Complex PTSD Research Articles

Mediterranean Diet Adherence, Physical Activity, and Advanced Glycation End Products in Complex PTSD: A Comprehensive Examination of Lifestyle and Cardiovascular Risk in War Veterans.

As accumulated evidence suggests that individuals with post-traumatic stress disorder (PTSD) encounter earlier and more frequent occurrences of cardiovascular diseases, the aim of this study was to ascertain the differences in lifestyle and cardiovascular risk between PTSD and complex PTSD patients. We enrolled 137 male war veterans with PTSD (89 had complex PTSD). The diagnosis was established based on 11th revision of International Classification of Diseases (ICD-11), and cardiovascular risk was estimated by the measurement of advanced glycation end products. Adherence to Mediterranean diet (MD) was lower in the complex PTSD group (2.2% vs. 12.5%, p = 0.015). Accordingly, patients with complex PTSD had lower healthy lifestyle scores in comparison to PTSD counterparts (50.6 ± 9.7 vs. 59.6 ± 10.1, p < 0.001), and a positive association was noted between MD adherence and a healthy lifestyle (r = 0.183, p = 0.022). On the other hand, differences were not noted in terms of physical activity (p = 0.424), fat % (p = 0.571) or cardiovascular risk (p = 0.573). Although complex PTSD patients exhibit worse adherence to MD and lower healthy lifestyle scores, these differences do not seem to impact physical activity, body composition, or estimated cardiovascular risk. More research is needed to clarify if this lack of association accurately reflects the state of the PTSD population or results from insufficient statistical power.

Retrospective ACEs predict complex PTSD symptoms in a large sample of Chinese young adults longitudinally: the moderating role of self-compassion

This longitudinal study in Mainland China (2021–2022) explored the impact of adverse childhood experiences (ACEs) on complex posttraumatic stress disorder (CPTSD) symptoms, with a focus on the role of self-compassion. Among 18,933 surveyed university students, 21.2% reported experiencing at least one ACE. Results revealed a clear relationship between ACEs and CPTSD symptoms. Furthermore, self-compassion, particularly the dimensions of self-judgment and isolation, moderated the association between retrospective ACEs and posttraumatic stress disorder (PTSD) and disturbance in self-organization (DSO) symptoms. These findings highlight the enduring impact of ACEs on CPTSD symptoms and emphasize the importance of early identification and targeted interventions, especially addressing self-judgment and isolation, to mitigate CPTSD risk among young Chinese adults.

Transgenerational trauma: Perceived parental style, children's adaptational efforts, and mental health outcomes in second generation and third generation holocaust offspring in Hungary.

The intergenerational impact of genocide has been studied in various contexts, however, the mechanisms of trauma transmission remain unclear. The present study aimed to better understand the relationship between parental trauma and offspring mental health by exploring mechanisms of trauma transmission in the children (n = 599) and grandchildren (n = 311) of Holocaust survivors (HS) in Hungary. In a cross-sectional online survey study, we used the paradigm developed by Danieli, Norris, Lindert, Paisner, Engdahl, et al. (2015) and Danieli, Norris, Lindert, Paisner, Kronenberg, et al. (2015) to assess HS parental styles (i.e., parenting impacted by efforts to cope with past traumatic experiences), as reported by offspring participants, as well as participants' reported level of adaptational impact, that is, their efforts to cope and adapt, and current mental health symptoms posttraumatic stress disorder (PTSD, complex PTSD [C-PTSD], anxiety, depression). We found differences in parental styles reported by generation; however, the mechanism of how it impacted offspring mental health was similar. Mediation analyses showed that more intense parental styles were associated with higher adaptational impact, which, in turn, was related to more mental health symptoms, in both generations. This is the first study to apply the Danieli paradigm in a third-generation sample and the first to assess the psychological impact of the Holocaust in an Eastern European country (Hungary), using systematic quantitative assessment. Our findings highlight the Holocaust's continued impact on the third generation, and the importance of raising awareness of the impact of collective traumas through educational programs, enhancing culturally sensitive and transgenerational trauma-informed mental health services, and fostering tolerance and diversity in public policy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Mindless to Mindful Parenting? Videofeedback-Enhanced Psychotherapy for Violence-Exposed Mothers and Their Young Children.

