In this blog, we will compare the symptoms of “complex trauma” to the symptoms of post-traumatic stress disorder (PTSD) as outlined in the DSM5, and to the symptoms of complex PTSD as outlined in the ICD11.
Complex Trauma – Not a Diagnosis
The first thing to understand about complex trauma is that it is not currently (April 2023) a diagnosis. When the term complex trauma is used there is no internationally recognised definition for this. In contrast if one was to say Posttraumatic Stress Disorder (PTSD) there would be a greater recognition of what this is. Similarly if one was to use the term Complex PTSD there would be a recognition of this across the world.
The term complex trauma is sometimes described in the following manner: A type of psychological injury that occurs as a result of prolonged and repeated exposure to traumatic events. This can include experiences such as childhood abuse, domestic violence, war, or other situations where an individual’s physical or emotional safety is threatened over a long period of time. Complex trauma can have a profound impact on an individual’s mental health, leading to a range of symptoms and difficulties in daily life. The explanation for complex trauma will often go on to state that this can result in a range of symptoms that may be different from those associated with single-event traumatic experiences. This is not true. Some people with single traumas have very severe symptoms.
Of importance is that the descriptions used for complex trauma are also the descriptions that apply for people who are suffering from PTSD and CPTSD. Below are the symptoms of Complex Trauma, as suggested by ChatGPT Mar 23 Version
Symptoms of Complex Trauma:
- Difficulty regulating emotions: Individuals with complex trauma may experience intense and fluctuating emotions, such as anger, fear, or sadness, and may have difficulty managing them.
- Negative self-concept: Individuals with complex trauma may have a negative self-image, low self-esteem, and a sense of shame or guilt.
- Interpersonal difficulties: Individuals with complex trauma may have difficulty forming and maintaining relationships, have trust issues, and may avoid social situations.
- Dissociation: Individuals with complex trauma may have a tendency to dissociate or mentally check out in response to stressful situations.
- Somatization: Individuals with complex trauma may experience physical symptoms, such as headaches or stomachaches, as a result of their trauma.
- Re-experiencing: Similar to PTSD, individuals with complex trauma may have intrusive memories or flashbacks of their traumatic experiences.
- Avoidance: Individuals with complex trauma may avoid people, places, or things that remind them of their trauma.
- Hyperarousal: Similar to PTSD, individuals with complex trauma may be easily startled, have a heightened sense of vigilance, and have difficulty sleeping.
If we compare these symptoms to the DSM5 PTSD symptoms and the ICD11 Complex PTSD symptoms you will notice a lot of overlap with the idea of complex trauma. These symptom lists are brief and each manual outlines more detail than is here. Similarly, there is a lot of overlap between the two diagnostic categories.
DSM5 PTSD Symptoms:
- Intrusive thoughts, memories or flashbacks
- Avoidance of trauma-related triggers
- Negative mood and beliefs about oneself, others or the world
- Increased arousal and reactivity
DSM5 PTSD also has specifiers and subtypes – Specifier dissociative subtype, chronic specifier
ICD11 Complex PTSD Symptoms:
- Affect dysregulation
- Negative self-concept
- Intense interpersonal difficulties
- Negative changes in meaning and identity
- Hyperarousal and hypervigilance
Why is all this important
Diagnostic categories help us understand what kind of treatment or therapy to provide. Therapies are developed in relationship to diagnosis. The term complex trauma doesn’t help decide on types of therapy and there may be danger that the person who believes they have complex trauma does not think that therapy for PTSD or CPTSD would help. The process of developing diagnosis occurs over a long period of time and with much debate. If you think you have the symptoms of complex trauma it is important to seek assistance from someone skilled in diagnosis. Sometimes the complexity that someone might experience is because they have more than one mental health problem and need assistance with each mental health condition.
If you or someone you know is experiencing symptoms of what you believe to be complex trauma, it is important to seek help from a mental health professional. The Centre for Clinical Psychology offers a range of services to help individuals with trauma, including individual assessment and therapy for co-morbid and complex situations . To book an appointment, please call 03 9077 0122 or visit their website at https://ccp.net.au/booking/.
American Psychiatric Association. (2013). Trauma and Stressor Related Disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425787.x07_Trauma_and_Stressor_Related_Disorders
World Health Organization. (2022). 6B41 Complex post traumatic stress disorder. ICD-11: International classification of diseases (11th revision). https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/585833559