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by Dr Margaret DeJong and Dr Jacob Ellis
Published: April 2018
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.
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