This article presents a frequent dilemma of treatment-seeking mothers suffering from complex posttraumatic stress disorder (PTSD) that is related to exposure to maltreatment and other forms of interpersonal violence. Namely, that complex PTSD symptoms, including dissociative states in mothers that are triggered by normative child emotion dysregulation, aggression, and distress during early childhood, hinder the development of a productive psychotherapeutic process in more traditional psychodynamic psychotherapies for mothers and children. The article thus presents clinician-assisted videofeedback exposure (CAVE) that characterizes a recently manualized brief psychotherapy for this population, called CAVE-approach therapy (CAVEAT). CAVEAT can be used on its own or to preface a deeper process using child-parent psychotherapy or other non-videofeedback-enhanced psychodynamic models. A clinical illustration is provided.

Factors associated with well-being among treatment-seeking UK Veterans: A cross-sectional study

LAY SUMMARY Veterans seeking treatment for mental health problems are likely to face more than one problem. Well-being is a concept that does not rely on any mental health diagnosis or difficulty and may offer a broader way to capture mental health. In this study, 428 UK Armed Forces Veterans seeking treatment for mental health difficulties at a UK-based charity completed a survey asking about mental health and well-being. Overall, treatment-seeking Veteran well-being was associated with symptoms of anxiety and depression, physical health, problems with anger, moral injury, posttraumatic stress disorder (PTSD), and complex PTSD. Sleep problems, alcohol misuse, and loneliness were also linked with well-being scores. These associations suggest that well-being may capture Veteran health in a way that is separate from any single diagnosis, meaning outcomes for Veterans with complex needs who require a range of support can be compared. These results also highlight the relevance of positive mental health, as opposed to mental ill health.

Understanding the Interplay Between ICD-11 Complex PTSD and Personality Disorder Features in Relation to Traumatic Life Events in a Trauma-Exposed Community Sample

In the ICD-11, PD and CPTSD overlap in impaired aspects of self- and interpersonal functioning, with implications for assessment and treatment. This article aimed to explore the relationship between CPTSD and PD features. A trauma-exposed community sample in Denmark (N = 470) completed the ITQ, PDS-ICD-11, and BTQ. Data were analyzed using exploratory structural equation modeling. Both two- and three-factor models were viable. In the two-factor model, both disturbances in self-organization (DSO) and PD items belonged to the same disturbed self-interpersonal functioning factor. Both factors predicted quality of life and functioning and were predicted by number of life events. In the three-factor model (PTSD, DSO, and PD), there was some overlap between DSO and PD items. Number of life events predicted belonging to the PTSD and DSO classes but not the PD class. The findings demonstrate clear overlapping and differentiating features. Multiple traumas and functioning in self-concept and relationships appear to differentiate.

Complex PTSD Pathway for Kingfisher Mother and Baby Unit

Complex PTSD Pathway for Kingfisher Mother and Baby Unit

Complex posttraumatic stress disorder and dissociation in trauma-exposed Chinese adolescents: a latent class analysis

ABSTRACT Background: Preliminary evidence provides support for the proposition that there is a dissociative subtype of Complex posttraumatic stress disorder (CPTSD). Research on this proposition would extend our knowledge on the association between CPTSD and dissociation, guide contemporary thinking regarding placement of dissociation in the nosology of CPTSD, and inform clinically useful assessment and intervention. Objectives: The present study aimed to investigate the co-occurring patterns of CPTSD and dissociative symptoms in a large sample of trauma exposed adolescents from China, and specify clinical features covariates of such patterns including childhood trauma, comorbidities with major depressive disorder (MDD) and generalized anxiety disorder (GAD), and functional impairment. Methods: Participants included 57,984 high school students exposed to the coronavirus disease 2019 (COVID-19) pandemic. CPTSD and dissociative symptoms, childhood traumatic experience, and functional impairment were measured with the Global Psychotrauma Screen for Teenagers (GPS-T). Major depressive disorder (MDD) and generalized anxiety disorder (GAD) symptoms were measured with the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7), respectively. Latent class analysis (LCA) was employed to test the co-occurring patterns of CPTSD and dissociative symptoms. Analysis of covariance (ANCOVA) and chi-square tests were respectively used to examine between-class differences in continuous and categorical clinical covariates. Results: A 5-class model emerged as the best-fitting model, including resilience, predominantly PTSD symptoms, predominantly disturbances in self-organization (DSO)symptoms, predominantly CPTSD symptoms, and CPTSD dissociative subtype classes. The CPTSD dissociative subtype class showed the lowest level of functioning and the highest rates of MDD, GAD and childhood trauma. Conclusions: Our findings provide initial empirical evidence supporting the existence of a dissociative subtype of CPTSD, and inform for further research and clinical practice on traumatized individuals.

