Table of ContentsView AllTable of ContentsC-PTSD vs. PTSDSymptoms in ChildrenSymptoms in AdultsCausesDiagnosisTreatmentNext in PTSD GuideHow to Recognize and Treat Complex PTSD
Table of ContentsView All
View All
Table of Contents
C-PTSD vs. PTSD
Symptoms in Children
Symptoms in Adults
Causes
Diagnosis
Treatment
Next in PTSD Guide
Complex post-traumatic stress disorder (C-PTSD) is a mental disorder that develops in response to complex trauma during childhood. Complex trauma is defined as prolonged exposure to traumatic events from which a person is unable to escape.
C-PTSD is regarded as a category ofpost-traumatic stress disorder (PTSD)that involves three additional symptoms: emotional dysregulation, negative self-beliefs, and interpersonal difficulties. It can affect both children and adults, although the treatment approach can vary.
Verywell / Jessica Olah
How Complex PTSD Differs From PTSD
Complex PTSD (C-PTSD) was proposed as a diagnosis for symptoms that result from these so-called “complex traumas.” It suggests that repeated traumatization during childhood causes a host of symptoms that are distinct from PTSD. The symptoms can manifest during childhood and persist into adulthood, or only emerge during adulthood.
The symptoms of C-PTSD fall under three broad categories:
These symptoms differ from PTSD in how they manifest. For example, self-blame and seeking a “rescuer” are commonly seen with C-PTSD but less so with PTSD.
Despite the ongoing debate, approximately 92% of people with C-PTSD also meet the criteria for PTSD.
Symptoms of C-PTSD in Children
PTSD is different in children because it occurs during the childhood development stages (the period of rapid physical, psychological, and social growth in children and adolescents). Experts suggest that C-PTSD causes symptoms distinct from PTSD because it disrupts this normal developmental process.
In children, C-PTSD may manifest with symptoms such as:
Symptoms of C-PTSD in Adults
In adults, C-PTSD can manifest with aninsecure attachment style(in which a person feels insecure about relationships) and problems with impulse control, emotional regulation, attention, and self-image.
Symptoms of C-PTSD commonly seen in adults include:
Causes and Risk Factors
Examples include:
The perpetrator of the trauma may not only include parents but also siblings and other household members.
The definition of C-PTSD is fast expanding to include exposure to trauma in the larger society as well as the home. Examples include persistent exposure to racism, sexism,homophobia,transphobia, and other forms of social marginalization.
With that said, C-PTSD is still defined as exposure to these and other traumas during childhood or adolescence which disrupt normal psychological and social development.
The WHO designates C-PTSD as a condition related to but separate from PTSD. To receive a diagnosis under the ICD-11, a person first needs to meet thecriteria for PTSDand experience these three additional symptoms:
C-PTSD can be difficult to diagnose as it shares symptoms with other mental disorders, includingborderline personality disorder (BPD),dissociative identity disorder (DID), andsomatic symptom disorder (SSD).
Obtaining an accurate diagnosis, ideally from a board-certifiedpsychiatristorpsychologist, can ensure the right treatment is dispensed.
There are no consistent guidelines for the treatment of C-PTSD. The approach can differ from that of PTSD in that PTSD involves a single traumatic event. With C-PTSD, the trauma involves interpersonal relationships which may be ongoing.
The treatment is age-specific and often differs between children and adults. With younger children, psychotherapy may be focused more onplay therapyrather than CBT, PET, or DBT. In extreme cases, treatment may only dispensed when the child is under protective custody.
There are no guidelines for the use of medication in treating C-PTSD, although some may be prescribed if there aresigns of depressionoranxiety. This includesselective serotonin reuptake inhibitors (SSRIs)likeZoloft (sertraline)andPaxil (paroxetine)which are commonly used to treat PTSD.
