Summary

Psychological trauma impacts many Australians. The effects can often go unnoticed by the public because the symptoms are not always immediately obvious to others. The symptoms typically impact a person’s perception of themselves and the world, and the impacts can be experienced at work, home, and personal relationships.

It’s estimated that 75% of Australian adults will experience a traumatic event in their lifetime, while 11% may go on to experience posttraumatic stress disorder (PTSD). Complex PTSD (C-PTSD), although less researched than conventional PTSD, is believed to impact 4% of Australians.

What constitutes PTSD versus C-PTSD often confuses people. This is understandable because C-PTSD was not officially defined until 2018. This article aims to outline the differences between PTSD and C-PTSD symptoms, followed by discussing how the conditions are diagnosed and the available treatment pathways.

So, what is PTSD?

PTSD is the development of certain symptoms following exposure to one or more traumatic events.

Trauma is defined as exposure to actual or threatened death, serious injury, or sexual violence. It can be experienced directly, witnessed by another, or learned about as happening to a close family member or friend.

Some negative life experiences can cause PTSD-like symptoms, but the event might not fit the definition of a ‘trauma.’ For example, discovering a partner’s affair, bankruptcy, and bullying can be traumatic and therefore cause the same or similar symptoms to PTSD despite not technically being a ‘trauma.’

People will often be diagnosed with Adjustment Disorder if the symptoms are caused by negative life events that do not meet the official definition of trauma.

How is PTSD diagnosed?

PTSD is typically diagnosed in a therapeutic setting, such as with a GP, Psychiatrist, Psychologist, Paediatrician, and/or mental health team. The primary assessment method is a ‘Clinical Interview’ or ‘Consultation’. A clinical interview is a discussion about the patient’s personal history and current symptoms, such as when the symptoms started, what makes the symptoms better or worse, and how the symptoms affect everyday life. The discussion can be in person or via telehealth.

Some doctors might check for medical conditions that could be contributing to the symptoms, such as requesting blood tests to check for thyroid problems. Some psychologists will use questionnaires to evaluate the range and severity of symptoms.

Throughout the diagnostic process, the health professional will consider whether other factors are causing or contributing to the symptoms. This is important because an accurate diagnosis is critical to developing an accurate treatment plan. For example, OCD and PTSD can sometimes look similar. Both conditions can feature intrusive and distressing thoughts about personal safety, avoidant behaviour, and significant anxiety. Despite looking similar, how the conditions are treated can be extremely different, so an accurate diagnosis is essential.

Finally, a diagnosis can only be made if the symptoms persist for more than one month, and the symptoms cause significant distress and/or interference in everyday functioning.

What is C-PTSD?

C-PTSD was officially defined by the World Health Organisation in 2018. It includes the core symptoms of PTSD but adds three additional considerations. These are called Disturbances in Self-Organisation (DSO).

Symptoms of DSO include:

1. Emotional Dysregulation: Difficulty managing emotional responses, such as intense anger or emotional numbness.
2. Negative self-concept: Persistent beliefs of being worthless, shameful, or damaged.
3. Disturbances in relationships: Difficulties in forming or maintaining close relationships or feeling disconnected from others.

C-PTSD is usually linked to long-term trauma that was difficult to escape, such as repeated exposure to childhood abuse (e.g., domestic violence, institutional sexual abuse), neglect, and/or being held hostage (Herman, 1992; Cloitre et al., 2013).

How is C-PTSD Diagnosed?

C-PTSD is diagnosed the same way as PTSD. That is, the patient discusses their symptoms with an appropriate healthcare provider in-person or via telehealth. The healthcare provider might also request medical tests and/or psychological testing to rule out other causes of the symptoms.

The diagnosing healthcare provider will often consider whether the person also has personality difficulties, such as borderline personality disorder (Resick et al., 2012). This is because the conditions can look very similar and sometimes co-exist. Diagnosing mental health conditions can be complex, because certain difficulties, such as post-traumatic symptoms and challenging personality-related patterns, can overlap or occur together. Experienced clinicians carefully consider these factors to ensure an accurate understanding of each person’s situation. This thorough process reflects the clinician’s training and judgment; mental health diagnoses are best based on clinical evaluation rather than a single medical test.

PTSD vs C‑PTSD: Comparison Table