Criteria For Complex PTSD

Criteria For Complex Post-Traumatic Stress Disorder

From: Chapter 6: Diagnosing and Identifying the Need for Trauma Treatment, in First stage trauma treatment: A guide for mental health professionals working with women (© CAMH 2003)

The diagnostic construct of complex PTSD or DESNOS is not currently recognized in the DSM-IV as a freestanding diagnosis, but is instead presented as associated features of PTSD. Complex PTSD is expected to be included in the next edition of the diagnostic guidebook, the DSM-V. However, it is unclear if it will be given the name complex PTSD or DESNOS. Currently, both terms are referred to interchangeably in the clinical literature in this area.

Simple post-traumatic stress consists of changes to three areas of functioning, while complex post-traumatic stress consists of changes to six domains of functioning. The diagnostic criteria for determining the presence of complex post-traumatic stress entails that a number of specific changes (outlined below) are present in each of the six domains of functioning.

Diagnostic criteria for complex post-traumatic stress responses
(I) Alteration in Regulation of Affect and Impulses
(A and one of B to F required)

  • affect regulation
  • modulation of anger
  • self-destructive behaviour
  • suicidal preoccupation
  • difficulty modulating sexual involvement
  • excessive risk-taking

(II) Alterations in Attention or Consciousness
(A or B required)

  • amnesia
  • transient dissociative episodes and depersonalization

(III) Alterations in Self-Perception
(Two of A to F required)

  • ineffectiveness
  • permanent damage
  • guilt and responsibility
  • shame
  • nobody can understand
  • minimizing

(IV) Alterations in Relations with Others
(One of A to C required)

  • inability to trust
  • revictimization
  • victimizing others

(V) Somatization
(Two of A to E required)

  • problems with the digestive system
  • chronic pain
  • cardiopulmonary symptoms
  • conversion symptoms
  • sexual symptoms

(VI) Alterations in Systems of Meaning
(A or B required)

  • despair and hopelessness
  • loss of previously sustaining beliefs

Luxenberg, Spinazzola, van der Kolk. Reprinted with permission from The Hatherleigh Company, Ltd., New, 1-800-367-2550. © 2001

This article has been copied from to provide people with information on complex PTSD diagnostic criteria. For more information please check out the link above and read their article on how that diagnosis is made.