What is "complex post-traumatic stress disorder"

n. A form of post-traumatic stress disorder that results from extended exposure to extreme trauma

Complex post-traumatic stress disorder (C-PTSD), also known as developmental trauma disorder (DTD) or complex trauma, is a proposed diagnostic term for a set of symptoms resulting from prolonged stress of a social and/or interpersonal nature, especially in the context of interpersonal dependence. Subjects displaying traits associated with C-PTSD include victims of chronic maltreatment by caregivers, as well as hostages, prisoners of war, concentration camp survivors, and survivors of some religious cults.

Situations causing the kind of traumatic stress that can lead to C-PTSD-like symptoms include captivity or entrapment (a situation lacking a viable escape route for the victim), as well as psychological manipulation ( gaslighting and/or false accusations), which can result in a prolonged sense of helplessness and deformation of one's identity and sense of self. C-PTSD is distinct from, but similar to, post-traumatic stress disorder (PTSD), somatization disorder, dissociative identity disorder, and borderline personality disorder.

Though mainstream journals have published papers on C-PTSD, the category is not formally recognized in diagnostic systems such as Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Statistical Classification of Diseases and Related Health Problems (ICD). C-PTSD was not included in DSM-IV or in DSM-5, published in 2013. However, the DSM includes "disorder of extreme stress, not otherwise specified" and the ICD has the similar code "personality change due to classifications found elsewhere" (31.1), both of whose parameters approximate C-PTSD.

C-PTSD involves complex and reciprocal interactions among multiple biopsychosocial systems. It was first described in 1992 by Judith Herman in her book Trauma & Recovery and an accompanying article. Forms of trauma associated with C-PTSD involve a history of prolonged subjection to totalitarian control including sexual abuse (especially child sexual abuse), physical abuse, emotional abuse, domestic violence, torture or psychological torture—all repeated or prolonged traumas in which there is an actual or perceived inability for the victim to escape.