childhood trauma. It may also be that BPD is on a different spectrum than dissociation (some spectra do not include BPD on dissociation, whereas others do), or even trauma.

There are those who have been abused in childhood and have other PDs, such as antisocial, narcissistic, avoidant. But childhood trauma is not the only predictive variable for such PDs, whereas it would appear that all those with BPD have some link to childhood trauma. This distinction is important, especially in terms of treatment.

There are those whose narcissism or antisocial personality disorders do not affect their job or level of functioning, even if it affects their relationships (which they largely don't care about, at least not the conventional ones who move on easily and leave those left behind in pain). Some psychologists would say that they don't have a mental disorder because they don't appear in distress and their lives are functioning, whereas other professionals assert that they are most likely reluctant to seek treatment due to their rigid beliefs and social interactions, but are nonetheless mentally ill. The stigma attached to a character flaw is segregating, stigmatizing, and uninviting, so it comes as no surprise that they (as well as others with a wide range of mental disorders) would not wish to seek treatment. There's also the notion of high-functioning mental illnesses, where the detection of distress is hidden and/or where their symptoms are managed in some naturalistic form, such as protective factors found in the environment (e.g., social support, conservation of resources, social capital).

It would appear that the main etiology of BPD is their fear of abandonment - fear that is based on trauma triggers that remind them about early childhood betrayal wounds, including emotional neglect, emotional abuse - with or without the presence of other forms of child maltreatment. It should be considered an "abandonment phobia," or specific phobia, which interferes in their relationships in many of the same ways that other PDs or even other disorders interfere in relationships. Would you say that a person's autism spectrum disorder or substance use disorder affect relationships? Yes! Would you assign a personality disorder to them? Perhaps, perhaps not. Should you assign a personality disorder to them? IMHO, NO!

Specific types of trauma exact specific types of disorders based on a person's lack of strengths, lack of protective factors, biological makeup, etc. The heterogeneity of trauma is such that different forms of trauma will exact different responses, and different cultural beliefs will exact different responses, and different levels of protective factors will determine whether or not symptoms are present or not. The etiology is what matters in terms of those who are symptomatic, and not just the etiology of trauma types, but also the historical accounts of environmental pathogens (e.g., poverty, neighborhood violence, school violence) and historical strengths (e.g., intelligence, strengths, social support, social capital, high socioeconimic status).

Those with chronic, complex, or continuous trauma will exact different behaviors than those with BPD (or what I'd like to see as abandonment phobias); those with CPTSD, chronic PTSD (as they call it at the VA), or continuous traumatic stress (as they call it on articles related to immigrants and/or human trafficking victimization) are not afraid of abandonment (which is differentiated here from rejection, in the form of social stigma, as opposed to interpersonal abandonment). many are afraid of being retraumatized (or shall I say revictimized) in ways that do not concern abandonment. For example, a rape victim may have CPTSD if she was revictimized over a period of time with sexual violence and then fears men or anyone in a position of power. Another example would be those who are minorities and experiencing continuous (not past) traumatic stress in the form of microaggressions, and their fears of being retraumatized coupled with their anger at the injustices they feel in society when they are discriminated against represent another form of traumatic stress - which is continuous in nature, not past.

While we're on the topic, the nature for which those with BPD are treated, including those who have been misdiagnosed, is CONTINUOUS traumatic stress in the form of microaggression trauma, in many of the same ways that minorities are experiencing their race-based or ethnicity-based or age-based or ability-based traumas. It's no wonder their prognosis is poor, even with the many new types of of treatments offered to them today. What may have helped the founder of DBT, Linehan, who has acknowledged her BPD, is the social support and higher SES and higher reputation and other strengths she possessed to aid her in a high-functioning form of BPD in order to arrive at a treatment for BPD. Many people with BPD, or abandonment phobia, do not hold such strengths, which is an important distinction to make, and which could explain why some are "treatment-resistant," whereas others are not.

But where's the research?

Where's the acknowledgment of strengths?

Where's the differential diagnoses challenges?

Where's the therapy abuse sequela that adds to past traumas and is tantamount to continuous traumatic stress?

It would seem that there's a lack of genuine concern and care for those with BPD.

I DO NOT have BPD, but I've had friend who did have it. It's sad what they are continuing to go through. It's sad that they are continuing to suffer.