Developmental couple therapy for complex trauma: Results of an implementation pilot study.

This pilot study examined the process and outcome of Developmental Couple Therapy for Complex Trauma (DCTCT) with seven couples. DCTCT is a novel form of couple therapy designed to address complexposttraumatic stress disorder symptomatology and couple-level distress in trauma survivors and their partners. These couples showed statistically significant improvements in overall trauma symptoms, emotion regulation capacities, and reductions in attachment-related anxiety. These results suggest that DCTCT may be a promising approach to intervention. Future directions include the development of a sequential care model, because resource limitations may not allow for all couples to receive the full treatment model over 40 weeks; it will also be important to address measurement issues in relation to mentalizing, to allow for observational coding across the course of therapy.

Complex Trauma and Mentalizing Ability in College Students With or Without Borderline Personality Disorder: A Mixed Method Approach

Background: Exposure to complex trauma in early childhood can undermine the development of mentalization capacity. Complex trauma has also been causally linked to borderline personality disorder (BPD). The inclusion of complex post-traumatic stress disorder in ICD-11 has made it imperative to have an in-depth understanding of complex trauma. Methods: This study used an explanatory sequential mixed method approach to assess the complex trauma and mentalizing ability in college students with BPD ( N = 62) in comparison to non-BPD students ( N = 60) and to explore the subjective experiences of complex trauma in students with BPD ( n = 10). Participants in both groups were assessed on the Childhood Experience of Care and Abuse Questionnaire and the Reading the Mind in the Eyes Test to assess complex trauma and mentalizing ability, respectively. Qualitative data were collected through focused interviews using a phenomenological approach. Results: Those with BPD had significantly higher rates of six types of complex trauma as compared to those without BPD; additionally, participants who had experienced sexual abuse performed better on mentalizing tasks than those who had not. The focused interviews revealed several themes, including “perpetrator,” “impact,” “symptoms,” and “strengths,” which indicated intergenerational trauma and hope for post-traumatic growth. Conclusion: Although participants with BPD experienced higher complex trauma, they also had better mentalizing capacities.

Aboriginal and Torres Strait Islander Complex Trauma and Strengths Questionnaire: psychometric evaluation

ABSTRACT Objective Complex post-traumatic stress disorder (complex trauma) describes a cluster of symptoms frequently associated with prolonged exposure to inescapable threats or abuse. For Aboriginal and Torres Strait Islander peoples in Australia impacted by complex trauma, there may be compounding factors, such as experiences of historical trauma, loss and socio-economic deprivation stemming from colonisation. However, there is no culturally appropriate tool to assess complex trauma. This paper presents the psychometric evaluation of a preliminary version Aboriginal and Torres Strait Islander Complex Trauma and Strengths Questionnaire (ACTSQ). Methods Following 2 years of rigorous Aboriginal-led co-design, participants were recruited through community networks and partner health services in South Australia, Victoria, and Northern Territory (October 2020–May 2022). A trained interviewer contacted Aboriginal (n = 109) and Torres Strait Islander (n = 1) parents aged >16 years by phone to complete the ACTSQ. Underlying domain structures were investigated with exploratory factor analysis and reviewed by experts to refine. Reliability and inter-rater reliability were assessed using McDonald’s Omega and Intraclass Correlation Coefficient (ICC). Results Forty-four items on five factors were retained. Factors were labelled complex trauma symptoms (16 items), grief, loss and disconnection (6 items), support and relationships (9 items), sense of self and strengths (7 items), and Cultural connections and resources (6 items). There were moderate correlations between factors, with the exception of factor 5. Omega was >0.75 for all factors. The inter-rater reliability for each factor was fair to good (ICC 0.5–0.7). Conclusions This study conducted a comprehensive psychometric validation that provides initial evidence towards the cultural validity of the ACTSQ to support assessment of complex trauma and strengths among Aboriginal and Torres Strait Islander peoples. Future studies are required to replicate and further evaluate the psychometric properties of the ACTSQ using larger samples.