Summary
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Karatzias T, Hyland P, Bradley A, et al.Risk factors and comorbidity of ICD‐11 PTSD and complex PTSD: findings from a trauma‐exposed population-based sample of adults in the United Kingdom.Depress Anxiety. 2019;36(9):887-894. doi:10.1002/da.22934.National Child Traumatic Stress Network.Complex trauma and developmental trauma disorder.Brewin CR.Complex post-traumatic stress disorder: a new diagnosis in ICD-11.BJ Psych Advances.2020;26(3):145–152. doi:10.1192/bja.2019.48fU.S. Department of Veterans Affairs.Complex PTSD - PTSD.American Psychological Association.Improved treatment for developmental trauma.Maercker A, Cloitre M, Bachem R, et al.Complex post-traumatic stress disorder.Lancet.2022 Jul 2;400(10345):60-72. doi:10.1016/S0140-6736(22)00821-2Crow TM, Levy KN, Bradley B, Fani N, Powers A.The roles of attachment and emotional dysregulation in the association between childhood maltreatment and PTSD in an inner-city sample.Child Abuse Negl. 2021 Jun 3;118:105139. doi:10.1016/j.chiabu.2021.105139Mental Health America.What is complex PTSD?Kennedy Krieger Institute.Treating complex trauma in child welfare.American Psychological Association.Treatments for PTSD.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Karatzias T, Hyland P, Bradley A, et al.Risk factors and comorbidity of ICD‐11 PTSD and complex PTSD: findings from a trauma‐exposed population-based sample of adults in the United Kingdom.Depress Anxiety. 2019;36(9):887-894. doi:10.1002/da.22934.National Child Traumatic Stress Network.Complex trauma and developmental trauma disorder.Brewin CR.Complex post-traumatic stress disorder: a new diagnosis in ICD-11.BJ Psych Advances.2020;26(3):145–152. doi:10.1192/bja.2019.48fU.S. Department of Veterans Affairs.Complex PTSD - PTSD.American Psychological Association.Improved treatment for developmental trauma.Maercker A, Cloitre M, Bachem R, et al.Complex post-traumatic stress disorder.Lancet.2022 Jul 2;400(10345):60-72. doi:10.1016/S0140-6736(22)00821-2Crow TM, Levy KN, Bradley B, Fani N, Powers A.The roles of attachment and emotional dysregulation in the association between childhood maltreatment and PTSD in an inner-city sample.Child Abuse Negl. 2021 Jun 3;118:105139. doi:10.1016/j.chiabu.2021.105139Mental Health America.What is complex PTSD?Kennedy Krieger Institute.Treating complex trauma in child welfare.American Psychological Association.Treatments for PTSD.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Karatzias T, Hyland P, Bradley A, et al.Risk factors and comorbidity of ICD‐11 PTSD and complex PTSD: findings from a trauma‐exposed population-based sample of adults in the United Kingdom.Depress Anxiety. 2019;36(9):887-894. doi:10.1002/da.22934.National Child Traumatic Stress Network.Complex trauma and developmental trauma disorder.Brewin CR.Complex post-traumatic stress disorder: a new diagnosis in ICD-11.BJ Psych Advances.2020;26(3):145–152. doi:10.1192/bja.2019.48fU.S. Department of Veterans Affairs.Complex PTSD - PTSD.American Psychological Association.Improved treatment for developmental trauma.Maercker A, Cloitre M, Bachem R, et al.Complex post-traumatic stress disorder.Lancet.2022 Jul 2;400(10345):60-72. doi:10.1016/S0140-6736(22)00821-2Crow TM, Levy KN, Bradley B, Fani N, Powers A.The roles of attachment and emotional dysregulation in the association between childhood maltreatment and PTSD in an inner-city sample.Child Abuse Negl. 2021 Jun 3;118:105139. doi:10.1016/j.chiabu.2021.105139Mental Health America.What is complex PTSD?Kennedy Krieger Institute.Treating complex trauma in child welfare.American Psychological Association.Treatments for PTSD.
Karatzias T, Hyland P, Bradley A, et al.Risk factors and comorbidity of ICD‐11 PTSD and complex PTSD: findings from a trauma‐exposed population-based sample of adults in the United Kingdom.Depress Anxiety. 2019;36(9):887-894. doi:10.1002/da.22934.
National Child Traumatic Stress Network.Complex trauma and developmental trauma disorder.
Brewin CR.Complex post-traumatic stress disorder: a new diagnosis in ICD-11.BJ Psych Advances.2020;26(3):145–152. doi:10.1192/bja.2019.48f
U.S. Department of Veterans Affairs.Complex PTSD - PTSD.
American Psychological Association.Improved treatment for developmental trauma.
Maercker A, Cloitre M, Bachem R, et al.Complex post-traumatic stress disorder.Lancet.2022 Jul 2;400(10345):60-72. doi:10.1016/S0140-6736(22)00821-2
Crow TM, Levy KN, Bradley B, Fani N, Powers A.The roles of attachment and emotional dysregulation in the association between childhood maltreatment and PTSD in an inner-city sample.Child Abuse Negl. 2021 Jun 3;118:105139. doi:10.1016/j.chiabu.2021.105139
Mental Health America.What is complex PTSD?
Kennedy Krieger Institute.Treating complex trauma in child welfare.
American Psychological Association.Treatments for PTSD.
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