Complex Trauma and PTSD

- Acute impatient, school, outpatient settings most likely
- Consider acuity, age, focus of setting
- Is trauma the main diagnosis, or an important comorbid condition?

complex trauma

o Daily routine, ADL’s
o IADL’s
o Coping skills
o Sensory processing, sensory diet
o Emotional regulation
o Social skills
o Cognition and learning
o Schoolwork
o Leisure interests
o Health promotion, physical activity
o Play
o Independent living skills/home maintenance
o Job skills
o Self-esteem
o Tolerating environments and people
o Participation and engagement
o Communication
o Conflict resolution
o Motor skills
o Executive function
o Health management

- Could be inpatient psychiatric setting, outpatient, any
- Likelihood you will encounter in VA or military healthcare settings
- Consider acuity, age, focus of setting
- Is trauma the main diagnosis, or an important comorbid condition?

- Self-management/symptoms management/coping skills
- Sleep and rest, leisure
- Cognitive and executive functions
- Work-related concentration, time management, focus, task execution
- Social participation

o Amount, duration, intensity, age
o Neurobiologic damage
o Resilience
o Social determinants of health
o Access to care

- absent caregiver
- exposure to traumatic events
- maltreatment
- poly-victimization
- violent environment

Impairement to:
- attachment and relationships
- physical health: body and brain
- emotional responses
- dissociation
- maladaptive behavior
- cognition: thinking and learning
- self-concept and future orientation

that is dependent on neurobiological damage and resiliency factors

• Exposure to actual or threatened death, serious injury, or sexual violence
• Intrusionary symptoms
• Persistent avoidance of triggers of the event(s)
• Negative alterations in cognition and mood after the traumatic event(s)
• Marked alterations in arousal and reactivity