In contrast to the actual trauma, which had a beginning, middle, and end, the symptoms of PTSD take on a timeless character. The traumatic intrusions themselves are horrifying: they interfere with dealing with the past, while distracting from being able to attend to the present. This unpredictable exposure to unbidden memories of the Inhibitors,research,lifescience,medical trauma usually leads to a variety of (usually maladaptive) avoidance maneuvers, ranging from avoidance of people or actions that remind them of the trauma, to drug and alcohol abuse, to emotional withdrawal from friends or activities that used to be potential sources of solace. Problems

with attention and concentration keep them from being engaged with their

surroundings with zest and energy Uncomplicated activities like reading, conversing, and watching television require extra effort. Inhibitors,research,lifescience,medical This loss of ability to focus, in turn, often leads to problems with taking one thing at a time and gets in the way of organizing one’s life to get it back on track. Disorders of extreme stress (DESNOS) The DSM-TV Field Trial8 demonstrated that it was not the prevalence of PTSD symptoms themselves, but depression, outbursts of anger, self-destructive behaviors, and feelings Inhibitors,research,lifescience,medical of shame, self-blame, and Selleck Fedratinib distrust that distinguished a treatment-seeking sample from a non-treatment seeking community sample with PTSD. The majority of people who seek treatment for traumarelated problems have histories of multiple traumas. One recent treatment-seeking sample9 suffered from a variety of other psychological problems, which in most cases Inhibitors,research,lifescience,medical were the chief presenting complaints, in addition to their PTSD symptoms: 77% suffered from behavioral impulsivity, affective Inhibitors,research,lifescience,medical lability, and aggression against self and others, 84% suffered from depersonalization and other

dissociative symptoms, 75% were plagued by chronic feelings of shame, self-blame, and feeling permanently damaged, and 83% complained of being unable to negotiate satisfactory relationships with others. These problems contribute significantly to impairment about and disability above and beyond the PTSD symptoms.10-12 Focusing exclusively either on PTSD, or on the depression, dissociation and character pathology prevent adequate assessment and treatment of traumatized populations. As part of the DSM.-IV Field Trial, members of the PTSD task force delineated a syndrome of psychological problems that have been shown to be frequently associated with histories of prolonged and severe interpersonal abuse. They called this “Complex PTSD,” or “Disorders of Extreme Stress Not Otherwise Specified (DESNOS) .