Understanding Complex PTSD

Updated on June 21, 2019


According to the American Psychiatric Association (2013), a mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. A mental disorder is usually associated with significant distress or disability in social, occupational, and/or other important spheres of one’s life.

In this article, we are focusing on a specific mental disorder called a disorder of extreme stress not otherwise specified (DESNOS), which is also referred to as Complex PTSD.    

What Is Complex PTSD?

Complex posttraumatic stress disorder comes about from prolonged severe abuse.  Often those that are diagnosed are victims of childhood abuse, victims of torture, or have experienced living in a war zone (Gore, 2018).

Symptoms of Complex PTSD

According to Blaz-Kapusta (2008), the symptoms of DESNOS are as follows:

Alterations in regulation of affect and impulses:

  • extreme emotional reaction, inappropriate to the situation
  • self-destructive behaviour (e.g., eating disorders, self-injury)
  • greater sexual impulses or extreme sexual inhibition
  • suicidal ideation
  • anger management problems

Disturbances in attention and consciousness:

  • dissociative episodes and depersonalization
  • amnesia or hyperamnesia due to traumatic experience.

Disturbances in self-perception:

  • negative self-concept
  • sense of helplessness
  • excessive feelings of shame, ignominy, and guilt
  • feeling dirty, disgraced, or marked with a stigma

Disturbances in relationships:

  • loss of trust
  • re-victimizing oneself and/or victimizing others


  • experiencing persistent pain
  • difficulties in digestive, circulatory and cardiopulmonary systems

Disturbances in meaning system:

  • loss of faith
  • sense of helplessness and anguish.

Why Should One Learn about Complex PTSD?

It is very important to gain an understanding of complex PTSD, especially if you are in a legal or mental health profession that advocates for immigrants.

Given the current political climate, with its anti-immigration policies, there has been an uptick in immigration cases targeting the removal of illegal immigrants and legal immigrants with temporary protected status. 155,000 immigrants were arrested last year by US Immigration and Customs Enforcement and a whopping 30% of those arrested had no criminal record. That is a 14% increase of illegal immigrants arrested by US Immigration and Customs Enforcement without a criminal record (Swales, 2018).  There has also been double the number of workplace inspection raids by ICE under the Trump administration (Swales, 2018).

It is important that legal professionals be educated about complex PTSD as it is likely that their clients–especially in U-visa or asylum cases–may be affiliated by this. This makes it difficult for these clients to remember events properly when questioned due to memory problems related to complex PTSD.  

What is the best way for legal professionals to receive this psychoeducational information about complex PTSD?  The easiest way would be to be given an online training via a learning management system such as CertCentral.  

This online learning platform can host content regarding complex PTSD and help legal professionals better work with immigrant clients that suffer from PTSD, complex PTSD, major depressive disorder, and any other mental health disorder. These online trainings are quick to create, and easy to deliver to legal professionals on mobile, tablet, or desktop devices.

It is best for legal professionals to also work with psychologists who can provide immigration psychological evaluations to their immigrant clients to help them with their immigration cases. Contact Dr. Joseph Giardino to provide these evaluations today.

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