ABSTRACT

The inclusion of the diagnosis of Posttraumatic Stress Disorder (PTSD) into the Diagnostic and Statistical Manual of Mental Disorders: DSM-III (American Psychiatric Association, 1980) was heralded by many as a significant development in the history of psychiatry. Primarily associated with the consequences of combat trauma, the diagnosis consisted of three main symptom criteria: (1) re-experiencing; (2) numbing; and (3) physiological hyperarousal, all with a number of manifestations. Not too long after publication, it became clear to many clinicians and researchers studying and treating childhood abuse that the diagnostic criteria for PTSD were not always an absolute fit for victims of childhood abuse, especially chronic abuse (i.e., “complex trauma”) and certain other forms of relational and developmental trauma. In response, Herman (1992) differentiated the consequences of early-life complex trauma from those associated with adult-onset (particularly combat-related) trauma, and proposed criteria for the diagnosis of Complex Posttraumatic Stress Disorder (CPTSD).