journal article Open Access Jan 01, 2021

Complex PTSD: Psychotherapy of Prolonged Traumatization

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Abstract
The article considers a new diagnostic category — complex post-traumatic stress disorder (CPTSD), introduced into the International Classification of Diseases (ICD-11). Differences in the mechanism of influence of situational and prolonged trauma are analyzed. CPTSD diagnostic criteria are compared to PTSD and BPD (borderline personality disorder) symptoms. The term “disturbances in self-organi¬zation” is analyzed, which explains the main mechanism of the impact of complex trauma and includes emotional dysregulation, disturbances in self-perception and relationships. Psychotherapeutic approaches developed for PTSD were shown to be insufficient for the treatment of CPTSD. The article reviews an approach to CPSTD therapy based on the consensus of experts in the field of post-traumatic stress and its possible limitations are discussed. “Component based psychotherapy” — another approach to CPTSD therapy — is described. Specific features of psychotherapy for complex trauma are discussed.
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References
35
[1]
Garanyan N.G. Kognitivno-bihevioral’naya psihoterapiya posttravmaticheskogo stressovogo rasstrojstva [Cognitive behavioral treatment in posttraumatic stress disorder]. Konsul’tativnaya psihologiya i psihoterapiya = Counseling Psychology and Psychotherapy, 2013. Vol. 3, pp. 46—72.
[2]
Leahy R., Sampl R. Posttravmaticheskoe stressovoe rasstrojstvo: kognitivnobihevioral’nyj podhod [Posttraumatic stress disorder: cognitive-behavioral approach]. Moskovskij psihoterapevticheskij zhurnal = Counseling Psychology and Psychotherapy, 2002. Vol. 1, pp. 1—18.
[3]
Padun M.A., Kotel’nikova A.V. Psihicheskaya travma i kartina mira. [Psychological trauma and basic assumptions]. M.: Institut psihologii RAN, 2012. 206 p. (In Russ.)
[4]
Shvarc A. [Schwartz A.] Terapiya kompleksnogo posttravmaticheskogo rasstrojstva: prakticheskoe rukovodstvo. [The complex PTSD: workbook]. SPb: «Dialektika», 2020. 176 p. (In Russ.)
[5]
Effektivnaya terapiya posttravmaticheskogo lichnostnogo rasstrojstva. [Effective treatment for PTSD] / E.B. Foa, T.M. Kin, M. D. Fridman — red. [per. s angl. pod obshch. red. N.V. Tarabrinoj]. M.: «Kogito-centr», 2005. 466 p.
[6]
Achterhof R., Huntjens R.J.C., Meewisse M.L., Kiers H.A.L. Assessing the application of latent class and latent profile analysis for evaluating the construct validity of complex posttraumatic stress disorder: cautions and limitations. European Journal of Psychotraumatology, 2019. Vol. 10(1), pp. 1—10. DOI: 10.1080/20008198.2019.1698223 10.1080/20008198.2019.1698223
[7]
Beck A.T. A 60-Year Evolution of Cognitive Theory and Therapy. Perspectives on Psychological Science, 2019. Vol.14(1), pp. 16—20. DOI:10.1177/1745691618804187 10.1177/1745691618804187
[8]
Blankenship D.M. Five efficacious treatments for posttraumatic stress disorder: an empirical review. Journal of Mental Health Counseling, 2017. Vol. 39(4), pp. 275— 288. DOI: 10.17744/mehc.39.4.01 10.17744/mehc.39.4.01
[9]
Chu J.A., Dell P.F., Van der Hart O., Cardeña E., Barach P.M., Somer E., Loewenstein R.J., Brand B., Golston J.C., Courtois C.A., Bowman E.S., Classen C., Dorahy M., Sar V., Gelinas D.J., Fine C.G., Paulsen S., Kluft R.P., Dalenberg C.J., Jacobson-Levy M., Nijenhuis E.R.S., Boon S., Chefetz R.A., Middleton W., Ross C.A., Howell E., Goodwin G., Coons P.M., Frankel A.S., Steele K., Gold S.N., Gast U., Young L.M., Twombly J. Guidelines for treating dissociative identity disorder in adults, third revision. Journal of Trauma and Dissociation, 2011. Vol. 12 (2), pp. 115—187. DOI: 10.1080/15299732.2011.537247 10.1080/15299732.2011.537247
[10]
Cloitre M., Courtois C.A., Charuvastra A., Carapezza R., Stolbach B.C., Green B.L. Treatment of complex PTSD: Results of the ISTSS expert clinician survey on best practices. Journal of Traumatic Stress, 2011. Vol. 24 (6), pp. 615—627. DOI: 10.1002/ jts.20697 10.1002/jts.20697
[11]
Cloitre M., Courtois C.A., Ford J.D., Green B.L., Alexander P., Briere J., Herman J.L., Lanius R., Stolbach B.C., Spinazzola, J., Van der Kolk B.A., Van der Hart O. The ISTSS Expert Consensus Treatment Guidelines for Complex PTSD in Adults, 2012. https://www.istss.org/ISTSS_Main/media/Documents/ISTSS-Expert-Concesnsus-Guidelines-for-Complex-PTSD-Updated-060315.pdf
[12]
Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis

