Complex posttraumatic stress disorder in women from a psychometric perspective

Herman's (1992a) formulation of complex PTSD was not incorporated into the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994), but finds ample confirmation in personality assessment of women in inpatient treatment for trauma-related disorders. This study relates MCMI-III and Adult Attachment Scale scores to a self-report measure of childhood abuse and neglect, the Childhood Trauma Questionnaire. Consistent with Herman's formulation, the data reveal a wide array of symptoms coupled with two facets of relationship disturbance: (a) enmeshment in ambivalence (depressive, dependent, and self-defeating personality as well as ambivalent attachment), and (b) more profound isolation (avoidant and schizoid personality coupled with profoundly insecure attachment). We present a model for using such psychometric findings in patient education and diagnostic evaluations.