Complex trauma in adolescents and adults: Effects and treatment
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KEY POINTS Exposure to multiple interpersonal traumas over the life span can have significant later psychological effects, both on the likelihood of posttraumatic stress disorder (PTSD) in response to a given stressor and in terms of a wide range of other symptoms and problems. Complex trauma can sometimes result in what has been referred to as complex PTSD, developmental trauma disorder, or enduring personality change after catastrophic events, often involving some combination of relational dysfunction, affect dysregulation, identity disturbance, and dysfunctional behavior. There are several empirically validated psychological and pharmacologic treatments relevant to complex trauma, most of which target individual symptom clusters. Psychological treatments for complex trauma effects tend to focus on processing trauma memories and cognitions and developing affect regulation skills and coping responses. Although selective serotonin reuptake inhibitors and related drugs can be helpful for the posttraumatic stress that sometimes follows complex trauma exposure, there are less data to suggest that the other, more personality-level difficulties associated with complex trauma respond well to pharmacologic interventions.