複雜性創傷後壓力症候群：修订间差异

'''{{地区用词|as=译|cn=复合性创伤后应激障碍<ref>世界卫生组织．ICD-11精神、行为与神经发育障碍临床描述与诊断指南 [M]．[https://psy.sjtu.edu.cn/index.php?m=content&c=index&a=show&catid=11221&id=224 王振] {{Wayback|url=https://psy.sjtu.edu.cn/index.php?m=content&c=index&a=show&catid=11221&id=224 |date=20240517095453 }}，[https://www.shspdjw.com/experts/30.html 黄晶晶] {{Wayback|url=https://www.shspdjw.com/experts/30.html |date=20240517095443 }},主译．北京：[[人民卫生出版社]], 2023: 9. {{ISBN|978-7-117-34848-5|plainlink=yes}}.</ref>|tw=複雜性創傷後壓力症候群|hk=tw|start={{lang|en|complex post-traumatic stress disorder, '''（英語：complexCPTSD'''}}|end=世卫组织译'''复杂性创伤后应激-{}-障碍'''<ref>World postHealth Organization (WHO, 世界卫生组织). [https://icd.who.int/browse/2024-01/mms/en?secondLanguageCode=zh#585833559 6B41 Complex post traumatic stress disorder，縮寫為C-PTSD，也稱為複雜disorder 复杂性创伤后应激障碍] {{Wayback|url=https://icd.who.int/browse/2024-01/mms/en?secondLanguageCode=zh#585833559 |date=20240324124825 }} // ICD-11 for Mortality and Morbidity Statistics 用于死因与疾病统计的ICD-11（[[国际疾病分类第十一次修订本]]） [DB/OL], 2019 (2024-01) [2024-05].</ref>}}是一種心理疾病，可能在個人很少或沒有機會逃脫的情況下，因長期反复的人際[[創傷症候群）]]經歷而形成。<ref name="Cook2005">{{cite journal | author = Cook, A. |author2=Blaustein, M. |author3=Spinazzola, J. |author4=Van Der Kolk, B. | year = 2005 | title = Complex trauma in children and adolescents | journal = Psychiatric Annals | volume = 35 | issue = 5 | pages = 390–398 | url = http://doi.apa.org/?uid=2005-05449-004 | accessdate = 2008-03-29|doi=10.3928/00485713-20050501-05 }}</ref>是一種心理疾病，可能在個人很少或沒有機會逃脫的情況下，因長期反复的人際[[創傷]]經歷而形成。<ref>{{Cite book|title=Keep pain in the past : getting over trauma, grief and the worst that's ever happened to you|last1 = Cortman | first1 = Christopher| last2 = Walden | first2 = Joseph | name-list-format = vanc |isbn=978-1-63353-810-8|location=Coral Gables, FL|oclc=1056250299|date = 2018-10-15}}</ref>C-PTSD與[[精神障礙]]的{{link-en|創傷模型|trauma model of mental disorders}}有關，也和長期持續的[[性]]、[[心理]]與{{link-en|自戀型（兒童）虐待|narcissistic (child) abuse}}和[[身體虐待]]或{{link-en|忽視|neglect}}、長期[[親密暴力]]、長期的職場或校園[[霸凌]]的受害者<ref>{{cite journal | vauthors = Hyland P, Murphy J, Shevlin M, Vallières F, McElroy E, Elklit A, Christoffersen M, Cloitre M | display-authors = 6 | title = Variation in post-traumatic response: the role of trauma type in predicting ICD-11 PTSD and CPTSD symptoms | journal = Social Psychiatry and Psychiatric Epidemiology | volume = 52 | issue = 6 | pages = 727–736 | date = June 2017 | pmid = 28194504 | doi = 10.1007/s00127-017-1350-8 | url = http://mural.maynoothuniversity.ie/11571/1/Hyland_Variation_2017.pdf | access-date = 2020-08-02 | archive-date = 2020-01-11 | archive-url = https://web.archive.org/web/20200111101303/http://mural.maynoothuniversity.ie/11571/1/Hyland_Variation_2017.pdf | dead-url = no }}</ref><ref>{{cite journal | vauthors = Ho GW, Karatzias T, Cloitre M, Chan AC, Bressington D, Chien WT, Hyland P, Shevlin M | display-authors = 6 | title = Translation and validation of the Chinese ICD-11 International Trauma Questionnaire (ITQ) for the Assessment of Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) | journal = European Journal of Psychotraumatology | volume = 10 | issue = 1 | pages = 1608718 | date = 2019-12-31 | pmid = 31143410 | pmc = 6522970 | doi = 10.1080/20008198.2019.1608718 }}</ref>、[[綁架]]和[[人質]]情況的受害者、{{link-en|契約奴隸|Indentured servitude}}、[[奴隸制]]和[[人口販運]]的受害者、[[血汗工廠]]工人、[[戰俘]]、[[集中營]]倖存者、[[寄宿學校|住宿學校]]倖存者、以及[[邪教]]組織或類似邪教組織的脫離者有關聯。<ref>{{cite journal | vauthors = Stein JY, Wilmot DV, Solomon Z | title = Does one size fit all? Nosological, clinical, and scientific implications of variations in PTSD Criterion A | journal = Journal of Anxiety Disorders | volume = 43 | pages = 106–117 | date = October 2016 | pmid = 27449856 | doi = 10.1016/j.janxdis.2016.07.001 }}</ref> 涉及被囚禁/誘騙的情況（缺乏為受害者提供可望成功的逃生路線或逃生感的一種情況）可能導致類似C-PTSD的症狀，其中包括長期的恐懼感，無價值感，[[習得性失助|無助感]]以及個人的自我認同和自我感受的變形。<ref name="TAR" />

