Complex post-traumatic stress disorder

Complex post-traumatic stress disorder (C-PTSD; also known as complex trauma) is a psychological disorder similar to post traumatic stress disorder (PTSD) which results from repetitive, prolonged trauma involving harm or abandonment by a caregiver or other interpersonal relationships with an uneven power dynamic. C-PTSD is associated with child abuse or neglect, intimate partner violence, kidnap victims, hostages, indentured servants, slaves, sweatshop workers, prisoners of war, concentration camp survivors, and defectors of cults or cult-like organizations. Situations involving captivity/entrapment (a situation lacking a viable escape route for the victim or a perception of such) can lead to C-PTSD-like symptoms, which include prolonged feelings of terror, worthlessness, helplessness, and deformation of one's identity and sense of self.

Some researchers argue that C-PTSD is distinct from, but similar to PTSD, somatization disorder, dissociative identity disorder, and borderline personality disorder. The main distinction being that it distorts a person's core identity, especially when prolonged trauma occurs during childhood development. It was first described in 1992 by Judith Herman in her book Trauma & Recovery and an accompanying article. Though mainstream journals have published papers on C-PTSD, the category is not yet adopted by either the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), or in the World Health Organization's (WHO) International Statistical Classification of Diseases and Related Health Problems, 10th Edition (ICD-10). However, it is proposed for the ICD-11, to be finalized in 2018.

The diagnosis of PTSD was originally developed for adults who had suffered from a single event trauma, such as rape, or a traumatic experience during a war. However, the situation for many children is quite different. Children can suffer chronic trauma such as maltreatment, family violence, and a disruption in attachment to their primary caregiver. In many cases, it is the child's caregiver who caused the trauma. The diagnosis of PTSD does not take into account how the developmental stages of children may affect their symptoms and how trauma can affect a child’s development. Currently there is no proper diagnosis for this condition, but the term developmental trauma disorder has been suggested. This developmental form of trauma places children at risk for developing psychiatric and medical disorders.

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