Complex posttraumatic stress disorder: evidence from the primary care setting

UMMS Affiliation

Department of Family Medicine and Community Health

Publication Date


Document Type



Adult; Analysis of Variance; Chi-Square Distribution; Child; Child Abuse, Sexual; Cluster Analysis; Depression; Dissociative Disorders; Family Health; Female; Humans; Middle Aged; Primary Health Care; Retrospective Studies; Somatoform Disorders; *Stress Disorders, Post-Traumatic; Survivors; Syndrome; Women's Health


Mental and Social Health | Primary Care | Psychiatry | Psychiatry and Psychology


Sexual abuse is a common problem among female primary care medical patients. There is a wide spectrum of long-term sequelae, ranging from mild to the complex symptom profiles consistent with the theories of a posttraumatic sense of identity. Generally, the latter occurs in the context of severe, chronic abuse, beginning in childhood and often compounded by the presence of violence, criminal behavior, and substance abuse in the family of origin. In this study we search for empirical evidence for the existence of a complex posttraumatic stress syndrome in 99 women patients at 3 family practice outpatient clinics who report a history of sexual abuse. A structured interview was administered by trained female interviewers to gather data on family history and psychiatric symptoms and diagnoses. Empirical evidence from cluster analysis of the data supports the theory of a complex posttraumatic syndrome. The severity gradient based on symptoms roughly parallels the severity gradient based on childhood abuse and sociopathic behavior and violence in the family of origin, with the most severely abused subjects characterized by symptom patterns that fit the description of a complex posttraumatic stress syndrome.

DOI of Published Version



Gen Hosp Psychiatry. 1998 Jul;20(4):214-24. Link to article on publisher's website

Journal/Book/Conference Title

General hospital psychiatry

Related Resources

Link to Article in PubMed

PubMed ID