PTSD and Complex PTSD

PTSD and Complex PTSD are both caused by trauma. PTSD can be caused either by a single traumatic event (e.g., earthquake, sexual assault, or serious auto accident) or by multiple traumatic events (e.g. several traumatic events during war). Complex PTSD can only be caused by multiple traumatic experiences which have a wider range of symptoms than those in the PTSD criteria. Typical causes involve the person being in a prolonged, and normally continuous, set of traumatic experiences over a considerable period of time. For example, child abuse lasting several years or prolonged captivity with severe mistreatment, e.g. in a concentration camp. [2] This related interpersonal abuse causes problems in many future relationships.

Complex PTSD has additional symptoms



Complex PTSD involves all key components of PTSD, plus :

Interpersonal difficulties, meaning relationship problems

Negative self-concept, for example persistent beliefs that you are ‘evil’, that good things won’t happen to you or aren’t ‘deserved’

Affect dysregulation, meaning being unable to manage the intensity of your own emotions

Recent research from the European Journal of Psychotraumatology described these differences, and showed clearly that they were not simply related to the presence of Borderline Personality Disorder, which is fairly common in people traumatized as children.[1] The DSM-5 manual for diagnosing mental disorders didn’t include Complex PTSD (despite the diagnosis first being proposed in 1992). [5]

The other key guide for diagnosing mental disorders is the International Classification of Diseases (ICD), which is published by the World Health Organizations in multiple languages. The next revision of the ICD should be published within 2 years and does include Complex PTSD.[4]

Sources

Cloitre, M., Garvert, D. W., Weiss, B., Carlson, E. B., & Bryant, R. A. (2014). Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis. European Journal of Psychotraumatology, 5(0). doi:10.3402/ejpt.v5.25097 Herman, J. L. (1992). Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. J Trauma Stress, 5(3), 377–391. doi:10.1007/bf00977235 World Health Organization. (December 9, 2014). ICD-11 Beta Draft (Joint Linearization for Mortality and Morbidity Statistics). Cloitre, M., Courtois, C.A., Ford, J.D., Green, B.L., Alexander, P., Briere, J., Herman, J.L., Lanius, R., Stolbach, B.C., Spinazzola, J., Van der Kolk, B.A., Van der Hart, O. (2012). The ISTSS Expert Consensus Treatment Guidelines for Complex PTSD in Adults. Retrieved from December 10, 2014 http://www.istss.org/ISTSS_Complex_PTSD_Treatment_Guidelines/5205.htm American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). Washington, D.C.: American Psychiatric Association. ISBN 0890425558.

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