複雜性創傷後壓力症候群：修订间差异

PTSD的診斷最初是為遭受單一事件創傷（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=5 December 2013 | url-status=dead }}</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 | 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>{{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=5 December 2013 | url-status=dead }}</ref> 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/> '''發育創傷障礙'''（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}}</ref> 在兒童時期反復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}}</ref><ref name="Cook2005" />

* ''依戀''－「存在關係{{link-en|界限線|Personal boundaries}}的問題，、缺乏信任，、[[社會孤立，]]、難以感知和回應他人的情緒狀態」

* ''生物學''－「感覺－運動發育障礙，、[[感覺統合]]困難，、{{link-en|身體化症|Somatization}}和醫療問題增加」

* ''情感或{{link-en|情緒調節|Emotional self-regulation}}''－「情緒調節不良，、難以識別、表達情緒與內在狀態，、難以溝通需求、欲望和願望」