PTSD的診斷最初是為遭受單一創傷事件（例如[[性侵]]）或[[戰爭]]中經歷過創傷的成年人開發的。<ref name = traumacenter>{{cite web | url=http://www.wmich.edu/traumacenter/pdf/Complex%20Trauma%20and%20Developmental%20Trauma%20Disorder1%5D.pdf | title=Complex Trauma And Developmental Trauma Disorder | publisher=National Child Traumatic Stress Network | access-date=14 November 2013 | archive-url=https://web.archive.org/web/20131205105733/http://www.wmich.edu/traumacenter/pdf/Complex%20Trauma%20and%20Developmental%20Trauma%20Disorder1%5D.pdf | archive-date=2013-12-05 | dead-url=yes }}</ref> 但是，許多孩子的情況截然不同。兒童可能會遭受長期創傷，例如：[[虐待]]、[[家庭暴力]]、[[機能不全家庭|家庭失能]]（英語：dysfunction），和可能包括和主要照顧者的[[依附理論|依戀]]中斷。<ref name = Ford>{{cite journal | vauthors = Ford JD, Grasso D, Greene C, Levine J, Spinazzola J, van der Kolk B | title = Clinical significance of a proposed developmental trauma disorder diagnosis: results of an international survey of clinicians | url = https://archive.org/details/sim_journal-of-clinical-psychiatry_2013-08_74_8/page/841 | journal = The Journal of Clinical Psychiatry | volume = 74 | issue = 8 | pages = 841–9 | date = August 2013 | pmid = 24021504 | doi = 10.4088/JCP.12m08030 }}</ref> 大部分情況是孩子的照顧者造成創傷。<ref name = traumacenter/> PTSD診斷未考慮兒童發育階段如何影響其症狀以及創傷如何影響兒童的成長。<ref name = traumacenter/> '''發育創傷症候群'''（英語：developmental trauma disorder，縮寫為DTD）一詞被提議視為兒童期的C-PTSD。<ref name = Ford/> 這種創傷的發展方式使兒童處於患精神和醫學疾病的風險中。<ref name = Ford/> {{link-en|貝索·馮·德·克洛|Bessel van der Kolk}}博士將DTD解釋為遭遇許多[[人際]]創傷，例如：人身傷害、性傷害、[[暴力]]或[[死亡]]。也可以透過主觀事件，如：{{link-en|遺棄|Abandonment (emotional)}}，[[背叛]]，失敗或[[羞恥]]造成。<ref name=":0">{{cite web | url=http://www.traumacenter.org/products/Developmental_Trauma_Disorder.pdf | title=Developmental trauma disorder | publisher=Psychiatric Annals | year=2005 | access-date=14 November 2013 | vauthors=van der Kolk B | pages=401–408 | archive-date=2017-11-16 | archive-url=https://web.archive.org/web/20171116131957/http://www.traumacenter.org/products/Developmental_Trauma_Disorder.pdf | dead-url=no }}</ref> 在兒童時期反覆遭受創傷將導致不同於PTSD的症狀。<ref name=":0" /> 庫克等人在七個方面描述了其症狀和行為特徵：<ref name="NCTSNWhitePaper">{{Cite book | editor-last = Cook | editor-first = Alexandra | editor2-last = Blaustein | editor2-first = Margaret | editor3-last = Spinazzola | editor3-first = Joseph | editor4-last = van der Kolk | editor4-first = Bessel | name-list-format = vanc | date = 2003 | title = Complex Trauma in Children and Adolescents: White Paper from the National Child Traumatic Stress Network, Complex Trauma Task Force | publisher = National Child Traumatic Stress Network | url = http://nursebuddha.files.wordpress.com/2011/12/complex-trauma-in-children.pdf | access-date = 2013-11-14 | archive-date = 2014-07-14 | archive-url = https://web.archive.org/web/20140714235620/http://nursebuddha.files.wordpress.com/2011/12/complex-trauma-in-children.pdf | dead-url = no }}</ref><ref name="Cook2005" />

經歷過早期生命發展不良的人際交往創傷的歷史，例如：性虐待、肢體虐待、暴力、對個人而言重要、崩潰性的創傷性喪失或主要照顧者背叛與兒童的關係，這被認為是複雜性創傷後壓力症候群的病理基礎。診斷、治療計劃和結果永遠互相關聯。<ref name= "Ford_2009">{{cite book | first1 = Julian D. | last1 = Ford | first2 = Marylene | last2 = Cloitre | chapter = Chapter 3: Best Practices in Psychotherapy for Children and Adolescents |editor-last1=Courtois |editor-first1=Christine A. |editor-last2=Herman |editor-first2=Judith Lewis | name-list-format = vanc |title=Treating complex traumatic stress disorders : an evidence-based guide | url = https://archive.org/details/treatingcomplext0000unse_t4e3 |date=2009 |publisher=Guilford Press |isbn=978-1-60623-039-8 |page=[https://archive.org/details/treatingcomplext0000unse_t4e3/page/60 60] |edition=1st}}</ref>