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Home > Post-Traumatic Stress Disorder vs. Complex PTSD

Post-Traumatic Stress Disorder vs. Complex PTSD

Dr. Martin counseling a patientAndrew L. Martin, PsyD

Post-Traumatic Stress Disorder (PTSD)  is a well-established psychological condition, recognized since 1980 by most mental health and medical organizations. Complex PTSD is a relatively new condition, recognized by some organizations (e.g., World Health Organization), but not by others (e.g., American Psychiatric Association). For a condition to be recognized as separate from other conditions, research must show differences large enough to significantly impact the diagnosis or treatment of the condition, and what constitutes large enough differences naturally varies between organizations.

Complex PTSD generally involves symptoms that are more severe and long-lasting than those associated with PTSD. Complex PTSD is also thought to develop from repeated, or long-lasting trauma, and to include all symptoms of PTSD plus additional symptoms of longstanding difficulty in regulating emotion, unstable sense of self, and difficulty forming and maintaining relationships. In addition, startle response may be diminished or exaggerated in Complex PTSD, versus only exaggerated in PTSD.1

Examples of repeated, long-lasting trauma associated with Complex PTSD include slavery, forced military service as a child, and frequent sexual, physical or emotional abuse, especially by family members. Often the traumatic event(s) are inescapable.

Emotional dysregulation may include strong emotional reactions to seemingly minor stressful events, violent outbursts of anger, and persistent dissociative symptoms (feeling detached from oneself – like an outside observer; or feeling like the world around oneself is unreal, dreamlike, or distorted is some way). An unstable sense of self may include seeing oneself as diminished, defeated or worthless because of feelings of guilt, shame or failure related to the traumatic event(s). Relationship problems may involve persistent difficulty sustaining relationships and feeling close to others, and avoiding socializing altogether. Females are at greater risk than males both for developing Complex PTSD and for showing more psychological distress and functional impairment.2

Complex PTSD, like PTSD, can significantly impact a person’s ability to function in social and work settings, and can also interfere with leisure activity.

As Complex PTSD is a relatively new diagnosis, there is little empirical research on its treatment. Considerations under study include when to employ exposure therapy versus supportive therapy, and how to deal with dissociative symptoms3. Clinicians have also suggested that Complex PTSD may require stabilizing treatment such as coping skill building, problem-solving, and meeting basic needs prior to turning the focus to trauma4.

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