People with borderline personality disorder (BPD) who also have posttraumatic stress disorder (PTSD) report dissociative trauma-related altered states of consciousness (TRASC) less often than normal waking consciousness (NWC) symptoms. TRASC are more strongly linked to dissociative experiences and childhood emotional neglect than NWC symptoms are, especially in those with both BPD and PTSD. The prediction that TRASC symptoms would be less intercorrelated than NWC symptoms was not supported. The 4-D model categorizes trauma symptoms across time, thought, body, and emotion, each possibly experienced as normal or dissociative.
Patients with borderline personality disorder who experience high levels of dissociative symptoms show diminished emotional learning during aversive conditioning, as measured by skin conductance responses, compared to patients without dissociation and healthy controls. The dissociative group showed no increase in valence or arousal to the conditioned stimulus and no differential skin conductance responses during acquisition or extinction phases. These differences were not explained by general psychopathology, trauma history, perceptual differences, or posttraumatic stress disorder. The findings suggest that state dissociation inhibits amygdala-based emotional learning processes, which may have implications for exposure-based psychotherapy.