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What is Trauma? 

Psychological trauma is the experience and psychological impact of events that are life threatening or include a danger of injury so severe that the person is horrified, feels helpless, and experiences a psychological alarm during and shortly after the experience. 
(Schauer, Neuner&Elbert, 2005) 

How Does PTSD Develop? 

PTSD can develop when a person is exposed to an extreme traumatic event associated with a real or perceived threat of death, severe physical injury or threat to the physical integrity (or witnessing a traumatic event). 
(Smucker & Gonzalez, 2005) 
During life some of us have an experience that is overwhelming, frightening, and beyond our control. We could find ourselves in a car crash, be the victim of an assault, or see an accident. Police, fire brigade or ambulance workers are more likely to have such experiences – they often have to deal with horrifying scenes. Soldiers may be exposed to violence and severe injury and see friends killed or injured. Some people, in time, get over experiences like this without needing help. 
 
However, for some people, traumatic experiences set off a psychological reaction that can last for months and sometimes years. This is called Post Traumatic Stress Disorder or PTSD for short. Some people may develop complex PTSD from prolonged and repeated interpersonal trauma. People who experience trauma, experience symptoms which they have never felt before and the symptoms make them them question their normality. Understanding the impact and effects of the trauma they experienced is an important and beneficial aspect of their treatment. 

DSM 5 criteria for PTSD 

A Exposure to actual or threatened death, serious injury or sexual violence 
 
B The presence of intrusive symptoms associated with the traumatic event(s) and beginning after the event(s) occurred 
 
C Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the event(s) occurred 
 
D Negative alterations in cognitions and mood associated with the traumatic event(s), and after the event 
E Marked alterations in arousal and reactivity associated with the traumatic event(s) beginning or worsening after the event(s) occurred 
 
F Duration of the disturbance is more than one month 
 
G The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning 
 
H The disturbance is not attributable to the physiological effects of a substance or other medical condition 
All 8 criteria have to be met to meet the PTSD diagnosis 

How Does Complex PTSD develop? 

Complex PTSD can develop from repetative ongoing traumatic experiences, unlike PTSD which can develop after a single traumatic experience. cPTSD often develops when people experience torture, sexual abuse, domestic violence, bullying etc. 
Type II Trauma 
What is the difference between PTSD and Complex PTSD? 
A person who has experienced prolonged, interpersonal complex trauma and has Complex PTSD may in particular experience the coloured symptoms. Difficulties may also include, finding it hard to trust others, complicated feelings towards a perpetrator and somatisation, (health problem with no physical evidence or reason). Complex trauma is severe, prolonged and repeated trauma, almost always of an interpersonal nature, often (but not always) beginning early in life. A particular feature of complex trauma is that victims can see the next traumatic event but can’t prevent it from happening. Complex Trauma often leads to further mental health issues such as mood & anxiety disorders. 
What are the clinical symptoms of Complex PTSD? 
Intrusive distressing memories 
 
Distressing dreams 
 
Flashbacks to the trauma 
 
Prolonged emotional distress - external/internal triggers 
 
Behaviours to avoid internal/external triggers/distress 
 
Inability to remember aspects of trauma 
Persistent negative beliefs about oneself/the world 
 
Persistent negative emotional states e.g. shame, guilt 
 
Feeling detached from others 
 
Reduced interest in significant activities 
 
Persistent inability to experience positive emotions 
 
Irritable behaviour and anger outburst 
Reckless or self destructive behaviour 
 
Hyper vigilance 
 
Exaggerated startle response 
 
Problems with concentration 
 
Sleep disturbance 
 
Some people have Dissociative symptoms 
DSM 5 criteria for cPTSD 
Complex Trauma emerges after prolonged, multiple experiences. 
A Alteration in regulation of emotions and compulsion 
B Alteration in attention and consciousness 
C Somatisation 
D Alteration in self perception 
E Alterations in perceptions of the perpetrator 
F Alterations in interpersonal relationships 
G Alterations in systems of meaning 
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