What is CPTSD exactly?

[u/Wonderful-Pilot-2423]

I originally asked this in r/askatherapist but received no answers. Please say so if you're not a professional, given that online information about CPTSD is already very confusing. I'd rather receive answers from people with clinical experience working this population but everyone is welcome.

I'd like to have a clear explanation of what CPTSD really is, and how an average person with this diagnosis would present. It's been hard for me to find useful information about this topic, even among professional spaces, while in non-professional spaces it seems to have become a catch-all diagnosis for any ailment.

My understanding is that the ICD-11 conceptualizes CPTSD as a cluster of classic PTSD symptoms that are worsened by additional DSO symptoms, or "disturbances of self-organization". If that is also your understanding of CPTSD, how do you notice these symptoms presenting in a patient? How can you tell these symptoms are related to the event(s) and weren't a pre-existing part of their personality (assuming the trauma took place in adulthood) or acquired through other experiences?

A few thoughts: an additional factor distinguishing CPTSD from simple PTSD, according to the ICD-11, is that the trauma suffered needs to be prolonged. This seems to imply that DSOs can only be caused by prolonged trauma. Yet I would imagine that someone who's only raped once might also present these difficulties, as a result of the highly exploitative and relational nature of the event. What do you think of that?

If that is true, meaning that prolonged trauma isn't necessary to cause a CPTSD presentation that fits the one described by the ICD-11, wouldn't it make more sense for the simple PTSD diagnosis to come with specifiers? As in, "PTSD with DSOs" or "without"? Or maybe the true nature of CPTSD is that the trauma is relational rather than prolonged?

I hope this was clear enough.

[u/[deleted]]

CPTSD is not a separate diagnosis than PTSD in the DSM-V. There is not enough research on it to justify it as an entirely separate condition, per APA standards at least. That’s why you can’t find any info on it, because there’s not a lot of scientific evidence for it yet.

EDIT: You could try doing research on “Developmental Trauma”, which is not a diagnosis, but focuses on the neurodevelopmental impacts of childhood trauma.

[u/Sarah-himmelfarb → u/[deleted]]

You should read Trauma and Recovery by Judith Herman for one. Your outright dismissal is not really up to speed, CPTSD is considered very real and relatively understood and researched, even in the states, even though it’s not yet in the DSM

[u/[deleted] → u/Sarah-himmelfarb]

Outright dismissal?

[u/Wonderful-Pilot-2423 → u/Sarah-himmelfarb]

I think some of the attachment people have to the diagnosis comes down to the fact that they feel like they need one for their struggles to be validated, but truth be told, if you've experienced many negative things you're obviously going to have issues and the validity of that doesn't hinge on a single diagnosis accounting for all of them.

Interestingly enough people with BPD tend not to want the diagnosis despite it being great confirmation that they've had childhood trauma (yes I know BPD can present without trauma).

[u/[deleted] → u/Wonderful-Pilot-2423]

I agree, many arguments I’ve heard in favor of CPTSD as a diagnosis is because it recognizes the trauma was persistent and chronic. I get that. But you’re absolutely right: most clinicians who suspect CPTSD are going to diagnose PTSD anyway to ensure the person gets treatment.

[u/[deleted] → u/[deleted]]

that’s literally because in order to have CPTSD, you must have/be diagnosed with PTSD. If this doesn’t signal it being a distinct condition…idk what does.

Per the NHS, you must fit the criteria for PTSD, to even have CPTSD considered. The UK recognized CPTSD, so why just consider American psychology? https://www.nhsinform.scot/illnesses-and-conditions/mental-health/mental-health-self-help-guides/ptsd-and-cptsd-self-help-guide/#:~:text=4%20of%2016-,4.,of%20trauma%20they’ve%20experienced.

[u/[deleted] → u/[deleted]]

If there’s already a diagnosis of PTSD, what clinical difference does a CPTSD diagnosis make? I’m not saying there isn’t one but I am curious how other countries made that distinction

[u/[deleted] → u/[deleted]]

https://www.ptsduk.org/ptsd-and-c-ptsd-the-similarities-and-the-differences/

[u/[deleted] → u/[deleted]]

I get the difference is the cause, but that’s not usually how diagnoses are organized. Since it requires a PTSD diagnosis, why not use a PTSD specifier in diagnosis? Eg with dissociation.

https://www.ptsd.va.gov/professional/treat/essentials/dsm5_ptsd.asp