A Preview of The  Newest Research on Complex Post-Traumatic Stress Disorder

There have been some truly remarkable research papers written about complex post-traumatic stress disorder (CPTSD) in the past few decades. Some of the research focuses exclusively on CPTSD while others can apply to any mental health disorder.

In this article, I’m going to break the ice in the series about complex post-traumatic stress disorder and new research findings.

A Definition of CPTSD


I realize that many reading this article are familiar with the definition of CPTSD. However, for the sake of those who are not we shall examine a description of complex post-traumatic stress disorder and some older research outcomes.

CPTSD is a psychological disorder formed in response to prolonged exposure to interpersonal trauma. CPTSD forms in the minds of those who have little hope or no chance of escaping the trauma perpetrated against their person.

Used to explain complex post-traumatic stress disorder, the trauma model of mental disorders is associated with repeated sexual, psychological, physical abuse or neglect, and chronic intimate partner violence. CPTSD can form in childhood or adulthood depending on when the traumatic experiences began.

Symptoms of complex post-traumatic stress disorder vary from person to person, but a comprehensive list is below:

  • Reliving the trauma through flashbacks and nightmares
  • Avoiding situations that remind them of the trauma
  • Dizziness or nausea when remembering the trauma
  • Hyperarousal, which means being in a continual state of high alert
  • The belief that the world is a dangerous place
  • A loss of trust in the self or others
  • Difficulty sleeping or concentrating
  • Startling easy by loud noises
  • A negative self-view
  • Changes in beliefs and worldview
  • Emotional regulation difficulties
  • Problems with relationships
  • Thoughts or actions of suicide
  • Fixating on the abuser or seeking revenge

Neuroimaging of PTSD and It’s relevance to CPTSD

3333333 While complex post-traumatic stress disorder has many differences from post-traumatic stress disorder (PTSD), the two are closely related. So, let us examine the outcomes of neuroimaging done on the brains of those living with PTSD to better understand brain changes from trauma.

A study conducted in 2013 concluded that not only were CPTSD and PTSD closely related, but there are also close similarities to borderline personality disorder (BPD) as well (Stevens,  Jovanovic, et. al. (2013)1. The similarities allowed researchers to conduct fMRI studies on those with PTSD and use the same data to project that the same damages were in the brains of people who live with CPTSD.

CPTSD and PTSD are not just for those who have experienced severe trauma such as rape or accidents. These two life-altering disorders affect fifty to seventy percent of the citizens of the United States and cost America over forty billion dollars per year. The suffering and impact on families and communities are profound, leaving many adults unable to cope with their lives and losing the ability to work well (Brenner, (2018)2.

Interestingly, some people traumatized individuals may not show symptoms for many years after the traumatic event. In fact, a paper published in the Neuroscience and Biobehavioral Review found that trauma-exposed people who presented without PTSD showed significantly smaller hippocampal volume, smaller amygdalae, and smaller cortical regions than healthy control subjects.

Not only were those brain regions affected, but regions that control intellect, such as the corpus callosum (the wiring of the brain) and smaller than average frontal lobe volume (the seat of intelligence) (Karl, Schaefer, et. al. (2006).3      

The Findings from Neuroimaging Post-Traumatic Stress Disorder

Researchers have conducted many research projects using different modes of neuroimaging, including fMRI, PET, and newer forms of visualizing the brain come into existence every year (Bremner, Randall et. al. (1995).

What researchers looked at the brains of those who have experienced severe traumatic events, such as those returning from war, they found damage to the amygdalae and hippocampi.

A study examined, with the then new neuroimaging tool functional magnetic resonance imaging (fMRI) in 1980 revealed smaller than normal volumes in both the hippocampi and amygdalae of people living with the diagnosis of PTSD.

What this study shows is how two vital regions of the brain associated with emotional regulation and memory consolidation are damaged when exposed repeatedly to traumatic stress.4, 5

Placing Complex Post-Traumatic Stress Disorder into a Spectrum


Mental health professionals are currently trying to decide if CPTSD is its own disorder, or if it belongs to a spectrum of trauma disorders. The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) the diagnostic bible of the psychological world, did not add CPTSD as a separate diagnosis. Now many mental professionals wish to list it under a spectrum of mental health disorders caused by trauma in both childhood and adulthood.

By placing complex post-traumatic stress disorder into a spectrum means linking it to a range of conditions by similar symptoms and traits. This spectrum may represent a range of severity from “severe” to “mild nonclinical deficits.”

While classifying trauma-based disorders into a spectrum may seem to lessen the impact of complex post-traumatic stress disorder, it does not. By putting CPTSD into a spectrum, it will finally receive recognition in the next Diagnostic and Statistical Manual of Mental Disorders.

What Neuroimaging is Teaching Us

Neuroimaging has become a powerful tool in recognizing and treating complex post-traumatic stress disorder. However, studies on CPTSD directly are nearly non-existent. By using neuroimaging techniques and tools such as fMRI, scientists are getting closer to understating how badly trauma impacts both children and adults.

Children who grow up under stress from living in a dysfunctional family where they experienced some type of abuse or neglect, grow up with significant changes in their brains. Since they have damage to their hippocampi and amygdalae, they have problems regulating their emotions and overreacting to triggers in their adult environment that cause conflict in forming adult relationships.


