Complex PTSD as a Diagnosis
There has been ongoing debate among mental health clinicians and researchers regarding the diagnosis of CPTSD. Although there were many who wished to see it included as a separate category in the 2015 edition of American Psychological Association Diagnostic & Statistical Manual of Mental Disorders, there were many who disagreed and much debate ensued (Bryant, 2012; Herman, 2012; Resnick et al., 2012a, 2012b; Weiss, 2012). In the end, it was included in the manual as a subsection under the more well-known Post Traumatic Stress Disorder (PTSD). However, research studies during and following this decision have provided growing evidence for the validity of CPTSD as a construct:
In addition to the numerous other findings regarding the validity of a unique and distinguishable class of trauma survivors who exhibit the symptom profile of CPTSD (Cloitre et al., 2013; Cloitre et al., 2014; Elklit et al., 2014; Knefel et al., 2015; Knefel & LuegerSchuster, 2013), researchers and clinicians now have a growing body of evidence, drawn from a multitude of distinct trauma populations, to support the construct validity of CPTSD as a distinct diagnostic entity (Hyland et al., 2016, p. 7).
As a result, it is anticipated that Complex PTSD will be included in the 11th version of the World Health Organization’s (WHO) International Classification of Diseases (ICD11) to be published in 2017-2018 as a separate and distinct entity. It is not known whether or when it might be included in the APA's diagnostic manual.
It should be noted that Complex PTSD is referred to alternately in the literature as Complex Trauma, Disorder of Extreme Stress Not Otherwise Specified (DESNOS), Developmental Trauma (relating to children). In view of the fact that "Complex PTSD" it is likely to be the term included in the ICD11 and that it has been and continues to be used extensively by both professionals and the public, it has been adopted here so that those of us who are dealing with it can begin our journey “out of the storm” and to share our knowledge and experiences to support and encourage one another along the way.
Bryant, R. A. (2012). Simplifying complex PTSD: Comment on Resick et al. (2012). Journal of Traumatic Stress, 25(3), 252-253. doi:10.1002/jts.21696
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.
Elklit, A., Hyland, P., & Shevlin, M. (2014). Evidence of symptom profiles consistent with posttraumatic stress disorder and complex posttraumatic stress disorder in different trauma samples. European Journal of Psychotraumatology, 51-10. doi:10.3402/ejpt.v5.24221
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., Shevlin, M., Elklit, A., Murphy, J., Vallières, F., Garvert, D. W., & Cloitre, M. (2016). An Assessment of the Construct Validity of the ICD-11 Proposal for Complex Posttraumatic Stress Disorder. Psychological Trauma: Theory, Research, Practice, And Policy, doi:10.1037/tra0000114
Kezelman, C., Hossack, N., Stavroupoulos, P. & Burley, P. (2015). The cost of unresolved childhood trauma and abuse in adults in Australia. Retrieved from: http://www.blueknot.org.au/WHO-WE-ARE/Our-Documents/Publications
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
Resick, P. A., Bovin, M. J., Calloway, A. L., Dick, A. M., King, M. W., Mitchell, K. S., & ... Wolf, E. J. (2012). A critical evaluation of the complex PTSD literature: Implications for DSM-5. Journal of Traumatic Stress, 25(3), 241-251. doi:10.1002/jts.21699
Resick, P. A., Wolf, E. J., Stirman, S. W., Wells, S. Y., Suvak, M. K., Mitchell, K. S., & ... Bovin, M. J. (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
Walker, P. (2013). Complex PTSD: From surviving to thriving. USA: Azure Coyote.
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
World Service Organization of Adult Children of Alcoholics. http://www.adultchildren.org/member-GlobalFellowship