Trauma refers to the way that some distressing events are so extreme or intense that they overwhelm a person’s ability to cope, resulting in lasting negative impact. The sorts of events that traumatise people are usually beyond the person’s control.
What we know about trauma
The term Complex Trauma is often used to describe the experience of multiple, chronic and prolonged, developmentally adverse traumatic events. These traumatic events often occur within the child’s caregiving system and include physical and emotional abuse, neglect and child maltreatment beginning early in childhood. While complex trauma is generally associated with poorer outcomes over time there is no simple one-to-one relationship between trauma exposure and mental health outcomes.
Post Traumatic Stress Disorder (PTSD) and Complex PTSD
PTSD is the diagnostic label used to describe a particular profile of symptoms that people sometimes develop after experiencing or witnessing a potentially traumatic event or events. PTSD does not describe the full range of reactions to traumatic events; there will be many children and young people who are ‘traumatised’ by events, but their particular difficulties will not fulfil the criteria for PTSD.
It has long been recognised that the reactions of some people following traumatic events extend beyond previous definitions of PTSD. The DSM-5 took this into account with their wide approach as mentioned above. However the approach taken by ICD-11 was to formally define a new diagnosis of Complex PTSD. According to the ICD-11, Complex PTSD consists of the same core symptoms of (ICD-11) PTSD, but has three additional groups of symptoms (which are sometimes referred to as ‘disturbances in self-organisation’ or ‘DSO’):
- Problems in affect regulation (such as marked irritability or anger, feeling emotionally numb)
- Beliefs about oneself as diminished, defeated or worthless, accompanied by feelings of shame, guilt or failure related to the traumatic event
- Difficulties in sustaining relationships and in feeling close to others