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

Complex post-traumatic stress disorder almost always has its origins in childhood. It appears when the person suffers various psychological traumas for a long time. They are situations of high – and continued – suffering, such as that caused by constant sexual abuse and negligence on the part of parents.

Most of us have already heard of post-traumatic stress disorder at some point. In some cases, it is necessary to add the “complex” label at the end because more conditions are manifested.. While the first defines a specific adverse experience, such as an assault or a car accident, the second has more particularities.

They are negative experiences that are repeated and feed each other daily. 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 is currently receiving much more attention from experts. We analyze it.

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

Complex post-traumatic stress disorder is also known as DESNOS (Disorder of Extreme Stress Not Otherwise Specified or extreme post-traumatic stress disorder 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 included in 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 disorder or DESNOS is very different from the others. After analyzing hundreds of cases from the child and adolescent psychiatry unit at 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 that of someone 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 sustained over time disrupts the child’s normal development. They usually assume there is something wrong with them. In their minds they harbor the conviction that there is something defective in their person that justifies why their parents or figures around them did not love them and abused them.

They show slower physical and psychological development. They tend to suffer 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 don’t know how to express their needs.They may suffer from selective amnesia. They show a lack of impulse control that often leads to episodes 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 disorders. Among the most common are lack of attention, problems in executive functions (planning, analysis, reflection, memory…). They usually 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 relationships, those based on abuse and mistreatment, are an example.. Having been in war scenarios or being kidnapped are other possible triggers. Let’s know the symptoms:

One of the most common characteristics of C-PTSD is dissociation. It is a phenomenon that includes everything from disconnection to depersonalization or derealization. They are defense mechanisms that the mind experiences to separate itself from the source of pain. It consists of separating oneself emotionally and cognitively from the environment or feeling that one is not part of one’s own body. It is also common to suffer from amnesia or loss of memory 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 from 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. It was found that one of the most effective therapeutic approaches to treat complex PTSD was 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. It is tried restructure these experiences in the present so that they do not disturb the person’s well-being and balance.

On the other hand, it is also common to resort to pharmacological therapies, with 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 worsen or reach extreme situations.

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