Complex PTSD as a Distinct Diagnostic Construct

Bryant, R. A. (2012). Simplifying Complex PTSD: Comment on Resick et al. Journal of Traumatic Stress, 25(3), 252-253. doi:10.1002/jts.21696

Cloitre, M., Garvert, D., Brewin, C., Bryant, R., & Maercker, A. (2013). Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis. European Journal of Psychotraumatology, 4.

Giourou E. et al. (2018). Complex posttraumatic stress disorder: The need to consolidate a distinct clinical syndrome or to reevaluate features of psychiatric disorders following interpersonal trauma? World J Psychiatry, 8(1), 12-19. Available:  Not available online.

Goodman, M. (2012). Complex PTSD is on the trauma spectrum: Comment on Resick et al. Journal of Traumatic Stress, 25(3), 254-255.

Herman, J. (1992). Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress, 5(3).

Herman, J. (2012). CPTSD is a distinct entity: Comment on Resick et al. (2012). Journal of Traumatic Stress, 25(3), 256-257. doi:10.1002/jts.21697

Hyland, P., et al. (2017). An assessment of the construct validity of the ICD-11 proposal for Complex Post Traumatic Stress Disorder. Psychological Trauma: Theory, Research, Practice, And Policy, doi:10.1037/tra0000114

Karatzias, T, et al. (2017). Evidence of distinct profiles of Posttraumatic Stress Disorder (PTSD) and Complex Posttraumatic Stress Disorder (CPTSD) based on the new ICD-11 Trauma Questionnaire (ICD-TQ), Journal of Affective Disorders, 207, 181-187.  Available:  Not available online.

Knefel, M., Garvert, D. W., Cloitre, M., & Lueger-Schuster, B. (2015). Update to an evaluation of ICD-11 PTSD and Complex PTSD criteria in a sample of adult survivors of childhood institutional abuse by Knefel & Lueger-Schuster (2013): A latent profile analysis. European Journal of Psychotraumatology, 61-6. doi:10.3402/ejpt.v6.25290

Rosenthal, M., Reinhardt, K. & Birrell, P.  (2016) Guest editorial: Deconstructing disorder: An ordered reaction to a disordered environment, Journal of Trauma & Dissociation, 17(2), 131-137.

van der Kolk, B. A., Roth, S. & Pelcovitz, D. (2005). Disorders of extreme stress: The empirical foundation of a complex adaptation to trauma. Journal of Traumatic Stress, 18(5), 389-399. 

 Weiss, D. S. (2012). Introduction to the special feature on Complex PTSD. Journal of Traumatic Stress, 25(3), 239-240. doi:10.1002/jts.21711


Cloitre, M., Garvert, D. W., Weiss, B., Carlson, E. B., & Bryant, R. A. (2014). Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis. European Journal of Psychotraumatology, 5(1), 25097

Cloitre, M., et al. (2009). A developmental approach to complex PTSD: Childhood and adult cumulative trauma as predictors of symptom complexity. Journal of Traumatic Stress, 22(5), 399-408. 

Danese, A. & van Harmelen, A. (2017). The hidden wounds of childhood trauma, European Journal of Psychotraumatology, 8(7).

Elklit, A., Hyland, P., & Shevlin, M. (2014). Evidence of symptom profiles consistent with Post Traumatic Stress Disorder and Complex Post Traumatic Stress Disorder in different trauma samples. European Journal of Psychotraumatology, 51(10). doi:10.3402/ejpt.v5.24221

Ford, J. D. & Courtois, C. A. (2014). Complex PTSD, affect dysregulation, and borderline personality disorder. Borderline Personality Disorder and Emotion Dysregulation, 1(1), 9.

Landy, M. S., Wagner, A. C., Brown-Bowers, A., & Monson, C. M. (2015). Examining the evidence for complex posttraumatic stress disorder as a clinical diagnosis. Journal of Aggression, Maltreatment & Trauma, 24(3), 215-236.

Resick, P. et al. (2012). A critical evaluation of the Complex PTSD literature: Implications for DSM-5. Journal of Traumatic Stress, 25(3), 241-251.

Resick, P. et al. (2012). Advocacy through science: Reply to comments on Resick et al. (2012). Journal of Traumatic Stress, 25(3), 260-263. doi:10.1002/jts.21702

van der Hart, O., Nijenhuis, E. R., & Steele, K. (2005). Dissociation: An insufficiently recognized major feature of complex posttraumatic stress disorder. Journal of Traumatic Stress, 18(5), 413-423.