Marylene Cloitre, Donn W. Garvert, Chris R. Brewin et al.

European Journal of Psychotraumatology 10.3402/ejpt.v4i0.20706
[13]
Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis

Marylene Cloitre, Donn W. Garvert, Brandon Weiss et al.

European Journal of Psychotraumatology 10.3402/ejpt.v5.25097
[14]
The International Trauma Questionnaire: development of a self‐report measure of ICD‐11 PTSD and complex PTSD

M. Cloitre, M. Shevlin, C. R. Brewin et al.

Acta Psychiatrica Scandinavica 10.1111/acps.12956
[15]
Corrigan F.M., Hull A.M. Neglect of the complex: why psychotherapy for post-traumatic clinical presentations is often ineffective. BJPsych Bulletin, 2015. Vol. 39, pp. 86—89. DOI: 10.1192/pb.bp.114.046995 10.1192/pb.bp.114.046995
[16]
Courtois C. A., Ford J. D. Treatment of complex trauma: A sequenced, relationship-based approach. Guilford Press, 2013. 378 p. 10.1037/e532062014-001
[17]
De Jongh A., Resick, P.A., Zoellner L.A., van Minnen A., Lee C.W., Monson C.M., Foa E.B., Wheeler K., ten Broeke E., Feeny N.C., Rauch S.A.M., Chard K., Mueser K.T., Sloan D.M., van der Gaag M., Rothbaum B.O., Neuner F., de Roos C., Hehenkamp L.M.J., Rosner R., Bicanic I.A.E. A critical analysis of the current treatment guidelines for complex PTSD in adults. Depression and Anxiety, 2016. Vol. 33 (5), pp. 359—369. DOI: 10.1002/da.22469 10.1002/da.22469
[18]
Distel M.A., Trull T.J., Derom C.A., Thiery E., Grimmer M.A., Martin N.G., Willemsen G., Boomsma D.I. Heritability of borderline personality disorder features is similar across three countries. Psychological Medicine, 2008. Vol. 38 (9), pp. 1219—1229. DOI: 10.1017/S0033291707002024 10.1017/s0033291707002024
[19]
Fernández Fillol C., Serrano-Ibáñez E. R., Ruiz-Párraga G. T., Ramírez Maestre C., Esteve Zarazaga R., López Martínez A. E. Effective therapies for the treatment of complex posttraumatic stress disorder: A qualitative systematic review. Salud Mental, 2018. Vol. 41(2), pp. 81—90. DOI: 10.17711/SM.0185-3325.2018.013 10.17711/sm.0185-3325.2018.013
[20]
Ford J.D., Courtois C.A. Treating Complex Stress Disorders in Children and Adolescents: Scientific Foundations and Therapeutic Models. NY: Guilford Press, 2013. 368 p.
[21]
Ford J.D. New findings questioning the construct validity of complex posttraumatic stress disorder (cPTSD): let’s take a closer look. European Journal of Psychotraumatology, 2020. Vol. 11(1), pp. 86—93. DOI: 10.1080/20008198.2019.1708145 10.1080/20008198.2019.1708145
[22]
Grossman F.K., Spinazzola J., Zucker M., Hopper E. Treating Adult Survivors of Childhood Emotional Abuse and Neglect: A New Framework. American Journal of Orthopsychiatry. 2017. Vol. 87 (1), pp. 86—93. DOI: 10.1037/ort0000225 10.1037/ort0000225
[23]
Harter S.L., Alexander P.C., Neimeyer R.A. Long-term effects of incestuous child abuse in college women: social adjustment, social cognition, and family characteristics. Journal of Consulting and Clinical Psychology, 1988. Vol. 56, pp. 5—8. 10.1037/0022-006x.56.1.5
[24]
Hopper E.K., Grossman F.K., Spinazzola J., Zucker M., Courtois C.A. van der Kolk B.A. Treating Adult Survivors of Childhood Emotional Abuse and Neglect: Component-Based Psychotherapy. The Guilford Press, 2018. 296 p.
[25]
