Complex PTSD is similar to Posttraumatic Stress Disorder.
However, while PTSD is associated with acute trauma, complex PTSD is the result
of repetitive, chronic patterns of interpersonal trauma, such as child or
domestic abuse. It is marked by problems with emotional regulation, sense of
self, and attachment to other people.
Currently, Complex PTSD is not formally recognized as a
discrete diagnosis separate from PTSD. However, many clinicians and researchers
have made a case for complex PTSD as a disorder in and of itself. They have
proposed lists of Complex PTSD symptoms for use in diagnosing the disorder.
A Set of Complex PTSD Symptoms
On their website, the Centre for Addition and Mental Health
(CAMH) proposes the following set of criteria for diagnosing complex PTSD:
I.
Alteration in Regulation of Affect and Impulses
a.
Affect regulation
b.
Modulation of anger
c.
Self-destructive behavior
d.
Suicidal preoccupation
e.
Difficulty modulating sexual involvement
f.
Excessive risk-taking
II.
Alterations in Attention or Consciousness
a.
Amnesia
b.
Transient dissociative episodes and
depersonalization
III.
Alterations in Self-Perception
a.
Ineffectiveness
b.
Permanent damage
c.
Guilt and responsibility
d.
Shame
e.
Nobody can understand
f.
Minimizing
IV.
Alterations in Relationships with Others
a.
Inability to trust
b.
Re-victimization
c.
Victimizing others
V.
Somatization
a.
Problems with the digestive system
b.
Chronic pain
c.
Cardiopulmonary symptoms
d.
Conversion symptoms
e.
Sexual symptoms
VI.
Alterations in Systems of Meaning
a.
Despair or hopelessness
b.
Loss of previously sustaining beliefs
These criteria encompass the basic symptoms that distinguish
complex PTSD.
Complex PTSD Symptoms in Children
versus Adults
Some psychologists propose making a distinction in
diagnostic criteria in cases of Complex PTSD in children, versus Complex PTSD
in adults.
A “Child and Adolescent Symptom Cluster” for Complex PTSD
has been proposed, encompassing seven domains:
·
Attachment
·
Biology
·
Affect or emotional dysregulation
·
Dissociation
·
Behavioral control
·
Cognition
·
Self-concept
An “Adult Symptom Cluster” for Complex PTSD symptoms would include:
·
Difficulty regulation emotions
·
Variations in consciousness, including
psychogenic amnesia, dissociation, or intrusive flashbacks of traumatic
episodes
·
Changes in self-perception; this often involves
a chronic sense of helplessness, along with irrational self-blame and feelings
of shame and guilt
·
Varying changes in perception of the person
perpetrating the abuse; this may involve attributing too much power to that
person, being preoccupied with revenge, or even idealizing that person
·
Alterations in relationships with others; this may
take the form of isolation and withdrawal, inability to trust, or reliance on
the idea of a “rescuer”
·
Loss of faith, or overwhelming sense of despair
There is not yet a formally accepted set of Complex PTSD
symptoms to be used as diagnostic guidelines. The DSM-IV and DSM-V, as well as
the ICD-10, do not include Complex PTSD as its own separate disorder. However,
symptoms have been identified and listed by clinicians and researchers. Complex
PTSD is the result of prolonged trauma, often in the form of interpersonal
abuse, and impacts the victim’s sense of self and attachment patterns in
interpersonal relationships in a way that is not necessarily reflected in the
accepted diagnostic criteria for PTSD.
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