Complex post-traumatic stress disorder (DESNOS): what does it consist of?

Childhood abuse or mistreatment in a dating relationship for years can lead to complex post-traumatic stress disorder.

Complex PTSD almost always originates in childhood. It appears when the person suffers various psychological traumas for a long time. These are situations of high -and continued suffering-, such as that caused by constant sexual abuse and negligence on the part of the parents.

Most of us have already heard of PTSD. In some cases, it is necessary to add the “complex” label at the end because more conditioning factors are manifested. While the first defines a specific adverse experience, such as an assault or a car accident, the second has more peculiarities.

They are negative experiences that are repeated and feedback on a daily basis. The victim is defenseless and, when he can finally leave behind that stormy and harmful experience at all levels, the abysmal wound of trauma opens. This condition was first described in the 1980s, and today it receives much more attention from experts. We analyze it.

Complex post-traumatic stress disorder (DESNOS): definition and origin

Complex PTSD is also known as DESNOS ( Disorder of Extreme Stress Not Otherwise Specified ). It should be noted that today this psychological reality is not yet included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

It is assumed that post-traumatic stress as such already shows different degrees and that one of them is particularly extreme. This would be the case of complex post-traumatic stress disorder, which has already been collected by the WHO International Classification of Diseases (ICD-11). It was in a 2013 New York University research paper that one aspect was emphasized.

Complex Post Traumatic Stress or DESNOS is very different from the others. After analyzing hundreds of cases from the child and adolescent psychiatry unit of the Langone Medical Center (New York), clear evidence of this particularity could be seen.

There are cases of children who, in addition to being neglected, have suffered abuse for years. In them, the psychological impact is different from the one who suffers a specific traumatic episode in their life.

What are the symptoms?

It is important to note that complex PTSD manifests differently in children than in adults. Therefore, a distinction must be made.

Symptoms of childhood and adolescent C-PTSD

The early experience of an adverse situation maintained over time disrupts the normal development of the child. They usually assume that there is something wrong with them. In their minds, they harbor the conviction that there is something defective in their person that justifies their parents or figures in their environment not loving them and abusing them.

  • They show slower physical and psychological development. They tend to suffer from greater somatization problems and medical problems.
  • They develop an insecure attachment that will make it difficult in the future to establish social and emotional relationships.
  • They have a lack of emotional regulation. They are unable to understand and control their emotions.
  • They do not know how to express their needs.
  • They can suffer selective amnesia.
  • They show a lack of impulse control that often leads to bouts of aggression.
  • You manifest insomnia problems, night terrors, and eating behavior problems.
  • It is common that they often lead to self-harm .
  • They have cognitive impairments . Among the most common is lack of attention, problems in executive functions (planning, analysis, reflection, memory …).
  • They tend to show immaturity in language and communication.
  • They have serious alterations in self-concept and personal image. Low self-esteem, feelings of shame.

Symptoms of C-PTSD (complex post-traumatic stress disorder) in adults

Complex post-traumatic stress in adults arises from various experiences. Traumatic dating relationships, those based on abuse and mistreatment, are one example. Having been in theaters of war or being kidnapped are other possible triggers. Let’s know the symptoms:

  • One of the most common features of C-PTSD is dissociation . It is a phenomenon that ranges from disconnection, to depersonalization or derealization. They are defense mechanisms that the mind experiences to separate itself from the focus of pain. It consists of emotionally and cognitively detaching oneself from the environment or feeling that one is not part of one’s own body.
  • It is also common to suffer amnesia or memory loss about some fragments of the past.
  • Feelings of guilt and worthlessness.
  • Problems connecting, relating and trusting others.
  • Somatizations (muscle pain, digestive disorders, headaches, etc).
  • Crisis in the value system.
  • Dysphoric states, going from effusiveness to irritability, suffering frequent anger, attacks of anger …
  • Self-harm.
  • Suicidal ideation

How is complex post-traumatic stress treated?

In 2018, a study was carried out in collaboration with the University of Oxford, the University of Sydney in Australia, and the University of Beijing in China. One of the most effective therapeutic approaches to treat complex PTSD was found to be eye movement desensitization and reprocessing ( EMDR ) therapy.

The objective of this approach is for the person to integrate these lived events (often fragmented or forgotten) so that remembering them does not generate so much pain and suffering. An attempt is made to restructure these experiences in the present so that they do not disturb the well-being and balance of the person.

On the other hand, it is also common to resort to pharmacological therapies, antidepressants being especially useful. However, as we well know, each case is unique and exceptional. The most decisive thing is to have specialized support as soon as possible so that these realities do not get worse or reach extreme situations.

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