Skip to main content
Resources

Complex Post-Traumatic Stress Disorder Test: Understanding the Diagnosis

Medically reviewed by Dr. Harold Hong, MDOn February 10, 2025
Written by Updated On February 10, 2025

KEY POINTS

  • Complex PTSD arises from prolonged trauma and involves symptoms beyond those of PTSD.
  • Diagnosing complex PTSD involves clinical assessments and other diagnostic tools.
  • Complex PTSD requires integrative treatment that may include different types of therapeutic modalities, medications, and holistic therapy.

Complex post-traumatic stress disorder (CPTSD) is a severe and often debilitating condition that arises from prolonged or repeated exposure to trauma, typically in situations where escape is difficult or impossible, like child abuse or domestic violence.[1] It shares similarities with traditional PTSD but presents with additional symptoms and complexities.

There is no test to diagnose complex PTSD, but there are diagnostic tools to identify CPTSD as a distinctive disorder from PTSD and determine a treatment plan.

SPEAK WITH AN ADMISSIONS COUNSELOR TODAY

What Is Complex PTSD?

Most people are familiar with PTSD, but complex PTSD is a separate condition that develops in response to long-term trauma, such as ongoing abuse, captivity, or chronic exposure to highly stressful situations. Unlike PTSD, which is often associated with a single traumatic event or isolated events, CPTSD results from prolonged trauma, particularly in situations where the person feels trapped or powerless.

There are several differences between PTSD and CPTSD, but the primary one is the length of the trauma. PTSD often arises from a single event, such as a natural disaster, assault, or car accident, while CPTSD occurs with prolonged or repeated trauma, such as prolonged child abuse or being held captive for a long period.

The symptoms can also differ. PTSD is marked by flashbacks, nightmares, avoidance of trauma reminders, and heightened arousal. CPTSD includes all PTSD symptoms but also features additional symptoms such as difficulties with emotional regulation, persistent negative emotions, problems with self-identity, and interpersonal difficulties.[2] Some symptoms overlap, however, such as intrusive memory, hypervigilance, and avoidance.

How Common Is CPTSD?

CPTSD is less common than traditional PTSD but still affects a significant portion of the population. The estimated prevalence rates are 1.5% for PTSD and 0.5% for CPTSD.[3] However, CPTSD is a new concept that arose when researchers recognized additional symptoms that emerge from long-term trauma that aren’t present with trauma that occurs from a single traumatic event.

Causes and Symptoms of CPTSD

There are several possible causes of CPTSD, including continuous exposure to traumatic events, such as physical or emotional abuse, domestic violence, or chronic neglect. This is common with long-term child abuse, combat scenarios, or long-term intimate partner violence.

Trauma experienced in situations where the person feels helpless or trapped, such as long-term abuse or captivity that may occur with sex trafficking, can also cause CPTSD. People who have been victims of torture, slavery, or genocide may also develop CPTSD.

Traumatic stress is associated with permanent changes in key areas of the brain, including the amygdala, the part of the brain that processes fear, and the hippocampus, the part of the brain that’s responsible for learning and memory.[4] The prefrontal cortex, the part of the brain that’s involved in executive function like personality expression and decision making, is also affected.

The symptoms of CPTSD include:

  • Re-experiencing trauma, such as intrusive memories, nightmares, and flashbacks.
  • Avoiding the trauma reminders and emotional numbness
  • Increased arousal, irritability, and hypervigilance.
  • Emotional regulation issues, such as difficulty managing emotions and intense feelings of anger or sadness.
  • Persistent feelings of worthlessness or guilt.
  • Difficulties in relationships, such as trust issues or a sense of isolation.

How Is CPTSD Diagnosed?

There is no test to diagnose CPTSD. Instead, the diagnosis involves a comprehensive assessment by a mental health professional. The process often includes a clinical interview with a detailed discussion of trauma history, symptoms, and current functioning. The results of the assessment are evaluated against the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for PTSD and CPTSD.

Self-report questionnaires may be used to diagnose CPTSD, such as the Clinician-Administered PTSD Scale (CAPS) or the PTSD Checklist (PCL). These tests can be helpful in assessing symptoms of CPTSD.

How Is CPTSD Treated?

The treatment for CPTSD typically involves a combination of psychotherapy, medication, and support services.

