Quickbite: Complex post-traumatic stress disorder in children and adolescents

The rationale for the clinical construct of complex post-traumatic stress disorder (CPTSD) in children is that it provides a coherent conceptualisation of the presenting symptoms resulting from severe and usually prolonged or repetitive interpersonal trauma. CPTSD is seen as a complicated adaptation to this traumatic experience.

In cases of child abuse the perpetrator is often in a caregiving role. Other causes in children and adults include experiences relating to war and refugee status. Victims of torture or domestic abuse may also develop CPTSD. In this module, we will focus on the impact of CPTSD in early childhood caused by abuse and neglect.

The term 'complex post-traumatic stress disorder' describes the pervasive developmental impact of complex trauma and its disruptive effect on core developmental processes including attachment, identity and self-regulation. Although not yet recognised in DSM-5 or ICD-10, the term is widely used by clinicians because it is clinically meaningful, capturing some of the more chronic symptomatology and extensive comorbidity. It provides a useful framework for treatment. A new proposal for diagnostic criteria for CPTSD has been accepted and will appear in ICD-11 (Brewin et al, 2017).

Given the high prevalence of abuse and neglect, clinicians will encounter children and young people who have experienced complex trauma in their clinical practice, and therefore need to be familiar with the relevant theory, assessment techniques and management.

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