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'''Complex Post-Traumatic Stress Disorder''' (C-PTSD) is a clinically recognized condition that results from extended exposure to prolonged social and/or interpersonal [[Psychological trauma|trauma]], including instances of [[physical abuse]], [[emotional abuse]], [[sexual abuse]], [[domestic violence]], [[torture]], chronic early [[maltreatment]] in a caregiving relationship, and [[war]]. It has been suggested that a differentiation between the diagnostic categorizations of C-PTSD and that of [[Post-traumatic stress disorder|Post traumatic stress disorder]] (PTSD), as C-PTSD better describes the pervasive negative impact of chronic trauma than does PTSD.<ref>van der Kolk, B.A. & Courtois, C.A. (2005). "Editorial comments: complex developmental trauma". ''Journal of Traumatic Stress'' '''18''', 385-388.</ref>
Complex post-traumatic stress (C-PTSD) is a clinically recognized condition that results from extended exposure to prolonged social and/or interpersonal [[Psychological trauma|trauma]], including instances of [[physical abuse]], [[emotional abuse]], [[sexual abuse]], [[domestic violence]], [[torture]], and chronic early [[maltreatment]] in a caregiving relationship. It has been suggested that a differentiation be made between the diagnostic categorizations of C-PTSD and [[Post-traumatic stress disorder|Post traumatic stress disorder]] (PTSD), as C-PTSD better describes the pervasive negative impact of chronic trauma than does PTSD.<ref>van der Kolk, B.A. & Courtois, C.A. (2005). "Editorial comments: complex developmental trauma". ''Journal of Traumatic Stress'' '''18''', 385-388.</ref>


As a descriptor, PTSD fails to capture some of the core characteristics of C-PTSD. These elements include psychological fragmentation, the loss of a sense of safety, trust, and self-worth, as well as the tendency to be revictimized, and, most importantly, the loss of a coherent sense of self. It is this loss of a coherent sense of self, and the ensuing symptom profile, that most pointedly differentiates C-PTSD from PTSD.
As a descriptor, PTSD fails to capture some of the core characteristics of C-PTSD. These elements include [[psychological fragmentation]], the loss of a sense of safety, trust, and self-worth, as well as the tendency to be revictimized, and, most importantly, the loss of a coherent [[sense of self]]. It is this loss of a coherent sense of self, and the ensuing symptom profile, that most pointedly differentiates C-PTSD from PTSD.


==Symptom profile==
==Symptom profile==
C-PTSD is characterized by chronic difficulties in many areas of [[emotional]] and [[interpersonal]] functioning. Symptoms may include:
C-PTSD is characterized by chronic difficulties in many areas of [[emotional]] and [[interpersonal]] functioning. Symptoms may include:


:* Difficulties [[emotional dysregulation|regulating emotions]], including symptoms such as [[dysthymia|persistent sadness]], suicidal thoughts, explosive anger, or covert anger, which is characteristic of [[passive-aggressive]] behavior
:* Difficulties [[emotional dysregulation|regulating emotions]], including symptoms such as [[dysthymia|persistent sadness]], [[suicide|suicidal thoughts]], [[Intermittent explosive disorder|explosive anger]], or covert anger, which is characteristic of [[passive-aggressive]] behavior


:* Variations in consciousness, such as forgetting  [[traumatic event]]s, reliving traumatic events, or having episodes of dissociation (during which one feels detached from one's mental processes or body)
:* Variations in consciousness, such as forgetting  [[traumatic event]]s, reliving traumatic events, or having episodes of [[dissociation]] and/or [[derealization]]


:* Changes in self-perception, such as a sense of helplessness, shame, guilt, stigma, and a sense of being completely different from other human beings
:* Changes in [[self-perception]], such as a sense of helplessness, shame, guilt, stigma, and a sense of being completely different from other human beings


:* Varied changes in the perception of the perpetrator, such as attributing total power to the perpetrator or becoming preoccupied with the relationship to the perpetrator, including a preoccupation with revenge
:* Varied changes in the perception of the perpetrator, such as attributing total power to the perpetrator or becoming preoccupied with the relationship to the perpetrator, including a preoccupation with revenge
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:* Alterations in relations with others, including isolation, distrust, or a repeated search for a rescuer
:* Alterations in relations with others, including isolation, distrust, or a repeated search for a rescuer


:* Loss of, or changes in, one's system of meanings, which may include a loss of sustaining faith or a sense of hopelessness and despair [http://www.ncptsd.va.gov/facts/specific/fs_complex_ptsd.html]
:* Loss of, or changes in, one's [[system of meaning]]s, which may include a loss of sustaining faith or a sense of hopelessness and despair [http://www.ncptsd.va.gov/facts/specific/fs_complex_ptsd.html]


==C-PTSD and Borderline personality disorder==
==C-PTSD and Borderline personality disorder==
[[Complex Post Traumatic Stress Disorder]] (C-PTSD) is a condition that is often attributed to an individual suffering chronic [[traumatic stress]], who is also exhibiting a breakthrough characteristics similar to those expressed by a [[Borderline Personality Disorder|borderline personality]] (BPD).
Complex post-traumatic stress (C-PTSD) is a condition that is often attributed to an individual suffering chronic [[traumatic stress]], who is also exhibiting a breakthrough characteristics similar to those expressed by a [[Borderline personality disorder|borderline personality]] (BPD).


