Complex Trauma and Mentalizing Ability in College Students With or Without Borderline Personality Disorder: A Mixed Method Approach

Background: Exposure to complex trauma in early childhood can undermine the development of mentalization capacity. Complex trauma has also been causally linked to borderline personality disorder (BPD). The inclusion of complex post-traumatic stress disorder in ICD-11 has made it imperative to have an in-depth understanding of complex trauma. Methods: This study used an explanatory sequential mixed method approach to assess the complex trauma and mentalizing ability in college students with BPD (N = 62) in comparison to non-BPD students (N = 60) and to explore the subjective experiences of complex trauma in students with BPD (n = 10). Participants in both groups were assessed on the Childhood Experience of Care and Abuse Questionnaire and the Reading the Mind in the Eyes Test to assess complex trauma and mentalizing ability, respectively. Qualitative data were collected through focused interviews using a phenomenological approach. Results: Those with BPD had significantly higher rates of six types of complex trauma as compared to those without BPD; additionally, participants who had experienced sexual abuse performed better on mentalizing tasks than those who had not. The focused interviews revealed several themes, including “perpetrator,” “impact,” “symptoms,” and “strengths,” which indicated intergenerational trauma and hope for post-traumatic growth. Conclusion: Although participants with BPD experienced higher complex trauma, they also had better mentalizing capacities.