CPTSD: A New Diagnosis Category in Post-traumatic Stress Disorder

Summary: Researchers provide a new summary of symptoms for the diagnosis of CPTSD, a sibling disorder of PTSD that has recently been officially recognized by the WHO. CPTSD usually occurs following prolonged exposure to traumatic experiences, such as abuse, torture, or domestic violence.

Source: University of Zurich

The World Health Organization (WHO) recently listed a new sibling diagnosis for post-traumatic stress disorder (PTSD), termed complex post-traumatic stress disorder (CPTSD).

An international team with the involvement of the University of Zurich has now summarized the symptoms of the long-awaited new diagnosis and issued guidelines for clinical assessment and treatment.

One of the most widely known responses to trauma is post-traumatic stress disorder, or PTSD. People affected by this mental disorder typically suffer intrusive memories or flashbacks that may overwhelm them.

But international experts have been aware for decades that some trauma victims or survivors exhibit a broader pattern of psychological changes, most commonly after prolonged or repetitive events—such as exposure to war, sexual abuse, domestic violence or torture—now termed CPTSD.

Expanded criteria

Many experts have thus been calling for the diagnostic requirements for PTSD to be adapted. Earlier this year, the WHO issued a new version of its International Classification of Diseases (ICD-11). The updated ICD now includes a new diagnosis for complex post-traumatic stress disorder (complex PTSD).

New symptoms—such as self-organization disturbances—were added to the previous symptoms of PTSD, which include flashbacks, nightmares, avoidance, social withdrawal and hypervigilance.

Key features of self-organization disturbances include excessive or heightened emotional responses, feelings of worthlessness and persistent difficulties in sustaining relationships and in feeling close to others.

An international team with the involvement of UZH has now published a study in The Lancet describing in detail how to diagnose complex PTSD based on a patient’s symptoms.

This shows a sad looking woman
Many experts have thus been calling for the diagnostic requirements for PTSD to be adapted. Image is in the public domain

The study describes the difficulties that may occur, the distinct features of the disease in children and adolescents, and the diagnostic differences that need to be made to closely related mental health disorders such as severe depression, bipolar disorders, psychoses or personality disorders.

Precise description of diagnosis and therapy

“We elaborate how the CPTSD diagnosis can be made in routine situations in emergency medical facilities and in regions with underdeveloped health care systems, for example,” says first author Andreas Maercker, professor of psychopathology and clinical intervention at the University of Zurich.

The study covers the latest findings on biopsychosocial correlations based on systematic selection criteria. The researchers also analyzed the evidence base for all available therapeutic studies and developed guidelines for treating CPTSD.

“This is particularly important, since not all countries use the WHO’s disease classification. Some have adopted the DSM-5 classification published by the American Psychiatric Association, which currently doesn’t list a diagnosis for complex PTSD,” explains Maercker, emphasizing the significance of their study.

About this CPTSD research news

Author: Press Office
Source: University of Zurich
Contact: Press Office – University of Zurich
Image: The image is in the public domain

Original Research: Closed access.
Complex post-traumatic stress disorder” by Andreas Maercker et al. The Lancet


Complex post-traumatic stress disorder

Complex post-traumatic stress disorder (complex PTSD) is a severe mental disorder that emerges in response to traumatic life events.

Complex PTSD is characterised by three core post-traumatic symptom clusters, along with chronic and pervasive disturbances in emotion regulation, identity, and relationships. Complex PTSD has been adopted as a new diagnosis in the ICD-11.

Individuals with complex PTSD typically have sustained or multiple exposures to trauma, such as childhood abuse and domestic or community violence.

The disorder has a 1–8% population prevalence and up to 50% prevalence in mental health facilities.

Progress in diagnostics, assessment, and differentiation from post-traumatic stress disorder and borderline personality disorder is reported, along with assessment and treatment of children and adolescents.

Studies recommend multicomponent therapies starting with a focus on safety, psychoeducation, and patient-provider collaboration, and treatment components that include self-regulatory strategies and trauma-focused interventions.

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  1. Very interesting diagnosis. I thought all PTSD’s were lumped into one category and it was left to the diagnostics to determine the breath of the causation.

    1. Yes and true too of cPTSD (and broken legs) yet a little closer to the details that “The genius” is in (maybe also though madness…Egads). Recent book titled What My Bones Know (or something like that) is an account of someone with cPTSD and yet her childhood and even family history is not nearly as heinously vicious and damaging as so many who line our city streets in tents and live all over the globe in terrible conditions. Oprah Winfrey had violence in her childhood and she claims to not have PTSD. There are so many factors. Relative to children born to hateful parents children who are victims of war have some semblance of “Order” in terms of “Reasons”, commrades etc. for the insanity that damages them, sometimes a collective story that helps mitigate damage ..or just disguise it. If someone has siblings, if they live in one place over time enough to connect with community members who hopefully aren’t abusers and/or are rescued…what sort of media they are exposed to, the food they eat, the air they breathe, their access to quiet and nature, if they have any good memories and if so are they potent enough to offset the bad ones and do they have hope for a future? That just is the very beginning of trying to assess the breath of the causation and thereby perhaps appropriate treatment. A child living with tormented parents and extended family has no collective story as does usually a child of war..maybe that is one of the best things about finally acknowledging how fragile our species is and having the means to is that this is a universal thing we humans have been inflicting on one another that needs addressed.

      A good medical Dr will have a thorough medical history as well as work with a team as well as be trained by a team that was trained by a team whose knowledge has been collected and tested much more so than in mental health where practitioners too often are trained and work in relative isolation and do not have the resources (time/money/training) to ask enough questions to get a diagnosis that is analogous to a medical dr who when for example faced with a fractured femur realizes there are so many factors that affect cause and effects and has at least a foundation of shared, cumulative “Organizational” (in this case species wide) knowledge to start with. It is as if we are just beginning to get the meaning or at least importances of the “Formative Years” for the whole species not just one’s own family or community or continent etc.

    1. Same here and the “Newness” may be just that it is being taken more seriously, recognized. Life is so short and human learning takes so long.

  2. Nice that it’s being recognized. Although, it’s disappointing that dissociation disorders(OSDD and Dissociation identity disorder) are not on the list of disorders it accompanies.

    1. True. During formative years identity formation can become fractured and/or deformed.

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