WHAT IS C-PTSD?

The International Classification of Diseases (ICD) and the World Health Organisation (WHO) recognise C-PTSD as a separate condition to PTSD, although the DSM-5 does not yet. 

Because C-PTSD is a relatively recent diagnosis, the level of awareness of its symptoms and treatment amongst front line workers (doctors, therapists, ect.) is limited. C-PTSD does not respond to conventional PTSD treatment which can, in fact, be damaging  (Ford, 1999;McDonagh-Coyle et al., 1999). Although PTSD is commonly found in patients with C-PTSD, this is not always the case. 

People are more likely to experience C-PTSD when the trauma was of an interpersonal nature. Extremely inconsistent or emotionally unavailable caregivers, or a chaotic upbringing can all contribute to the development of  C-PTSD. 

Further, predictors in the severity of symptoms include; duration of exposure to trauma and the earlier in the person's life that the trauma occurs.Additionally, C-PTSD can be associated with chronic sexual, psychological, and physical abuse or neglect, chronic intimate partner violence, prolonged bullying, institutional abuse,as well as other situations where the individual perceives little or no chance of escape.

Both PTSD and C‑PTSD involve core symptoms such as re‑experiencing the trauma, avoidance of reminders, and heightened threat perception (hypervigilance or hyperarousal). However, C‑PTSD adds three additional clusters of symptoms, often referred to as “disturbances in self‑organization (DSO)” (World Health Organization, 2024; Trauma Dissociation, n.d.):

1. Affective Dysregulation – Difficulty managing emotions, often experiencing intense sadness, anger, or fear, and feeling emotionally “numb” or shut down.
    
2. Negative Self‑Concept – Deep, persistent feelings of worthlessness, shame, guilt, or failure or permanently damaged as a result of trauma. Individuals  may blame themselves for the traumatic events, leading to a damaged sense of identity and low self-esteem.
    
3. Interpersonal Difficulties – Ongoing problems in relationships, such as avoiding closeness or intimacy due to fear, mistrust, or discomfort in trusting others. They may feel disconnected and unsafe in social situations. which may  lead to chronic loneliness or isolation.
    

These additional symptoms reflect how prolonged or repeated trauma can affect identity, emotional regulation, and social functioning beyond what is typically seen in PTSD. 

While it is not a mandatory symptom for C-PTSD diagnosis, it is not uncommon for individuals with the diagnosis to experience suicidal ideation, substance abuse, depressive symptoms, psychotic symptoms, and somatic complaints.