DBT, PTSD, Prolonged Exposure, Exposure therapy, BPD


According to the Biosocial Developmental Model for Borderline Personality Disorder (BPD), individuals with a biological vulnerability (i.e., heightened emotional sensitivity and impulsive tendencies), plus an invalidating environment may develop BPD (Crowell, Beauchaine, & Linehan, 2009). Individuals with BPD are especially difficult to treat, because of their “extreme emotional, behavioral, and cognitive dysregulation” (Crowell, Beauchaine, & Linehan, 2009). Though challenging to treat, BPD can be successfully treated using Dialectical Behavior Therapy (DBT) (Linehan, 1993; Linehan 2015). Similarly, Posttraumatic Stress Disorder (PTSD) is complex and often burnout inducing to treat, because of the intensity of the emotional content related to traumatic events and high symptom severity including flashbacks, dissociation, and nightmares (Foa, 1993). PTSD can be adequately treated using exposure-based interventions, such as prolonged exposure (Foa, Chrestman, & Gilboa-Schechtman, 2009). However, when BPD is comorbid with PTSD, symptom severity is often heightened to such a degree that neither DBT nor exposure-based therapy are sufficient treatments. This literature review discusses the problems related to treating individuals with comorbid BPD and PTSD, and the benefits of the current treatment protocol, Dialectical Behavior Therapy Prolonged Exposure.