THE RELATIONSHIP BETWEEN PERCEIVED SOCIAL SUPPORT AND SYMPTOMS OF CPTSD IN VICTIMS OF DOMESTIC VIOLENCE

Objective. The article is devoted to the peculiarities of traumatization of persons affected by domestic violence. The subject is the nature of the relationship between perceived social support (PSS) and symptoms of complex post-traumatic stress disorder (CPTSD) for the development of methods of helping victims of domestic violence. Long-term traumatic impact on the injured person from a significant loved one, in the absence of adequate and sufficient social support, can manifest itself in re-experiencing, hypervigilance, emotional dysregulation, the formation of a negative self-image, and disturbances in close relationships. Methodology. The study was carried out using the International Trauma Questionnaire (ITQ) and the Multidimensional Scale of Perceived Social Support (MSPSS). 99 people aged 18 to 61 years old with experience of domestic violence were interviewed. The methods used were descriptive analysis, checking the normality of variables using the Kolmagorov-Smirnov test, and C. Spearman’s correlation analysis. Results. Individuals with more severe CPTSD symptoms were found to demonstrate lower levels of PSS. Therefore, to minimize the symptoms of CPTSD, it is advisable to develop skills related to social interaction and building close relationships. Practical implications. The results are applicable in the process of providing crisis and rehabilitation psychological assistance to victims of domestic violence.

The Existential Challenges of Stress, Trauma, and Psychopathology and Their Integration to the Self: A Self-Determination Theory Perspective

AbstractIn much current research on stress, trauma, and psychopathology, there is a converging interest in the role of the stress response in engendering trauma, emotional dysregulation, and mental illness. Both the acute stressors known from post-traumatic stress disorder (PTSD) and the early-life, persistent stressors involved in complex PTSD, may create a stress response that is not properly downregulated. This leaves the person in a permanent state of high arousal and hypervigilance, common characteristics of many psychiatric disorders. It is suggested that such stressors are examples of the challenges that confront everyone: trivial, optimal, or overwhelming. Trivial challenges are mundane, optimal challenges invite learning and development, and overwhelming challenges may lead to trauma and mental ill-being. For a promising perspective on life’s challenges, we turn to Self-Determination Theory (SDT). In SDT, mental health and human flourishing derive from the satisfaction of three basic psychological needs: for autonomy, competence and relatedness, as well as from the integration of experiences and challenges to the self. It is proposed in this paper that the overwhelming challenges involved in trauma and psychopathology are experiences that frustrate or thwart psychological needs and thus fail to integrate to the self. Such experiences may still be internalized, albeit as “introjects”—“thrown in,” swallowed whole, not digested properly. They remain outside of the self, exerting pressure on it through guilt, shame, ego-involvement, pride, etc., in the process producing much anguish and mental pain. Thus, as challenges are part and parcel of the human experience, trauma and psychopathology appear as outcomes of human development, rather than as essentially incomprehensible aberrations.

Utilization of Mental Health Provision, Epistemic Stance and Comorbid Psychopathology of Individuals with Complex Post-Traumatic Stress Disorders (CPTSD)-Results from a Representative German Observational Study.

Background: Complex post-traumatic stress disorder (CPTSD) is a severely debilitating recently added symptom cluster in the International Classification of Diseases (ICD-11). So far, only limited information on mental health treatment-uptake and -satisfaction of individuals with CPTSD is available. The aim of this study is to investigate these aspects in a representative sample of the German general population. Methods: Participants completed the International Trauma Questionnaire (ITQ) to identify participants with CPTSD, as well as questionnaires on mental health treatment uptake and satisfaction, adverse childhood experiences, anxiety, depression, working ability, personality functioning, and epistemic trust. Results: Of the included n = 1918 participants, n = 29 (1.5%) fulfilled the criteria for CPTSD. Participants with CPTSD had received mental health treatment significantly more often than participants with PTSD or depression (65.5% vs. 58.8% vs. 31.6%; p = 0.031) but reported significantly less symptom improvement (52.9% vs. 78.0% vs. 80.0%; p = 0.008). Lower levels of epistemic trust were associated with higher CPTSD symptoms (p < 0.001). Conclusions: Our study shows that while the vast majority of individuals with CPTSD had received mental health treatment, subjective symptom improvement rates are not satisfactory. CPTSD was associated with a broad number of comorbidities and impairments in functioning. Lower levels of epistemic trust may partially explain worse treatment outcomes.

