Is CPTSD Similar to Other Disorders?
Related Disorders to CPTSD
Complex Post-Traumatic Stress Disorder (CPTSD) has similarities with PTSD, as well as various personality disorders (mainly Borderline Personality Disorder) but it describes conditions that these other diagnoses fail to adequately address. For certain individuals, CPTSD provides a much way of understanding the roots of their symptoms.
CPTSD is also different from Borderline Personality Disorder in that it is rooted in specific experiences and situations (the somewhat similar Borderline Personality Disorder, for example, can have no apparent situational cause, and there is evidence that it may have a genetic/hereditary basis). CPTSD is also no different from the more widely-discussed Post-Traumatic Stress Disorder (PTSD) as PTSD is more often the result of isolated, “one-time” traumatic events.
Post-Traumatic Stress Disorder (PTSD)
PTSD was originally researched to understand and address the symptoms of veterans returning from the Vietnam War; suffering from the ongoing effects of combat. Researchers and clinicians alike have since attempted to use the same diagnosis to help victims of repeated traumas like sexual abuse and domestic violence. While there are similarities in the symptoms, there are important differences which PTSD does not address (Courtois, 2004).
At its root, CPTSD involves damage to an individual’s sense of self (PTSD does not address this). Traumatic situations in childhood (such as abuse, neglect or captivity) erode a child’s sense of self-worth, and this leads to long-term “psychological fragmentation” (Herman, 1997).
In other words, when traumas occur early in life, they can interrupt a child’s psychological development. It is this disruption of key developmental stages that causes CPTSD, and differentiates it from PTSD. For example, one key difference between CPTSD and PTSD is that PTSD does not include insecure attachment as a symptom. This means that people with CPTSD often have trouble forming healthy relationships, due to the damaging relationships they experienced at a young age. Unfortunately, this long-term effect on personality also makes people with CPTSD prone to re-victimization (Ide and Paez, 2000).
Borderline Personality Disorder
Perhaps more similar to CPTSD, Borderline Personality Disorder (BPD) involves unstable emotions, excessive fears of abandonment, unstable sense of self, and self harm (NIMH Website).
Sufferers of BPD, as well as CPTSD, show patterns of seeking strong emotional ties with their abusers. This is due to a universal tendency to seek closer attachment in the face of danger (Van Der Kolk, 1989). With BPD, the underlying causes of these tendencies may be less clear: in 25% of BPD cases, there is no evidence of childhood neglect or abuse, and there may simply be a genetic predisposition for the disorder (Distel et. al, 2007). In CPTSD, on the other hand, victims develop these patterns as a response to repeated traumas that warp their intuitive understandings of how to trust and form attachments with others.
In comparing CPTSD to other psychological disorders, it’s important to understand that there is no clear delineation between each disorder, and that every individual will have a unique background and a unique set of symptoms. The reason for the introduction and CPTSD (as well as the need for further research) is that researchers and clinicians have found these other diagnoses inadequate in helping victims of long-term trauma, especially when it impacts development during childhood.
Other Related Disorders
To say that Complex Post-Traumatic stress disorder is often misdiagnosed would be an understatement, just as it would be foolish to believe that PTSD and BPD are the only disorders that encompass the spectrum of related disorders. The fact is that there are many diagnoses that victims are often mislabeled as having before complex trauma is even considered. That is not to say that chronic, repeated trauma does not lead to other disorders or that there isn’t a heightened opportunity for two different diagnoses to be comorbid, or occurring at the same time in an individual suffering from CPTSD (or more). Similar diagnoses include (but are not limited to):
- Oppositional Defiant Disorder
- Major Depression
- Bipolar Disorder
- Separation Anxiety
- Disassociative Identity Disorder (formerly known as Multiple Personality Disorder)
- Somatization Disorder
- Eating Disorders
- Phobic Disorder
- Obsessive Compulsive Disorder
More recently, the addition of Developmental Trauma Disorder and Enduring Personality Change After Catastrophic Experience in addition to Disorder of Extreme Stress Not Otherwise Specified (DESNOS) have only served to convolute the issue even further and is all the more reason why there clearly needs to be a separate and distinct disorder of Complex Post-Traumatic Stress Disorder that is separate from the aforementioned diagnoses.
“Borderline Personality Disorder”. NIMH. Retrieved 20 June 2016.
Courtois, Christine A. “Complex Trauma, Complex Reactions: Assessment and Treatment.” Psychotherapy: Therapy, Research, Practice, Training 41.4 (2004): 412-25
Distel, M. A.; Trull, T. J.; Dermon, C. A.; Thiery, E. W.; Grimmer, M. A.; Martin, N. G.; Willemsen, G.; Boosma, D. I. (2007). “Heritability of borderline personality disorder features is similar across three countries” (PDF). Psychological Medicine 2 (1): 43-49.
Ide, N., Paez, A. (2000). “Complex PTSD: A review of current issues”. The Aftermath of Violence–From Domestic Abuse to Political Terror. New York, NY: Basic Books, 1997. Print.
Nemčić-Moro, I., Frančišković, T., Britvić, D., Klarić, M., & Zečević, I. (2011). Disorder of extreme stress not otherwise specified (DESNOS) in Croatian war veterans with posttraumatic stress disorder: case-control study. Croatian Medical Journal, 52(4), 505–512. http://doi.org/10.3325/cmj.2011.52.505
Van Der Kolk, B. A. (1989). “The compulsion to repeat the trauma. Re-enactment, revictimization, and masochism.” The Psychiatric Clinics of North America 12 (2): 389-411.
Van der Kolk, B. A. (2005). Developmental Trauma Disorder. Psychiatric Annals, 35(5), 401-408.