When Trauma Gets Mislabelled: How Rape Survivors Are Being Diagnosed With Personality Disorders Instead of PTSD
- clairelouise7485
- Oct 29
- 2 min read
When Trauma Gets Mislabelled: How Rape Survivors Are Being Diagnosed With Personality Disorders Instead of PTSD
The Hidden Misdiagnosis
When someone survives rape or sexual assault, the psychological consequences can be life-changing. Post-Traumatic Stress Disorder (PTSD) — or its long-term form, Complex PTSD (CPTSD) — is a recognised outcome of extreme trauma.
Yet many survivors in the UK are instead being diagnosed with Borderline Personality Disorder (BPD), known in the NHS as Emotionally Unstable Personality Disorder (EUPD).This diagnostic substitution can occur within months of an assault, even though BPD is defined as a long-term personality pattern that develops from adolescence — not a single, acute event.
When trauma responses are reframed as personality defects, survivors are blamed for the symptoms of their own injury.
How the System Creates the Problem
This confusion isn’t just clinical — it’s built into the UK’s compensation system.
The Criminal Injuries Compensation Authority (CICA) pays damages to victims of violent crime. Its tariff-based scheme lists fixed payments for certain psychological injuries, such as:
Post-Traumatic Stress Disorder (lifelong) – about £22,000
Emotionally Unstable Personality Disorder (EUPD) – about £22,000
Because CICA has no separate category for Complex PTSD, assessors and clinicians sometimes classify trauma-related symptoms as “EUPD” to fit the form.That single tick-box decision can reframe a survivor’s condition from “trauma injury” to “personality disorder,” shifting how their suffering is understood and compensated.
Why Mislabelled Trauma Matters
Financially:A BPD label can affect whether a mental injury is treated as new or pre-existing, and it may limit the overall compensation available.
Clinically:Survivors diagnosed with personality disorders often face stigma and reduced empathy in healthcare, where trauma symptoms may be dismissed as manipulation or instability.
Legally:A misdiagnosis can reduce credibility in legal proceedings, distorting how responsibility for harm is understood.
The result is a double injury — first the assault, then the system’s misinterpretation of its effects.
What Needs to Change
Trauma-informed assessments: Both CICA and NHS evaluators should use diagnostic frameworks that recognise trauma as injury, not personality defect.
Recognition of Complex PTSD: The CICA tariff should explicitly include CPTSD as a category, reflecting the ICD-11 standard now used by the NHS.
Clinician training: Health professionals must learn to distinguish between trauma-related dysregulation and personality-based patterns.
Right to correction: Survivors should be allowed to annotate or challenge disputed diagnoses within their NHS records to ensure safe, appropriate care.
Reframing the Narrative
When the system labels a rape survivor with a personality disorder instead of PTSD, it does more than misdiagnose — it invalidates the survivor’s reality.Trauma is not a flaw in personality; it is a response to violence.
Recognising that difference is the first step toward true recovery and justice.
Comments