Complex post-traumatic stress disorder

Maercker, Andreas; Cloitre, Marylène; Bachem, Rahel; Schlumpf, Yolanda R.; Khoury, Brigitte; Hitchcock, Caitlin; Bohus, Martin

doi:10.1016/s0140-6736(22)00821-2

Cited by 188 publications

(134 citation statements)

References 117 publications

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“…Complex posttraumatic stress disorder (CPTSD) has recently been included in the 11th revision of the International Classification of Diseases (World Health Organization, 2018 ) as a sibling disorder to posttraumatic stress disorder (PTSD). The addition of CPTSD to the diagnostic classifications has prompted a debate about the suitability of existing evidence-based treatments for persons who have developed CPTSD after trauma (Cloitre, 2015 ; De Jongh et al, 2016 ; Maercker et al, 2022 ). Separating CPTSD from PTSD has also led to an expectation that CPTSD is more difficult to treat (Lehrner & Yehuda, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

“…Also, it has been suggested that treatment length should be extended relative to treating PTSD (Cloitre, 2020 ). However, studies examining dropout and treatment length are, to date, lacking, and treatment recommendations for youth with CPTSD are pending new studies (Jensen et al, 2020 ; Maercker et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

“…In sum, to move the field forward there is a need for treatment studies that examine clinical samples with different trauma exposures using measurements developed to measure PTSD and CPTSD for children and adolescents (Cloitre et al, 2021 ; Maercker et al, 2022 ). In this paper, we address this gap by examining what characterizes youth who have developed CPTSD and whether TF-CBT is helpful for treating CPTSD.…”

Section: Introductionmentioning

confidence: 99%

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Complex PTSD and treatment outcomes in TF-CBT for youth: a naturalistic study

Jensen

Braathu

Birkeland

et al. 2022

European Journal of Psychotraumatology

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Background: Complex posttraumatic stress disorder (CPTSD) has recently been added to the ICD-11 diagnostic system for classification of diseases. The new disorder adds three symptom clusters to posttraumatic stress disorder (PTSD) related to disturbances in self-organization (affect dysregulation, negative self-concept, and disturbances in relationships). Little is known whether recommended evidence-based treatments for PTSD in youth are helpful for youth with CPTSD. Objectives: This study examined whether Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is useful in reducing PTSD and CPTSD in traumatized youth. Methods: Youth ( n = 73, 89.0% girls, M age = 15.4 SD = 1.8) referred to one of 23 Norwegian child and adolescent mental health clinics that fulfilled the criteria for PTSD or CPTSD according to ICD-11 and received TF-CBT were included in the study. Assessments were conducted pre-treatment, and every fifth session. Linear mixed effects models were run to investigate whether youth with CPTSD and PTSD responded differently to TF-CBT. Results: Among the 73 youth, 61.6% ( n = 45) fulfilled criteria for CPTSD and 38.4% ( n = 28) fulfilled criteria for PTSD. There were no differences in sex, age, birth country, trauma type, number of trauma types or treatment length across groups. Youth with CPTSD had a steeper decline in PTSD and CPTSD compared to youth with PTSD. The groups reported similar levels of PTSD and CPTSD post-treatment. The percentage of youth who dropped out of treatment was not different across groups. Further, the groups did not differ significantly in number of received treatment sessions. Conclusions: This is the first study to examine whether TF-CBT is helpful for youth who have CPTSD using a validated instrument for measuring CPTSD. The results suggest that TF-CBT may be useful for treating CPTSD in youth. These are promising findings that should be replicated in studies with larger sample sizes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Complex PTSD and treatment outcomes in TF-CBT for youth: a naturalistic study

Jensen

Braathu

Birkeland

et al. 2022

European Journal of Psychotraumatology

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“…So it is necessary to keep in mind that people with the history of such experiences might be at greater risk of developing not only PTSD but also disturbances in self-organization symptoms. However, the results in different studies with various samples are not consistent, probably confirming the role of personal and environmental factors resulting in vulnerability or resilience to horrific life experiences ( Maercker et al, 2022 ). This means that evaluating the reactions to potentially traumatic experiences might be more important than the type of trauma itself.…”

Section: Discussionmentioning

confidence: 95%

Exploring the links between various traumatic experiences and ICD-11 PTSD and Complex PTSD: A cross-sectional study

et al. 2022

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BackgroundThe 11th revision of the International Classification of Diseases (ICD-11) included two distinct trauma-related diagnoses—Posttraumatic Stress Disorder (PTSD) and Complex Posttraumatic Stress Disorder (CPTSD). The initial diagnostic factor for both disorders is exposure to a traumatic event. This study aimed to explore whether exposure to different traumatic experiences distinguish risk for PTSD and CPTSD.MethodsThe study sample comprised 158 trauma-exposed participants, M(SD)age = 33.61(9.73). The Life Events Checklist-Revised (LEC-R) was used to evaluate trauma exposure, and the International Trauma Questionnaire (ITQ) was used to assess risk for ICD-11 PTSD and CPTSD. Multinomial logistic regression was used to determine traumatic events as predictors of risk for PTSD and CPTSD.ResultsAnalysis revealed that sexual abuse experienced in childhood or adulthood was associated with both PTSD and CPTSD. History of other unwanted sexual experiences and childhood physical abuse predicted CPTSD compared to PTSD, whereas exposure to natural disasters predicted PTSD compared to CPTSD.ConclusionsThe results showed that experiences of certain traumatic events, such as sexual trauma, childhood physical abuse or natural disasters, might help distinguish risk for PTSD and CPTSD. Nevertheless, future studies on specific aspects of trauma exposure are necessary.

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“…With the introduction of the new dimension of "negative alterations in mood and cognition" and the dissociative subtype of PTSD, we have 636,120 symptom combinations to establish the diagnosis [8]. Moreover, the 11th edition of the International Classification of Diseases (ICD-11), but not the DSM-5, introduced the new category of complex PTSD characterized by disorders in identity, interpersonal relationships, and affective regulation [9]. Therefore, it is not surprising that the diagnostic systems have a moderate degree of agreement [2].…”

Section: The History and Diagnosis Of Ptsdmentioning

confidence: 99%

Trauma and Remembering: From Neuronal Circuits to Molecules

Kéri

2022

Life

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Individuals with posttraumatic stress disorder (PTSD) experience intrusions of vivid traumatic memories, heightened arousal, and display avoidance behavior. Disorders in identity, emotion regulation, and interpersonal relationships are also common. The cornerstone of PTSD is altered learning, memory, and remembering, regulated by a complex neuronal and molecular network. We propose that the essential feature of successful treatment is the modification of engrams in their unstable state during retrieval. During psychedelic psychotherapy, engrams may show a pronounced instability, which enhances modification. In this narrative review, we outline the clinical characteristics of PTSD, its multifaceted neuroanatomy, and the molecular pathways that regulate memory destabilization and reconsolidation. We propose that psychedelics, acting by serotonin-glutamate interactions, destabilize trauma-related engrams and open the door to change them during psychotherapy.

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Complex post-traumatic stress disorder

Cited by 188 publications

References 117 publications

Complex PTSD and treatment outcomes in TF-CBT for youth: a naturalistic study

Complex PTSD and treatment outcomes in TF-CBT for youth: a naturalistic study

Exploring the links between various traumatic experiences and ICD-11 PTSD and Complex PTSD: A cross-sectional study

Trauma and Remembering: From Neuronal Circuits to Molecules

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