Defining and Assessing Complex Posttraumatic Stress Disorder in Severely Mentally Ill Patients in the Public Mental Health System

Saturday, March 24, 2018
5:00 PM - 6:00 PM

This paper describes a seven-factor model for complex posttraumatic stress disorder in adult patients with severe mental illness. This presentation will describe clinical features of complex PTSD and evaluate preliminary evidence of a measure of complex trauma. Case study examples will illustrate the model. Previous research (Miele & O’Brien, 2010) showed that PTSD in children and adolescents is more pervasive than recognized. The present effort will show that complex trauma is much more common than ‘simple’ PTSD in adult patients suffering from chronic mental illnesses.


This paper follows from the ICD-11 differentiation between ‘simple’ and complex PTSD (Cloitre et al., 2012). The present model for defining complex PTSD identifies seven factors that are often present in severely mentally ill adults: history of polysymptomatic presentation and multiple psychiatric diagnoses, severe family mental illness history, presence of a multitude of traumatic events with early onset, high levels of psychosocial stress, PTSD symptoms along with pervasive sysfunction in self-experience, affect dysregulation, and interpersonal problems (Cloitre et al., 2013). Patients (n = 50) came from a public mental health program and had been categorized as suffering from severe mental illnesses. Clinician ratings are being completed for these patients on the complex PTSD assessment instrument.

Edward J. O'Brien

Professor of Psychology
Marywood University
Scranton, Pennsylvania

B.A. in Psychology (with honors), University of Kansas at Lawrence; M.S. and Ph.D. (Clinical Psychology), University of Massachusetts at Amherst; Residency in Clinical Psychology, University of Texas Health Science Center at San Antonio.