International Trauma Questionnaire and Posttraumatic Cognitions Inventory-9: validity evidence and measurement invariance of their Brazilian versions

BackgroundThe International Trauma Questionnaire (ITQ) is used to measure posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (CPTSD) symptoms, and the Posttraumatic Cognitions Inventory-9 (PTCI-9) is used to measure posttraumatic cognitions. Both tools have been translated for use in Brazil. However, the psychometric properties of the Brazilian versions were not investigated, and no study has verified the invariance of these tools for many traumatic event types.ObjectiveThis study examined the validity, reliability, and measurement invariance of the Brazilian versions of the ITQ and the PTCI-9 for trauma type, gender, race, age group, education level, and geographical region.MethodsA total of 2,111 people (67.74% women) participated in an online survey. The scale models were tested via confirmatory factor analyses and measurement invariance through multigroup analyses. Pearson’s correlation analyses were used to examine the relationships between PTSD, CPTSD, posttraumatic cognitions, and depressive symptoms.ResultsExcept for the affective dysregulation factor, the reliabilities of the ITQ and PTCI-9 dimensions were adequate. Models with six correlated dimensions for the ITQ and three correlated dimensions for the PTCI-9 showed adequate fit to the data. The ITQ and PTCI-9 exhibited scalar invariance for gender, race, age group, education level, and geographical region. The ITQ also demonstrated full invariance for trauma type. The factors of both instruments were related to each other and to depressive symptoms, with higher effect sizes for posttraumatic cognitions and complex posttraumatic stress disorder symptoms.ConclusionWe recommend using the Brazilian versions of the ITQ and PTCI-9, which are crucial tools for assessing and treating trauma-related disorders.

An open pilot trial of a behavioural intervention to reduce violence by young adults with early psychosis receiving treatment in an early intervention services setting: A protocol.

Despite the public health impact of violence among young adults with psychosis, behavioural interventions to reduce the risk of engaging in violence remain rare. For young adults with early psychosis, cognitive behavioural therapy (CBT)-based psychotherapy has efficacy in reducing impairment and improving functioning. However, no CBT-based intervention to reduce violence has been formally adapted for young adults with early psychosis. This protocol outlines the first clinical trial of a behavioural intervention to reduce violence for young adults with early psychosis. This study is set in an early intervention services (EIS) setting and seeks to adapt and pilot Psychological Intervention for Complex PTSD and Schizophrenia-Spectrum Disorder (PICASSO), a CBT-based intervention, through an iterative process utilizing mixed-methods assessments. All research will occur at OnTrackNY, the largest EIS program in the United States. This study will consist of an open pilot trial, with four EIS clinicians delivering the intervention to one to two EIS participants per round. In this mixed-methods study, both quantitative measures (acceptability, feasibility and hypothesized mediators of target outcome collected on a weekly basis) and qualitative interviews (with EIS clinicians at weeks 4, 8 and 12) will be conducted. Transcripts will be analyzed using thematic content analysis. Two to three rounds of iterative modifications are anticipated (n = 10-16 EIS participants total). Recruitment began in February 2024 and is expected to continue over a 9-12-month period. Because violent behaviour causes interpersonal disruptions such as incarceration and increased caregiver burden, an innovative intervention to reduce violence risk could have broader health impact for this vulnerable population. Adapting the PICASSO intervention to the EIS setting will optimize its acceptability and feasibility by the intended target population.

Enhanced Skills Training in Affective and Interpersonal Regulation versus Treatment as Usual for ICD-11 Complex PTSD: A Pilot Randomised Controlled Trial (The RESTORE Trial)

Introduction: Complex PTSD (CPTSD) is a relatively new condition in ICD-11. This pilot randomised controlled trial aimed to compare a four-module intervention developed to target all symptoms of ICD-11 CPTSD, namely Enhanced Skills in Affective and Interpersonal Regulation (ESTAIR) with treatment as usual (TAU). The purpose of the study was to assess feasibility, safety, acceptability, and preliminary outcomes at the end of treatment and 3-month follow-up. Methods: A total of N = 56 eligible veterans with CPTSD were randomised to either ESTAIR (n = 28) or TAU (n = 28). Linear mixed models were conducted to assess CPTSD severity, the primary outcome, as measured by the International Trauma Questionnaire (ITQ). Results: Treatment dropout in ESTAIR and TAU was low and equivalent (18% vs. 11%; χ2 (1) = 1.19, p = 0.275), and study retention was high, supporting the feasibility of the study. No serious adverse effects and very few adverse effects occurred, none of which were deemed related to the study. ESTAIR provided significantly greater reduction in CPTSD severity across time for ITQ PTSD (p < 0.001) and DSO (p < 0.001) symptoms. CPTSD pre-to-post effect sizes for ESTAIR were large (PTSD d = 1.78; DSO d = 2.00). Remission of probable CPTSD diagnosis at post-treatment was substantially greater in ESTAIR compared to TAU with only 13.6% versus 84% (p < 0.001) retaining the diagnosis. Conclusion: A trial of ESTAIR versus TAU for the treatment of ICD-11 CPTSD indicates the potential efficacy of ESTAIR as well as its feasibility, safety, and acceptability.