Psychotherapy, or talk therapy, is the main treatment for CPTSD. Often, cognitive behavioral therapy (CBT), or trauma-focused CBT, is used. This type of therapy relies on a trained, licensed mental health professional offering support, education, and guidance to help you understand how your body responds to trauma and learn how to manage symptoms. Because avoidance is common with PTSD and CPTSD, therapists may use exposure therapy to encourage you to enter situations that cause anxiety and learn to cope in healthy ways.

Another type of trauma-focused therapy is eye movement desensitization and reprocessing (EMDR). With this treatment, you focus on sounds or movements while thinking about the traumatic events, which can relieve some of the emotional charge that’s associated with them.

Dialectical behavioral therapy (DBT) may also be used. Similar to CBT, DBT was created for people with intense emotions and focuses on understanding and managing feelings in healthier ways.

There are no medications approved by the FDA to treat CPTSD specifically, but some medications can help with the symptoms. Antidepressants like norepinephrine reuptake inhibitors (SNRIs) or selective serotonin reuptake inhibitors (SSRIs), anti-anxiety medications, and sleep medications may be used.

In addition to evidence-based therapies, holistic programs like art therapy and yoga can help with mood regulation and may inspire feelings of hope. Support groups can be an important part of CPTSD recovery and building a network of recovery peers with similar experiences.

Get Help for CPTSD

Complex PTSD can be debilitating, often including frightening or challenging moments and reliving trauma, which can take a toll on your physical and mental health. Fortunately, professional treatment with evidence-based therapies can help you manage your traumatic memories and establish healthy coping strategies.

SPEAK WITH AN ADMISSIONS COUNSELOR TODAY

Related Topics

Frequently Asked Questions About Complex PTSD

CPTSD and borderline personality disorder (BPD) can have overlapping symptoms, such as difficulties forming relationships and emotional instability. They are distinct diagnoses, however. CPTSD arises from prolonged trauma and involves symptoms related to that, including avoidance, hypervigilance, and re-experiencing the trauma. BPD is a personality disorder characterized by a pervasive pattern of instability in relationships, poor self-image, and poor emotional regulation. BPD often includes intense anger, depression, and anxiety.

Yes, children can develop CPTSD. The symptoms may manifest differently in children compared to adults, however. Children often display more behavioral symptoms like aggression, withdrawal, or re-enacting the trauma. Diagnosis and treatment for children with CPTSD involve age-appropriate methods of therapy like play therapy.

Yes, CPTSD is treatable. People who undergo treatment for CPTSD often experience improvement. The prognosis is based on several factors, including the duration and severity of the trauma, the individual’s support system, and how well they adhere to treatment.

Supporting someone with CPTSD involves being empathetic, patient, and non-judgmental. Encourage them to seek professional help and offer to assist with finding resources or attending therapy sessions if they wish. Don’t push them to talk about their trauma and respect their boundaries.

While CPTSD is typically associated with interpersonal trauma, such as abuse or captivity, it can be caused by other prolonged or repeated trauma, including natural disasters. The key factor in CPTSD is the duration and impact of the trauma on your ability to cope and process the experience.

While professional treatment is crucial for CPTSD, self-help strategies like mindfulness, stress management, and maintaining a healthy lifestyle can complement professional care.

The duration of CPTSD treatment varies based on your individual needs and severity of symptoms, but it can range from several months to several years.

It’s important to seek help from a licensed mental health professional experienced in trauma and PTSD. Therapists who specialize in trauma-focused therapies or those with expertise in CPTSD are ideal.

Sources

[1,2] Va.gov: Veterans Affairs. Complex PTSD. (2007, January 1). Retrieved from https://www.ptsd.va.gov/professional/treat/essentials/complex_ptsd.asp on 2024, August 29.

[3] Guzman Torres, E., Krause-Utz, A., & Sack, M. (2023, January 5). Predictors of complex PTSD: The role of Trauma Characteristics, Dissociation, and Comorbid Psychopathology. Borderline personality disorder and emotion dysregulation. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9814348/ on 2024, August 29.

[4] Bremner, J. D. (2006). Traumatic stress: Effects on the brain. Dialogues in clinical neuroscience. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181836/#:~:text=Brain%20areas%20implicated%20in%20the,norepinephrine%20responses%20to%20subsequent%20stressors on 2024, August 29.

Amanda Stevens, BS

Medical Content Writer

Amanda Stevens, BS

Amanda Stevens is a highly respected figure in the field of medical content writing, with a specific focus on eating disorders and addiction treatment. Amanda earned a Bachelor of Science degree in Social Work from Purdue University, graduating Magna Cum Laude, which serves as a strong educational foundation for her contributions.