Complex PTSD: A syndrome in survivors of prolonged and repeated trauma.

This paper reviews the evidence for the existence of a complex form of post-traumatic disorder in survivors of prolonged, repeated trauma. This syndrome is currently under consideration for inclusion in DSM-IV under the name of DESNOS (Disorders of Extreme Stress Not Otherwise Specified). The current diagnostic formulation of PTSD derives primarily from observations of survivors of relatively circumscribed traumatic events. This formulation fails to capture the protean sequelae of prolonged, repeated trauma. In contrast to a single traumatic event, prolonged, repeated trauma can occur only where the victim is in a state of captivity, under the control of the perpetrator. The psychological impact of subordination to coercive control has many common features, whether it occurs within the public sphere of politics or within the private sphere of sexual and domestic relations.

[1]  J. C. Perry,et al.  Dr. Herman and Associates Reply , 1989 .

[2]  J. Kinzie,et al.  The prevalence of posttraumatic stress disorder and its clinical significance among Southeast Asian refugees. , 1990, The American journal of psychiatry.

[3]  D. Gelinas.  The persisting negative effects of incest. , 1983, Psychiatry.

[4]  D. Halperin.  Group processes in cult affiliation and recruitment , 1982 .

[5]  Lucy S. Dawidowicz.  The War Against the Jews , 1975 .

[6]  A. Biderman.  Social-Psychological Needs and "Involuntary" Behavior as Illustrated by Compliance in Interrogation , 1960 .

[7]  W. Niederland.  Clinical observations on the "survivor syndrome". , 1968, The International journal of psycho-analysis.

[8]  J. Briere,et al.  Sexual abuse histories and sequelae in female psychiatric emergency room patients. , 1989, The American journal of psychiatry.

[9]  H. M. Ploeg,et al.  Being held hostage in The Netherlands: A study of long-term aftereffects , 1989 .

[10]  J. Fleck,et al.  Posttraumatic stress disorder among survivors of Cambodian concentration camps. , 1984, The American journal of psychiatry.

[11]  F. Putnam.  Diagnosis and Treatment of Multiple Personality Disorder , 1989 .

[12]  E. Bliss.  Multiple Personality, Allied Disorders and Hypnosis , 1986 .

[13]  D Finkelhor,et al.  Impact of child sexual abuse: a review of the research. , 1986, Psychological bulletin.

[14]  C. A. Ross,et al.  Structured interview data on 102 cases of multiple personality disorder from four centers. , 1990, The American journal of psychiatry.

[15]  G. McRoberts,et al.  Childhood stress and dissociation in a college population. , 1989 .

[16]  G. Goldstein,et al.  Survivors of imprisonment in the Pacific theater during World War II. , 1987, The American journal of psychiatry.

[17]  C. Tennant,et al.  The psychological effects of being a prisoner of war: forty years after release. , 1986, The American journal of psychiatry.

[18]  R. Emerson Dobash,et al.  Violence Against Wives: A Case Against the Patriarchy , 1981 .

[19]  R. Post,et al.  The clinical phenomenology of multiple personality disorder: review of 100 recent cases. , 1986, The Journal of clinical psychiatry.

[20]  A. Mosnaim,et al.  Posttraumatic Stress Disorder: Etiology, Phenomenology, and Treatment , 1990 .

[21]  J. Kroll,et al.  Drs. Kroll and Sheehan Reply , 1989 .

[22]  A. Burgess,et al.  Response patterns in children and adolescents exploited through sex rings and pornography. , 1984, The American journal of psychiatry.

[23]  Lieut.-Colonel M. E. S. Laws O.B.E.,et al.  Prisoners of War , 1987 .

[24]  R. Jaffè.  Dissociative phenomena in former concentration camp inmates. , 1968, The International journal of psycho-analysis.

[25]  Henry Krystal,et al.  Massive Psychic Trauma , 1970 .

[26]  J. Morrison.  Split Minds/Split Brains: Historical and Current Perspectives , 1989 .

[27]  B. Richardson,et al.  Assault experiences of 100 psychiatric inpatients: evidence of the need for routine inquiry. , 1987, The American journal of psychiatry.

[28]  H. Harlow,et al.  Brainwashing, Conditioning, and DDD (Debility, Dependency, and Dread) , 1957 .

[29]  O. Kernberg.  Borderline Personality Organization , 1967, Journal of the American Psychoanalytic Association.

[30]  Judith Lewis Herman,et al.  Trauma and Recovery , 2015 .

[31]  E. Stover,et al.  Prisoner without a Name, Cell without a Number , 1982 .

[32]  D. Russell.  Lives of Courage: Women for a New South Africa , 1990 .