Physical & Psychological Co-Morbidities


Anda, R.  et al. (2006). The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience, 256(3), 174–186. Available:

Boscarina, J. (2006). Post Traumatic Stress Disorder and physical illness: Results from clinical and epidemiologic studies, Annals of the New York Academy of Sciences. Available:

Brown, D., et al. (2009). Adverse childhood experiences and the risk of premature mortality, American Journal of Preventative Medicine, 37(5), 389-396. Available:

Kelly-Irving, M. et al. (2013). Adverse childhood experiences and premature all-cause mortality, European Journal of Epidemiology, 28. Available:

Lanius, R., Vermetten, E. & Pain, C. (Eds).  (2010).  The Impact of Early Life Trauma on Health and Disease: The Hidden Epidemic. Available:

Middlebrooks, J. & Audage, M. (2008). The effects of childhood stress on health across the lifespan: Project report. National Center for Injury Prevention and Control of the Centers for Disease Control and Prevention.  Available:

Najavits, L. et al. (2017).  The science of childhood trauma as a driver of chronic illnesses, CTIPP Science Notes (1), 1-4. Available:

Pace, T. & Heim, C. (2011). A short review on the psychoneuroimmunology of posttraumatic stress disorder: From risk factors to medical comorbidities, Brain, Behavior & Immunity, 25(1), 6-13. Available: 

Schonkoff, J. et al. (2012). The lifelong effects of early childhood adversity and toxic stress, Pediatrics, 129(1). Available:

Schonkoff, J., Boyce, T. & McEwen, B. (2009). Neuroscience, molecular biology, and the childhood roots of health disparities: Building a new framework for health promotion and disease prevention, Psychiatry.  Available:


 Dube, S. et al. (2002). Adverse childhood experiences and personal alcohol abuse as an adult, Addictive Behaviors, 27, 713-725.  Available:

 Strine, T. et al. (2012). Associations between adverse childhood experiences, psychological distress, and adult alcohol problems, American Journal of Health Behavior, 36(3), 408-423. Available:

   Autoimmune & Inflammatory Diseases/Illnesses

 Danese, A. & McEwen, B. (2012). Adverse childhood experiences, allostasis, allostatic load, and age-related disease, Physiology & Behaviour, 106(1), 29-39. Available:

Danese, A. Moffitt, T. & Harringtion, H. (2009). Adverse childhood experiences and adult risk factors for age-related disease, depression, inflammation, and clustering of metabolic risk markers, JAMA Pediatrics.  Available:

Dube, S. et al. (2009). Cumulative childhood stress and autoimmune diseases in adults, Psychosomatic Medicine, 71(2), 243-250.  Available:

Michopoulos, V., et al. (2016). Inflammation in Fear- and Anxiety-Based Disorders: PTSD, GAD, and Beyond, Neuropsychopharmacology. Available:

Plantinga, M., et al. (2013). Association between posttraumatic stress disorder and inflammation: A twin study, BMC Medicine, 30, 125-130.  Available:


Brown, M., Thacker, L. & Cohen, S. (2014). Association between adverse childhood experiences and diagnosis of cancer. PLOS ONE 9(1). Available:

 Kelly-Irving, M. et al. (2013). The embodiment of adverse childhood experiences and cancer development: potential biological mechanisms and pathways across the life course, International Journal of Public Health, 58(1), 3-11. Available:

  Eating Disorders

Bacon, L & Aphramor, L. (2011).  Weight science: evaluating the evidence for a paradigm shift, Nutrition Journal, 10(9). Available here.

Brewerton, T.  (2007). Eating disorders, trauma, and comorbidity: Focus on PTSD, Eating Disorders: The Journal of Treatment & Prevention, 15:4, 285-304. Available here.

Briere, J. & Scott, C. (2007). Assessment of trauma symptoms in eating-disordered populations, The Journal of Treatment & Prevention, 15:4, 347-358.  Available:

Farr, O., Sloane, D., Keane, T. & Mantozoros, C. (2014). Stress- and PTSD-associated obesity and metabolic dysfunction: A growing problem requiring further research and novel treatments, Metabolism, 63(12), 1463–1468. Available here.

Masodkar, K., Johnson, J. & Peterson, M. (2016). Review of Posttraumatic Stress Disorder and Obesity: Exploring the Link, The Primary Care Companion for CNS Disorders, 18(1).  Available here.

Mason, S. et al., (2015). Child maltreatment’s heavy toll: The need for trauma-informed obesity prevention, American Journal of Preventive Medicine. Available here.

Michopoulos, V. et al. (2015). The mediating role of emotion dysregulation and depression on the relationship between childhood trauma exposure and emotional eating, Appetite, 91, 129-136. Available here.

