title: Trauma-related altered states of consciousness in women with BPD with or without co-occurring PTSD.
abstract: BACKGROUND
  A "4-D model" was recently described as a theoretical framework for categorizing trauma-related symptoms into four phenomenological dimensions (the experience of time, thought, body, and emotion) that can present either in the form of normal waking consciousness (NWC) or as dissociative experiences, that is, trauma-related altered states of consciousness (TRASC).
  
  
  METHODS
  The present study examined the predictions of the 4-D model in 258 persons with borderline personality disorder (BPD) with (n=126) versus without (n=132) posttraumatic stress disorder (PTSD).
  
  
  RESULTS
  As measured by the Borderline Symptom List, consistent with the predictions of the 4-D model, in comparison with symptom endorsements theorized to be associated with NWC, measures of TRASC were less frequent, and more strongly correlated with both Dissociative Experience Scale scores and severity of childhood emotional neglect, particularly in persons with both BPD and PTSD. Our prediction that symptoms of TRASC would be less intercorrelated in comparison with distress associated with NWC symptoms, however, was not supported.
  
  
  CONCLUSIONS
  Findings are discussed as they pertain to the symptomatology of BPD, PTSD, and dissociation.
authors.affiliation: Department of Psychiatry, Western University, London, ON, Canada ; Department of Psychology, Western University, London, ON, Canada ; Graduate Program in Neuroscience, Western University, London, ON, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Frewen
authors.affiliation: Department of Psychosomatic Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/ Heidelberg University, Mannheim, Germany.
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Kleindienst
authors.affiliation: Department of Psychiatry, Western University, London, ON, Canada ; Graduate Program in Neuroscience, Western University, London, ON, Canada.
authors.forename: Ruth
authors.initials: R
authors.lastname: Lanius
authors.affiliation: Department of Psychosomatic Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/ Heidelberg University, Mannheim, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Schmahl
keywords: 4-D model; Dissociation; borderline personality disorder; childhood abuse and neglect; posttraumatic stress disorder; trauma-related altered states of consciousness