[33]  Niederland Wg.  Clinical observations on the "survivor syndrome". , 1968 .

[34]  A. Biderman.  Communist attempts to elicit false confessions from Air Force prisoners of war. , 1957, Bulletin of the New York Academy of Medicine.

[35]  J. Herman,et al.  Father-Daughter Incest , 1977, Signs: Journal of Women in Culture and Society.

[36]  E. Fromm,et al.  Hypnotherapy and hypnoanalysis , 1986 .

[37]  S. Ferenczi.  Confusion of tongues between adults and the child , 1988 .

[38]  J. Briere.  The Long‐Term Clinical Correlates of Childhood Sexual Victimization , 1988, Annals of the New York Academy of Sciences.

[39]  J. C. Perry,et al.  Childhood origins of self-destructive behavior. , 1991, The American journal of psychiatry.

[40]  L. Kolb.  Heterogeneity of PTSD. , 1989, The American journal of psychiatry.

[41]  P. Rieker,et al.  Victims of violence and psychiatric illness. , 1984, The American journal of psychiatry.

[42]  J. Kroll,et al.  Depression and posttraumatic stress disorder in Southeast Asian refugees. , 1989, The American journal of psychiatry.

[43]  J. Herman,et al.  Father-Daughter Incest. , 1982 .

[44]  Primo Levi.  Survival in Auschwitz : the Nazi assault on humanity , 1959 .

[45]  Albert D. Biderman,et al.  The manipulation of human behavior , 1961 .

[46]  J. Briere,et al.  Post Sexual Abuse Trauma , 1987 .

[47]  L. Walker.  The Battered Woman , 1979 .

[48]  R. Kluft.  Incest and subsequent revictimization: The case of therapist-patient sexual exploitation, with a description of the sitting duck syndrome. , 1990 .

[49]  P. Coons.  Multiple Personality Disorder , 1994 .

[50]  J. Morrison.  Childhood sexual histories of women with somatization disorder. , 1989, The American journal of psychiatry.

[51]  D. Sugarman,et al.  An Analysis of Risk Markers in Husband to Wife Violence: The Current State of Knowledge , 1986, Violence and Victims.

[52]  J. C. Perry,et al.  Childhood trauma in borderline personality disorder. , 1989, The American journal of psychiatry.

[53]  M. Horowitz.  Stress response syndromes , 1976 .

[54]  L. Terr.  Chowchilla revisited: the effects of psychic trauma four years after a school-bus kidnapping. , 1983, The American journal of psychiatry.

[55]  E. Hilberman.  Overview: the "wife-beater's wife" reconsidered. , 1980, The American journal of psychiatry.

[56]  E. Brett,et al.  Imagery and posttraumatic stress disorder: an overview. , 1985, The American journal of psychiatry.

[57]  E. Zigler,et al.  Do abused children become abusive parents? , 1987, The American journal of orthopsychiatry.

[58]  P. Rieker,et al.  The victim-to-patient process: the disconfirmation and transformation of abuse. , 1986, The American journal of orthopsychiatry.

[59]  John Weiner,et al.  Letter to the Editor , 1992, SIGIR Forum.

[60]  J. B. Miller,et al.  Childhood sexual and physical abuse as factors in adult psychiatric illness. , 1987, The American journal of psychiatry.

[61]  F. Frankenburg,et al.  Discriminating borderline personality disorder from other axis II disorders. , 1990, The American journal of psychiatry.

[62]  Ginny Nicarthy.  Getting free: A handbook for women in abusive relationships , 1982 .

[63]  B. Kolk.  The compulsion to repeat the trauma. Re-enactment, revictimization, and masochism. , 1989 .

[64]  K. Christie,et al.  Prisoners of War , 1943, Social Service Review.

[65]  L. Shengold.  Soul Murder: The Effects of Childhood Abuse and Deprivation , 1989 .

[66]  N. Goldstein.  The Council on Psychiatric Services , 1986 .

[67]  M. Swartz,et al.  Oscillations of attachment in borderline personality disorder. , 1989, The American journal of psychiatry.

[68]  E. Rawlings,et al.  Survivors of terror: Battered women, hostages, and the Stockholm Syndrome. , 1988 .

[69]  H. Merskey,et al.  Briquet's Treatise on hysteria. A synopsis and commentary. , 1980, Archives of general psychiatry.

[70]  J. Gayford.  Wife battering: a preliminary survey of 100 cases. , 1975, British medical journal.

[71]  J. Herman.  Considering Sex Offenders: A Model of Addiction , 1988, Signs: Journal of Women in Culture and Society.

[72]  John C. Campbell,et al.  Fear No Evil , 1988 .