Assessing complex PTSD and PTSD: validation of the German version of the International Trauma Interview (ITI)

ABSTRACT Background: With the introduction of the ICD-11 into clinical practice, the reliable distinction between Posttraumatic Stress Disorder (PTSD) and Complex Posttraumatic Stress Disorder (CPTSD) becomes paramount. The semi-structured clinician-administered International Trauma Interview (ITI) aims to close this gap in clinical and research settings. Objective: This study investigated the psychometric properties of the German version of the ITI among trauma-exposed clinical samples from Switzerland and Germany. Method: Participants were 143 civilian and 100 military participants, aged M = 40.3 years, of whom 53.5% were male. Indicators of reliability and validity (latent structure, internal reliability, inter-rater agreement, convergent and discriminant validity) were evaluated. Confirmatory factor analysis (CFA) and partial correlation analysis were conducted separately for civilian and military participants. Results: Prevalence of PTSD was 30% (civilian) and 33% (military) and prevalence of CPTSD was 53% (civilians) and 21% (military). Satisfactory internal consistency and inter-rater agreement were found. In the military sample, a parsimonious first-order six-factor model was preferred over a second-order two-factor CFA model of ITI PTSD and Disturbances in Self-Organization (DSO). Model fit was excellent among military participants but no solution was supported among civilian participants. Overall, convergent validity was supported by positive correlations of ITI PTSD and DSO with DSM-5 PTSD. Discriminant validity for PTSD symptoms was confirmed among civilians but low in the military sample. Conclusions: The German ITI has shown potential as a clinician-administered diagnostic tool for assessing ICD-11 PTSD and CPTSD in primary care. However, further exploration of its latent structure and discriminant validity are indicated.

Compassion-Focused Therapy for the Treatment of ICD-11-Defined Complex Posttraumatic Stress Disorder.

The most effective treatments for ICD-11-defined complex posttraumatic stress disorder (CPTSD) remain unknown. Further research is needed to determine whether such treatments for CPTSD are the same as or different from-or require integration with-existing gold standard treatments for posttraumatic stress disorder (PTSD). Individuals with CPTSD experience the hallmark symptoms of PTSD (i.e., reexperiencing symptoms, avoidance symptoms, and the pervasive sense of perceived threat) and pervasive disturbances in self-organization, including affective dysregulation, negative self-concept, and difficulties with interpersonal relationships. Compassion-focused therapy (CFT) is a transdiagnostic approach that was originally developed to treat shame and self-criticism. CFT helps individuals learn how to regulate their emotions, shift their emotional response style from shaming and self-critical to wise and understanding, and engage in more compassionate and rewarding patterns of relating to self and others. This article describes CFT's possible application in the treatment of CPTSD and delineates areas for future research.

Posttraumatic stress disorder (PTSD) and complex PTSD in eating disorder treatment-seekers: Prevalence and associations with symptom severity.

Although childhood trauma and posttraumatic stress disorder (PTSD) have been well-researched in eating disorder epidemiology, prevalence rates are unavailable for complex PTSD (CPTSD). Under recently introduced ICD-11 criteria, individuals with CPTSD have both PTSD symptoms and additional disturbances in self-organization (DSO). Using ICD-11 criteria, this study aimed to determine the prevalence of PTSD and DSO symptoms, diagnostic rates of PTSD and CPTSD, and childhood trauma exposure in eating disorder treatment-seekers. Participants (N = 217) were individuals attending residential, partial hospitalization, and outpatient services who completed measures of eating disorder- and trauma-related symptoms and childhood adverse experiences. One third of participants reported PTSD symptoms, and over half reported DSO symptoms, with probable ICD-11 diagnostic rates of 3.8% for PTSD and 28.4% for CPTSD. CPTSD was significantly more prevalent than PTSD and more common in higher levels of care. Both PTSD and DSO symptom severity were positively correlated with eating disorder symptoms and impairment, rs =.285-.642. DSO symptom severity was a significant and unique explanatory factor of eating disorder severity and impairment. The findings highlight the prevalence of CPTSD in eating disorder populations and the association between DSO symptoms and eating psychopathology independent of PTSD symptoms. Implications are discussed for adjunct treatment approaches for individuals with comorbid eating disorders and PTSD or CPTSD.