Exposure to multiple traumas, especially childhood sexual abuse, has been proven to lead to a cluster of symptoms now known as complex post-traumatic stress disorder (C-PTSD), which differs from PTSD both in diagnosis and treatment.
The term post-traumatic stress disorder (PTSD) was first included in the DSM-111 in 1980, to formally diagnose those survivors who had experienced extreme stress or trauma, particularly the returned Vietnam veterans who were seeking treatment for effects of combat stress. A PTSD diagnosis has been proven to be more relevant for people who are traumatised from the result of single-incident traumas, such as witnessing a murder, a natural disaster, terrorist attack or a single instance of sexual abuse. These are unexpected incidents from which the witness or victim is unable to move on, or to integrate after a reasonable period of time.
Symptoms such as flashbacks, panic attacks and depression along with a range of other maladaptive coping behaviours, including drug and alcohol abuse and avoidance of people/places that remind them of the trauma, are contained within in the diagnosis of PTSD.
It later became apparent that PTSD did not account for the more complicated cluster of reactions and symptomatology presented by victims of prolonged abuse such as domestic violence and sexual abuse. The major difference between PTSD and C-PTSD is the loss of a coherent sense of self, which may be expressed through dissociative disorders along with multiple other symptoms. Exposure to complex trauma by children, in particular, results in a loss of the capacity for self-regulation and healthy inter-personal relationships.
Complex trauma arises from prolonged, repetitive stress offered to the victims by persons who were in a position of trust, such as parents, caregivers or other adults in positions of authority. This could be caused by extreme harm or abandonment and the effects would be greatest if they occurred in early childhood whilst critical parts of the brain were still under formation.
The treatment for either PTSD or C-PTSD have some similarities but treatment of C-PTSD is likely to be long term and multifaceted. Counselling for both, however, has been proven to have the greatest benefits in allowing the trauma survivor to regain a full and productive life.
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