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:

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

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:

Masodkar, K., Johnson, J. & Peterson, M. (20`6). Review of Posttraumatic Stress Disorder and Obesity: Exploring the Link, The Primary Care Companion for CNS Disorders, 18(1).  Available:

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

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:

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:

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:

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. Available:

  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