Is Dissociation an Integral Aspect of Borderline Personality Disorder, Or Is It a Comorbid Disorder?

Although two-thirds of people diagnosed with borderline personality disorder (BPD) have dissociative symptoms, the nature of BPD dissociative experiences, their mechanisms, and their relationship to BPD pathology are not well understood. The risk factors for BPD are diverse, the dissociative symptoms vary greatly, and the symptoms of BPD are heterogeneous. We propose this heterogeneity is best addressed by studying subgroups of BPD (i.e., those with low, moderate, and high levels of dissociative symptoms). A quarter to one-third of persons diagnosed with BPD have negligible dissociative symptoms. In the high group, less than a quarter have Dissociative Identity Disorder (DID). The middle group – the 50% of BPD cases with moderate dissociative symptoms – seems to involve a diverse and confusing mixture of neurodevelopmental, attachment, genetic, stress and trauma factors. Examination of these three groups suggests that BPD and Complex Dissociative Disorders are separate disorders that are sometimes comorbid.