What is complex PTSD or cPTSD and how is it different from PTSD? What can we do to address these issues? PTSD is an emotional response to trauma. Complex PTSD is not a diagnosis that we have in our medical manual. It’s simply a term that describes a different type of experience that someone has as a result of chronic traumatic experiences that have occurred over time. It is usually childhood trauma that causes it. It could be neglect, abuse, or even sexual. The trauma can have a profound impact on your development and personality because it is happening during your most vulnerable developmental years.
This is the diagnosis criteria for PTSD taken from the Diagnostic and Statistical Manual of Mental Disorders. This information is not intended to be used for self-diagnosis. For a diagnosis of PTSD, it is best to see a professional.
Posttraumatic Stress Disorder. These criteria are applicable to children aged 6 and older.
An exposure to actual or threatened death, serious injuries, or sexual violence in any (or all) of the following:
1 Experience the trauma directly.
2 Witnessing the event(s), in person.
3 Finding out that the traumatizing event occurred to a family member or friend. If a friend or family member is threatened or dies, the event must be violent or accidental.
4 Repeated or extreme exposure to the traumatic details (e.g. first responders who collect human remains, police officers who are repeatedly exposed to details about child abuse).
B The presence of one or more of the following intrusion signs associated with the traumatic events, beginning after the event(s) occurred.
1. Recurrent, intrusive, and involuntary distressing memories of the trauma(s) are present.
2. Recurrently disturbing dreams where the content or affect of the dream is related to the trauma(s).
3. Dissociative reactions, also known as flashbacks, are when the person feels or acts like the trauma(s) is recurring.
4. Exposition to external or internal cues that represent or resemble a traumatic event can cause intense or prolonged psychological distress.
5. A marked physiological reaction to external or internal cues that represent or resemble a traumatic event.
C Consistent avoidance (or abstinence) from stimuli that are associated with the trauma event(s), starting after the traumatic events occurred. This can be demonstrated by either one or both of these:
1. Avoidance or attempts to avoid distressing memories or thoughts about the traumatizing event or its close relatives.
Avoidance or attempts to avoid external reminders (peoples, places, conversations activities, objects, situations, etc.) that trigger distressing memories, thoughts or feelings about the traumatic event or are closely related.
D Negative mood and cognition changes associated with the traumatic events, beginning or worsening following the event(s), as shown by two (or more of the following):
1 Unable to recall an important aspect of the trauma event(s). This is usually due to dissociative memory and not other factors like head injury, alcohol, drugs, etc.
2. Persistent, exaggerated negative beliefs and expectations about oneself, other people, or the world (e.g. “I am bad,” “No one can trust me,” “The whole world is dangerous,” or “My nervous system is permanently destroyed”).
Three Persistent, distorted cognitions regarding the cause or effects of the trauma event(s). This leads the individual to blame others or himself.
4 Persistently negative emotional state (e.g. fear, terror, anger, guilt or shame).
5 Significantly decreased interest in or participation in important activities.
6 Feelings that others are distant or detached.
7 Consistent inability or incapacity to feel positive emotions (e.g. inability to feel happiness, satisfaction, or love).
E. Symptoms of arousal or reactivity changes that are associated with the trauma event(s), beginning/worsening after the trauma event(s) occurred. This can be demonstrated by one (or more)
1 Anger outbursts and irritable behavior (with little to no provocation) are usually expressed verbally or physically toward people or objects.
2 Self-destructive or reckless behavior.
4 Exaggerated startle response.
Five problems with concentration
6 Sleep disturbance: e.g. difficulty falling asleep, staying asleep, or having trouble sleeping.
F The duration of the disturbance (Criteria C, D and E) is greater than one month.
G A disturbance that causes significant distress or impairment in a social, occupational, or any other important area of functioning.
H The disturbance is not due to any physiological effects of a substance (e.g. medication, alcohol, or other medical condition).