
                   Complex Post-Traumatic Stress Disorder
                                      
   Recommended DSM diagnostic criteria, per Trauma and Recovery by Judith
   Herman, c1992 by Basic Books.
   
    1. A history of subjection to totalitarian control over a prolonged
       period (months to years). Examples include hostages, prisoners of
       war, concentration-camp survivors, and survivors of some religious
       cults. Examples also include those subjected to totalitarian
       systems in sexual and domestic life, including survivors of
       domestic battering, childhood physical or sexual abuse, and
       organized sexual exploitation.
    2. Alterations in affect regulation, including:
          + persistent dysphoria
          + chronic suicidal preoccupation
          + self-injury
          + explosive or extremely inhibited anger (may alternate)
          + compulsive or extremely inhibited sexuality (may alternate)
    3. Alterations in consciousness, including:
          + amnesia or hypermnesia for traumatic events
          + transient dissociative episodes
          + depersonalization/derealization
          + reliving experiences, either in the form of intrusive
            post-traumatic stress disorder symptoms or in the form of
            ruminative preoccupation
    4. Alterations in self-perception, including:
          + sense of helplessness or paralysis of initiative
          + shame, guilt, and self-blame
          + sense of defilement or stigma
          + sense of complete difference from others (may include sense
            of specialness, utter aloneness, belief no other person can
            understand, or nonhuman identity)
    5. Alterations in perception of perpetrator, including:
          + preoccupation with relationship with perpetrator (includes
            preoccupation with revenge)
          + unrealistic attribution of total power to perpetrator
            (caution: victim's assessment of power realities may be more
            realistic than clinician's)
          + idealization or paradoxical gratitude
          + sense of special or supernatural relationship
          + acceptance of belief system or rationalizations of
            perpetrator
    6. Alterations in relations with others, including:
          + isolation and withdrawal
          + disruption in intimate relationships
          + repeated search for rescuer (may alternate with isolation and
            withdrawal)
          + persistent distrust
          + repeated failures of self-protection
    7. Alterations in systems of meaning:
          + loss of sustaining faith
          + sense of hopelessness and despair
       
   [INLINE]
   
  return to [1]SI main page

References

   1. file://localhost/usr/home/llama/Web/psych/injury.html
