Thus, rather than from lack of consistent empirical data and missing implications for assessment and treatment, Complex PTSD, as a living entity, has suffered from unresolved conceptual dilemmas.

While patients with Complex PTSD share early life stress in the form of developmental traumata as a common etiological feature, nevertheless, they can also be diagnosed as having somatoform, dissociative, mood, eating, substance use, and/or borderline personality disorders depending on features of the index episode or even concurrently (Van der Kolk, 1996). Among others, comorbidity covering multiple spectra of psychopathology and atheoretical character of DSM classifications have prevented Complex PTSD from being recognized as a distinct diagnostic category. Despite these long-term and intensive efforts, it is not known if this concept will be represented in the final version of DSM-5 (American Psychiatric Association, 2010). Composition of a trauma-related disorders section would facilitate integration of knowledge and expertise about interrelated and overlapping consequences of trauma.Īlthough not represented in official psychiatric classifications (American Psychiatric Association, 1994 World Health Organization, 1992), Complex PTSD has been proposed by many clinicians and researchers as a diagnostic category for two decades (Courtois, 2004 Herman, 1992 Van der Kolk, 1996).

Given the current conceptualization of DSM-5, this paper proposes Complex PTSD to be a subtype of the DSM-5 PTSD. We welcome considerations of subsuming Adjustment Disorders, Acute Stress Disorder, PTSD, and Dissociative Disorders under one rubric, i.e., Section of Trauma, Stress, or Event Related Disorders. While a preschooler age variant of PTSD is under consideration, the proposed diagnosis of Developmental Trauma Disorder (child version of Complex PTSD) has not secured a place in the DSM-5 yet. As disorders with highest prevalence of chronic traumatization in early years of life, dissociative disorders and personality disorder of borderline type are maintained as DSM-5 categories however, recognition of a separate type of trauma-related personality disorder is unlikely.

Recognition of dissociative character of several symptom dimensions and introduction of items about negative affects such as shame and guilt imply an indirect improvement toward better coverage of the consequences of developmental trauma in the existing category of PTSD. Despite intensive efforts by its proponents for two decades, it is not known yet if Complex PTSD will take a place in the final version of DSM-5. This paper evaluates representation of clinical consequences of developmental psychological trauma in the current proposal of DSM-5.

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