Borderline Personality Disorder is, from a psycho-social perspective, an on-going inability to regulate emotions (a [[dysregulation]] of affect) consequent to an antecedent [[disability]] or [[dysfunction]] in the development of [[appropriate]] social skills. The magnitude of difficulty is disabling. Complex Post Traumatic Stress Disorder is characterized by a breakdown of previously effective social skills in the face of, or consequent to, trauma. Trauma, by definition, overwhelms established [[coping skills]].
Borderline personality disorder is, from a [[psychosocial]] perspective, an on-going inability to regulate emotions (a [[dysregulation]] of affect) consequent to an antecedent [[disability]] or [[dysfunction]] in the development of [[appropriate]] social skills. The magnitude of difficulty is disabling. Complex post-traumatic stress is characterized by a breakdown of previously effective social skills in the face of, or consequent to, trauma. Trauma, by definition, overwhelms established [[coping skills]].


In the first case, BPD is thought to develop in part through the maladaptive experience, perception and interpretation of preconscious or pre-verbal experiences on the part of an infant who has a predisposition to anxiety and/or depression.  In the second case, the trauma associated with C-PTSD is seen as causing a breakdown in the social skills that previously allowed for the adaptive management of overwhelming social and psycho-social stressors.
In the first case, BPD is thought to develop in part through the maladaptive experience, perception and interpretation of preconscious or pre-verbal experiences on the part of an infant who has a predisposition to anxiety and/or depression.  In the second case, the trauma associated with C-PTSD is seen as causing a breakdown in the social skills that previously allowed for the adaptive management of social and psychosocial stressors.


In both cases, future trauma, on-going trauma, and/or symbolic re-enactment of a past trauma can exacerbate the failure of response, as informed by [[emotional dysregulation]].
In both cases, future trauma, on-going trauma, and/or symbolic re-enactment of a past trauma can exacerbate the failure of response, as informed by [[emotional dysregulation]].


==See also==
==See also==
[[Borderline personality disorder]]
[[Psychology]]
[[Traumatic stress]]
[[Traumatic stress]]


==References==
==References==
<references />
<references />

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Complex post-traumatic stress (C-PTSD) is a clinically recognized condition that results from extended exposure to prolonged social and/or interpersonal trauma, including instances of physical abuse, emotional abuse, sexual abuse, domestic violence, torture, and chronic early maltreatment in a caregiving relationship. It has been suggested that a differentiation be made between the diagnostic categorizations of C-PTSD and Post traumatic stress disorder (PTSD), as C-PTSD better describes the pervasive negative impact of chronic trauma than does PTSD.[1]

As a descriptor, PTSD fails to capture some of the core characteristics of C-PTSD. These elements include psychological fragmentation, the loss of a sense of safety, trust, and self-worth, as well as the tendency to be revictimized, and, most importantly, the loss of a coherent sense of self. It is this loss of a coherent sense of self, and the ensuing symptom profile, that most pointedly differentiates C-PTSD from PTSD.

Symptom profile

C-PTSD is characterized by chronic difficulties in many areas of emotional and interpersonal functioning. Symptoms may include:

  • Changes in self-perception, such as a sense of helplessness, shame, guilt, stigma, and a sense of being completely different from other human beings
  • Varied changes in the perception of the perpetrator, such as attributing total power to the perpetrator or becoming preoccupied with the relationship to the perpetrator, including a preoccupation with revenge
  • Alterations in relations with others, including isolation, distrust, or a repeated search for a rescuer
  • Loss of, or changes in, one's system of meanings, which may include a loss of sustaining faith or a sense of hopelessness and despair [1]

C-PTSD and Borderline personality disorder

Complex post-traumatic stress (C-PTSD) is a condition that is often attributed to an individual suffering chronic traumatic stress, who is also exhibiting a breakthrough characteristics similar to those expressed by a borderline personality (BPD).

Borderline personality disorder is, from a psychosocial perspective, an on-going inability to regulate emotions (a dysregulation of affect) consequent to an antecedent disability or dysfunction in the development of appropriate social skills. The magnitude of difficulty is disabling. Complex post-traumatic stress is characterized by a breakdown of previously effective social skills in the face of, or consequent to, trauma. Trauma, by definition, overwhelms established coping skills.

In the first case, BPD is thought to develop in part through the maladaptive experience, perception and interpretation of preconscious or pre-verbal experiences on the part of an infant who has a predisposition to anxiety and/or depression. In the second case, the trauma associated with C-PTSD is seen as causing a breakdown in the social skills that previously allowed for the adaptive management of social and psychosocial stressors.

In both cases, future trauma, on-going trauma, and/or symbolic re-enactment of a past trauma can exacerbate the failure of response, as informed by emotional dysregulation.

See also

Borderline personality disorder Psychology Traumatic stress

References

  1. van der Kolk, B.A. & Courtois, C.A. (2005). "Editorial comments: complex developmental trauma". Journal of Traumatic Stress 18, 385-388.