The rationale for the clinical construct of complex
post-traumatic stress disorder (PTSD) in children is that it
provides a coherent conceptualisation of the presenting symptoms
resulting from abuse and neglect. Complex PTSD is seen as a
complicated adaptation to prolonged psychological trauma, which is
interpersonal in nature.
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, and victims
of torture or domestic abuse may also develop complex PTSD. In
this module, we will focus on the impact of complex PTSD in early
childhood caused by abuse and neglect.
The term 'complex PTSD' describes the
pervasive developmental impact of complex trauma and its disruptive
effect on core developmental processes including attachment,
identity and self-regulation. Although not 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.
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.