Today I want to talk about Complex Post Traumatic Stress Disorder (Complex PTSD, C-PTSD).  I didn’t even know it existed until my therapist and I were talking about my diagnoses last week.  According to the Department of Veteran Affairs’ National Center for PTSD, the difference between PTSD and Complex PTSD is a matter of length of exposure to the trauma.
For instance, car accidents, natural disasters, and rape are considered traumatic events of time-limited duration. But chronic traumas continue or repeat for months or years at a time.   Some examples of traumas associated with Complex PTSD include:
- concentration camps
- prisoner of war camps
- prostitution brothels
- long-term domestic violence
- long-term child physical abuse
- long-term child sexual abuse
- organized child exploitation rings
Although PTSD isn’t split into two types yet “officially” in the DSM-IV manual, many mental health professionals see it as a necessity.   The diagnosis of Complex PTSD requires that the individual experienced a prolonged period (months to years) of total control by another. The other criteria are symptoms that tend to result from chronic victimization:
* Alterations in emotional regulation. May include persistent sadness, suicidal thoughts, explosive anger, or inhibited anger.
* Alterations in consciousness. Includes forgetting traumatic events, reliving traumatic events, or having episodes in which one feels detached from one’s mental processes or body.
* Changes in self-perception. May include helplessness, shame, guilt, stigma, and a sense of being completely different from other human beings.
* Alterations in how the perpetrator is perceived. Examples include attributing total power to the perpetrator, becoming preoccupied with the relationship to the perpetrator, or preoccupied with revenge.
* Alterations in relations with others. Examples include isolation, distrust, or a repeated search for a rescuer.
* Changes in one’s system of meanings. May include a loss of sustaining faith or a sense of hopelessness and despair.
Survivors of Complex PTSD may abuse alcohol or drugs, avoid thinking or talking about the trauma, or self-mutilate to escape.  Or a combination of these things.
According to Roth et. al, sexual abuse might be a critical risk factor in developing C-PTSD (1997).  As someone that has experienced prolonged child sexual abuse, I can see why it could be a critical risk factor.  Child sexual abuse is damaging on so many levels.  This is not to say that other forms of trauma “don’t count,” they do, but child sexual abuse happens when we are still developing our minds, bodies and personalities.

If you want more information about Complex PTSD, please visit:

Complex PTSD – National Center for PTSD. (n.d.). National Center for PTSD Home. Retrieved October 1, 2010, from
Roth, S., Newman, E., Pelcovitz, D., der Kolk, B. v., & Mandel, F. (1997). Complex PTSD in victims exposed to sexual and physical abuse: results from the DSM-IV Field Trial for Posttraumatic Stress Disorder. Journal of Traumatic Stress, 10(4), 539-555.