Psychotraumatology is now increasingly concerned with the effects of cumulative, prolonged, interpersonal trauma, whose clinical manifestations rarely fall within the diagnosis of Post-Traumatic Stress Disorder. These characteristics were first described by Judith Herman in 1992 in reference to Complex Post-Traumatic Stress Disorder.
Complex PTSD has only recently been formally recognised in the ICD-11, and research is progressively clarifying its associated symptom configurations, including disturbances in self-organisation, in terms of affect dysregulation, negative self-concept and difficulties in the relational sphere, alongside the core symptoms of PTSD: re-experiencing the trauma, avoidance, and a persistent sense of threat.
Addressing psychological trauma today means confronting a major turning point, both from a scientific and a clinical perspective. Above all, it means exploring the barriers that hinder the translation of research into good practice and clinical care, within health policies and in the choice of service models capable of adequately supporting the complex impact of trauma.
At present, the majority of people exposed to trauma do not have access to appropriate treatments capable of transforming their life histories from traumatic wounds into healed experience. Some of the key challenges concern the training of professionals in integrated and multidisciplinary models, cultural differences, and the historical moment in which we are currently living.
