What It Is, Symptoms & Treatment

What is CPTSD?

Complex post-traumatic stress disorder (CPTSD, C-PTSD or cPTSD) is a mental health condition that can develop if you experience chronic (long-term) trauma. It involves stress responses, such as:

  • Anxiety.
  • Having flashbacks or nightmares.
  • Avoiding situations, places and other things related to the traumatic event.
  • Heightened emotional responses, such as impulsivity or aggressiveness.
  • Persistent difficulties in sustaining relationships.

Examples of chronic trauma include:

  • Long-term child physical or sexual abuse.
  • Long-term domestic violence.
  • Being a victim of human or sex trafficking.
  • War.
  • Frequent community violence.

While CPTSD is often associated with chronic trauma in childhood, adults who experience chronic trauma can also develop the condition.

CPTSD as a diagnosis

Experts across the field of psychology disagree on if CPTSD is a distinct condition and diagnosis.

For example, two organizations that publish professional reference books have different opinions about CPTSD. In 2019, The World Health Organization (WHO) listed CPTSD in its 11th revision of the International Classification of Diseases (ICD-11). But the American Psychological Association (APA), which publishes the Diagnostic and Statistical Manual of Mental Disorders (DMS-5), doesn’t recognize CPTSD as a distinct condition. The DSM-5 does list a sub-type of post-traumatic stress disorder (PTSD) called dissociative PTSD that seems to encompass CPTSD symptoms.

Some experts believe that CPTSD, PTSD and borderline personality disorder (BPD) may exist on a spectrum of trauma-related mental health conditions that vary in the severity of their symptoms.

What’s the difference between CPTSD and PTSD?

The main differences between PTSD and CPTSD are the length of trauma and the symptoms.

Traditionally, experts thought PTSD generally developed from short-term trauma, such as a vehicle accident or a natural disaster. With research, they realized that people who experience long-term, repeated trauma tend to have other symptoms in addition to the symptoms of PTSD.

Both CPTSD and PTSD involve symptoms of psychological and behavioral stress responses, such as flashbacks, hypervigilance and efforts to avoid distressing reminders of the traumatic event(s).

People with CPTSD typically have additional symptoms, including chronic and extensive issues with:

  • Emotion regulation.
  • Identity and sense of self.
  • Relationships.

What’s the difference between CPTSD and BPD?

CPTSD and borderline personality disorder (BPD) share several similar symptoms, such as impulsive behavior, feelings of worthlessness and difficulty forming lasting relationships. Because of this, some experts wonder if these conditions are actually distinct.

According to existing criteria for each condition, the main difference is that chronic trauma has to be the cause of CPTSD, whereas trauma doesn’t have to be the cause of BPD. However, BPD is strongly associated with childhood trauma, such as abuse or neglect.

Another difference is that a person usually develops BPD by young adulthood. A person can develop CPTSD at any age.

How common is CPTSD?

As CPTSD is a newer diagnosis, research is lacking on how common the condition is. But experts estimate that it may affect 1% to 8% of the world population.


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