Palmisano, G., Innamorati, M. & Vanderlinden, J. (2016). Life adverse experiences in relation with obesity and binge eating disorder: A systematic review, Journal of Behavioral Addictions 5(1), 11-31. Available here

Palmisano, G., et al. (2018) Childhood traumatic experiences and dissociative phenomena in eating disorders: Level and association with the severity of binge eating symptoms, Journal of Trauma & Dissociation, 19(1), 88-107, Available here.

Tagay, S., Schlottbohm, E., Reyes-Rodriguez, M., Repic, N. & Senf, W. (2014). Eating disorders, trauma, PTSD, and psychosocial resources, Eating Disorders: The Journal of Treatment & Prevention, 22:1, 33-49. Available here.

Waller, G., Corstorphine, E. & Mountford, V. (2007). The role of emotional abuse in the eating disorders: Implications for treatment, Eating Disorders: The Journal of Treatment & Prevention, 15:4, 317-331.

  Suicidality & Self-Harm

Dube, S. et al. (2001). Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: Findings from the Adverse Childhood Experiences Study, JAMA Network. Available:

Ford J. D. & Gómez, J. (2015) The relationship of psychological trauma and dissociative and posttraumatic stress disorders to nonsuicidal self-Injury and suicidality: A review. Journal of Trauma & Dissociation, 16(3), 232-271

Assessment and Treatment

Cloitre, M., Courtois, C., Ford, J. Green, B., Alexander, P., Briere, J., Herman, J. Lanius, R., Pearlman, L., Stolbach, B., Spinazzola, J. & van der Hart, O. (2012). ISTSS expert consensus treatment guidelines for Complex PTSD in adults. International Society for Traumatic Stress Studies.

Courtois, C. A. (2008). Complex trauma, complex reactions: Assessment and treatment. Psychological Trauma: Theory, Research, Practice, and Policy, S(1), 86–100.

de Arellano, M. A., Ko, S. J., Danielson, C. K. & Sprague, C. M. (2008). Trauma-informed interventions: Clinical and research evidence and culture-specific information project. Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress.

Ford, J. D. (2015). Complex PTSD: Research directions for nosology/assessment, treatment, and public health. European Journal of Psychotraumatology, 6(1), 27584.

Gómez, J., Lewis, J., Noll, L., Smidt, A. & Birrell, P. (2015) Shifting the focus: Nonpathologizing approaches to healing from betrayal trauma through an emphasis on relational care, Journal of Trauma & Dissociation, 17(2), 165-185.

Grossman, F., Spinazzola, J., Zucker, M. & Hopper, E. (2017). Treating adult survivors of childhood emotional abuse and neglect: A new framework. American Journal of Orthopsychiatry, 87(1), 86–93.

Heide, F. J. J. T., Mooren, T. M., & Kleber, R. J. (2016). Complex PTSD and phased treatment in refugees: A debate piece. European Journal of Psychotraumatology, 7(1), 28687

Jongh, A., Resick, P. A., Zoellner, L. A., Minnen, A., Lee, C. W., Monson, C. M., ... & Rauch, S. A. (2016). Critical analysis of the current treatment guidelines for complex PTSD in adults. Depression and Anxiety, 33(5), 359-369.

Krammer, S., Kleim, B., Simmen-Janevska, K., & Maercker, A. (2016). Childhood trauma and complex posttraumatic stress disorder symptoms in older adults: a study of direct effects and social-interpersonal factors as potential mediators. Journal of Trauma & Dissociation, 17(5), 593-607.

Rosenthal, M., Reinhardt, K. & Birrell, P. (2016). Deconstructing disorder: An ordered reaction to a disordered environment, Journal of Trauma & Dissociation, 17(2), 131-137.

Tarocchi, A., Aschieri, F., Fantini, F. & Smith, J. (2013). Therapeutic assessment of complex trauma: A single-case time-series study. Clinical Case Studies, 12(3).

van der Kolk, B. A. (2002). The assessment and treatment of complex PTSD. Treating trauma survivors with PTSD, 127-156.

Related Research

Digitale, E. (2016). Traumatic stress changes brains of boys, girls differently. Stanford Medicine News Centre

Haskell, L. & Randall, M. (2009). Disrupted attachments: A social context complex trauma framework and the lives of Aboriginal Peoples in Canada. Journal of Aboriginal Health.

Powers, A., Fani, N., Carter, S., Cross, D., Cloitre, M., & Bradley, B. (2017). Differential predictors of DSM-5 PTSD and ICD-11 complex PTSD among African American women. European Journal of Psychotraumatology, 8(1).

Söchting, I., Corrado, R., Cohen, I., Ley, R. & Brasfield, C. (2007).  Traumatic pasts in Canadian Aboriginal people: Further support for a Complex Trauma conceptualization? British Columbia Medical Journal, 49(6), 320-326.

Research Conducted at OOTS