Since the hippocampus and amygdala are vital for memory formation, survivors of childhood neglect and abuse have problems remembering events or even suffer from dissociative amnesia. Dissociative amnesia includes forgetting having said or done something or losing time for short periods without having alters like with dissociative identity disorder.

Clearly, complex post-traumatic stress disorder is highly disruptive to the lives of those living under its influence. However, new and exciting research about not just CPTSD but other mental health disorders as well shine a new light of hope for future treatments.

A Hint of Things to Come  

This piece has been a review of the basic knowledge many of my readers already have about CPTSD. In the next article, I am going to share some very important discoveries that could mean not just treatments, but possibly a cure.

Be sure to watch for the next installment in this two-part series because the next article will not only blow your mind but also give you hope and encouragement.


 Stevens, J. S., Jovanovic, T., Fani, N., Ely, T. D., Glover, E. M., Bradley, B., & Ressler, K. J. (2013). Disrupted amygdala-prefrontal functional connectivity in civilian women with posttraumatic stress disorder. Journal of psychiatric research47(10), 1469-1478.

2. Brenner, G.H, (2018). New Study Shows Brain Change After Psychological Trauma. Psychology Today. Retrieved from: https://www.psychologytoday.com/us/blog/experimentations/201812/new-study-shows-brain-change-after-psychological-trauma

3. Karl, A., Schaefer, M., Malta, L. S., Dörfel, D., Rohleder, N., & Werner, A. (2006). A meta-analysis of structural brain abnormalities in PTSD. Neuroscience & Biobehavioral Reviews, 30(7), 1004-1031. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/16730374/

4. Bremner, J. D., Randall, P., Scott, T. M., Bronen, R. A., Seibyl, J. P., Southwick, S. M., … & Innis, R. B. (1995). MRI-based measurement of hippocampal volume in patients with combat-related posttraumatic stress disorder. The American journal of psychiatry, 152(7), 973.

5. Pitman, R. K., Rasmusson, A. M., Koenen, K. C., Shin, L. M., Orr, S. P., Gilbertson, M. W., … & Liberzon, I. (2012). Biological studies of post-traumatic stress disorder. Nature Reviews Neuroscience, 13(11), 769.










10 thoughts on “A Preview of The  Newest Research on Complex Post-Traumatic Stress Disorder



    > Shirley J. Davis posted: “There have been some truly remarkable research > papers written about complex post-traumatic stress disorder (CPTSD) in the > past few decades. Some of the research focuses exclusively on CPTSD while > others can apply to any mental health disorder. In this ar” >


  2. Interesting Insight

    Pointing out the difference because many think they are one of the same and when you see your trauma is not the same as being subjected and enduring it. I can correlate from experience never in million years I thought this would be me.

    I endured from 9-16 at the hand of the one that suppose to be there to protect you and gave you life. “It” did and thanks for my life but its not yours and for what horrific torment I endured.

    “I hope your decaying existence is mortified in the Belly of Brimstone even that would be too good for Mommy Dearest You twisted Suka”





      1. It does for many times I would say to myself why …what did I do to make you so mad? When I did work up courage from being inspired by my mate that was being physical abuse by his father. I thought I could trust then I was told to stop telling stories because it was so surreal ” after that I was almost certain I would be dead by morning and knew if I was going to fight for my will to live it was on me.

        At 9 yrs old my only friend when I was snuff into the Basement of Secrets was my Bear Saemus aka Sae Sae

        I was forced to play Hyde’s twisted games and would pray just to be finally over but there was fire inside said don’t let them win.

        Darkness became my friend of restitution as long as I was hidden a way in the dark I couldn’t be found but it bloody basement only so many ghastly places you can hide.

        I know its a lot to take in”

        I am far from okay but I’m surviving taken Day by Day when I am lay to rest in peace I take it because never know when I am going to have that again.

        The Constant Roller Coaster is unforgiving ride of Dismay.

        Thanks for the words of perseverance Shirley



        1. Believe it or not, your story isn’t too much to take in. My story and those of others in the DID community are equally tragic and seemingly bizarre. All any of us can do is live one day at a time and overcome all we can of our histories. I know things seem bleak at the moment, but once you have worked through the darkness of your past enough, you will begin to see glimpses of the light that is on the other side. I too can live in despair even after 30 years of treatment but I know for sure that if I hang in there the clouds will part and the sun will shine again. Living with DID is tremendously difficult, but we find a way.

          Be easy with and good to yourself and remember, those people didn’t make you sick overnight it took years. Your healing won’t be quick either but I’ll tell you what my therapist Paula once told me to say to folks who were in despair about healing, “Tell them,” she said, “that healing will take longer than what they want but not as long as they fear.”

          In the meantime, may I suggest an online support group to you? There are lots of them out there but the one that has helped me the most and is the safest is called Ivory Garden at http://www.igdid.org. I’ve been a member there since 2012 and have found lasting friendships and tons of support there. Pat Goodwin owns the site and charges a $20 one time fee to join only because it keeps undesirable trolls away.


          1. Thanks for suggestion to online group Shirley and been fighting My whole life others are afraid or stray from the darkness I don’t . I embrace it with open arms it moulded me into the Alpha I am.

            I will never bow down ever to the Storm”

            “There is saying goes like this: Those that are not wolves are eaten by wolves ” Russian Proverb

            I execute my actions with conviction!

            Thanks for the Support Shirley



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