Complex posttraumatic stress disorder and child maltreatment in forensic inpatients

Abstract

There is converging evidence that forensic inpatients represent a severely traumatized population, particularly with respect to child maltreatment including sexual, physical, and emotional abuse as well as emotional and physical neglect. One of their possible aftermaths is captured by the syndrome of complex posttraumatic stress disorder (PTSD). This study investigated the prevalence of child maltreatment and complex PTSD in forensic patients. A total of 32 patients (28 men, 4 women) with a mean age of 36.9 years (SD = 11.8) were studied with the Structured Interview for Disorders of Extreme Stress (SIDES) and the Childhood Trauma Questionnaire (CTQ). The majority had experienced emotional abuse (75%), neglect (59%), and physical abuse (52%). The three-month prevalence of complex PTSD was 28% and the lifetime prevalence was 44%. Subjects with complex PTSD had significantly more physical abuse than those without complex PTSD, but did not differ in the other types of trauma. In line with previous research our results indicate that (a) a substantial proportion of forensic patients has been severely victimized in childhood and (b) nearly half meet diagnostic criteria for complex PTSD. These findings have important implications for the treatment process.