Howard A.P. Treating Complex Stress Disorders in Children and Adolescents: Scientific Foundations and Therapeutic Models. Child & Family Behavior Therapy, 2014. Vol. 36 (2), pp. 140—150. DOI: 10.1080/07317107.2014.910734. 10.1080/07317107.2014.910734
[26]
Karatzias T., Murphy P., Cloitre M., Bisson J., Roberts N., Shevlin M., Hyland P., Maercker A., Ben-Ezra M., Coventry P., Mason-Roberts S., Bradley A., Hutton P. Psychological interventions for ICD-11 complex PTSD symptoms: systematic review and meta-analysis. Psychol Med., 2019. Vol. 49(11), pp. 1761—1775. DOI: 10.1017/S0033291719000436 10.1017/s0033291719000436
[27]
Luxenberg T., Spinazzola J., van der Kolk B.A., Hidalgo J., Hunt C. Complex trauma and disorder of extreme stress (DESNOS) diagnosis, part one: assessment. Directions in Psychiatry, 2001. Vol. 21, pp. 373—392.
[28]
Maercker A., Brewin C.R., Bryant R.A., Cloitre M., van Ommeren M., Jones L.M., Humayan A., Kagee A., Llosa A.E., Rousseau C., Somasundaram D.J., Souza R., Suzuki Y., Weissbecker I., Wessely S.C., First M.B., Reed G.M. Diagnosis and  classification of disorders specifically associated with stress: proposals for ICD-11. World Psychiatry, 2013. Vol. 12(3), pp. 198—206. DOI: 10.1002/wps.20057 10.1002/wps.20057
[29]
Pelcovitz D., van der Kolk B., Roth S., Mandel F., Kaplan S., Resick P. Development of a criteria set and a structured interview for disorders of extreme stress (SIDES). Journal of Traumatic Stress, 1997. Vol. 10 (1), pp. 3—16. DOI: 10.1023/a:1024800212070 10.1002/jts.2490100103
[30]
Powers M.B., Halpern J.M., Ferenschak M.P., Gillihan S.J., Foa E.B. A meta-analytic review of prolonged exposure for posttraumatic stress disorder. Clinical Psychology Review, 2010. Vol. 30(6), pp. 635—641. DOI: 10.1016/j.cpr.2010.04.007 10.1016/j.cpr.2010.04.007
[31]
Schamess G., Shilkret R. Ego psychology. In: J. Berzoff, L. M. Flanagan, P. Hertz (Eds.) Inside out and outside in: Psychodynamic clinical theory and psychopathology in contemporary multicultural contexts. Rowman & Littlefield, 2011, pp. 62—96.
[32]
Spinazzola J., Hodgdon H., Liang Li-Jung, Ford J.D., Layne C.M., Pynoos R., Stolbach B., Briggs E.C., Kisiel C. Unseen Wounds: The Contribution of Psychological Maltreatment to Child and Adolescent Mental Health and Risk Outcomes. Psychological Trauma Theory Research Practice and Policy, 2014. Vol. 6 (1), pp. 18—28. DOI: 10.1037/a0037766 10.1037/a0037766
[33]
Teicher M.H., Samson J.A., Anderson C.M., Ohashi K. The effects of childhood maltreatment on brain structure, function and connectivity. Nature reviews Neuroscience, 2016. Vol. 17 (10), pp. 652—666. DOI: 10.1038/nrn.2016.111 10.1038/nrn.2016.111
[34]
Childhood traumas: an outline and overview
American Journal of Psychiatry 10.1176/ajp.148.1.10
[35]
Van der Kolk B.A. Developmental Trauma Disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 2005. Vol. 35 (5), pp. 401—408. DOI:10.3928/00485713-20050501-06 10.3928/00485713-20050501-06
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Published
Jan 01, 2021
Vol/Issue
29(3)
Pages
69-87
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Funding
Russian Foundation for Basic Research Award: 19-013-00011
Cite This Article
M.A. Padun (2021). Complex PTSD: Psychotherapy of Prolonged Traumatization. Counseling Psychology and Psychotherapy, 29(3), 69-87. https://doi.org/10.17759/cpp.2021290306