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Symposium

Conflict, Disasters, and Trauma- and Stressor-related Disorders
Symposium

Symposium 21 - Treatment of ICD-11 Complex Posttraumatic Stress Disorder

Thursday, June 25, 2026
4:00 PM - 5:30 PM PDT
Location: Yerba Buena Salon 13, B3 Level
CE: 1.5

Keywords: PTSD (Posttraumatic Stress Disorder), Diagnosis, Treatment
Level of Familiarity: All
Recommended Readings: Berliner, L., Bisson, J. I., Cloitre, M., Forbes, D., Goldbeck, L., Jensen, T., Lewis, C., Monson, C. M., Olff, M., Pilling, S., Riggs, D. S., & Roberts, N. P. (2019). ISTSS guidelines position paper on complex PTSD in adults. International Society for Traumatic Stress Studies.Cloitre, M. (2021). Complex PTSD: assessment and treatment. European Journal of Psychotraumatology, 12(Suppl ):1866423. doi: 10.1080/20008198.2020.1866423.,   Cloitre, M. (2021). Complex PTSD: assessment and treatment. European Journal of Psychotraumatology, 12(Suppl ):1866423. doi: 10.1080/20008198.2020.1866423.,   Karatzias, T., Murphy, P., Cloitre, M., Bisson, J., Roberts, N., Shevlin, M., Hyland, P., Maercker, A., Ben-Ezra, M., Coventry, P., Mason-Roberts, S., Bradley, A., & Hutton P. (2019). Psychological interventions for ICD-11 complex PTSD symptoms: systematic review and meta-analysis. Psychological Medicine, 49(11):1761-1775. doi: 10.1017/S0033291719000436.,   Karatzias, T., Bohus, M., Shevlin, M., Hyland, P., Bisson, J.I., Roberts, N., & Cloitre M. (2023). Distinguishing between ICD-11 complex post-traumatic stress disorder and borderline personality disorder: clinical guide and recommendations for future research. British Journal Psychiatry, 223(3):403-406. doi: 10.1192/bjp.2023.80.,   Cloitre, M., Hyland, P., Prins, A., & Shevlin, M. (2021). The International Trauma Questionnaire (ITQ) measures reliable and clinically significant treatment-related change in PTSD and complex PTSD. European Journal of Psychotraumatology, 22;12(1):1930961. doi: 10.1080/20008198.2021.1930961.

Posttraumatic stress disorder (PTSD) can develop after exposure to a broad range of traumatic events and shows heterogenous patterns of symptoms. Both the American Psychiatric Association and the World Health Organisation have acknowledged this heterogeneity in their latest diagnostic manuals. While DSM-5 broadened the definition of PTSD to include a new symptom cluster (alterations of cognitions and mood) and the addition of a dissociative subtype, the World Health Organisation introduced a distinction between ICD11-PTSD and complex PTSD (ICD-11 CPTSD) under a general parent category of Disorders Specifically Related to Stress in ICD-11.

This symposium will present some of the research leading to the ICD-11 revision, and current research on diagnostic and treatment development and evaluation stimulated by it. Marylene Cloitre will discuss research supporting the diagnostic distinction between ICD-11 PTSD and CPTSD, assessment tools, and emerging evidence of its clinical utility. Thanos Karatzis will present results of a randomized controlled trial comparing ESTAIR, a flexible 4-module intervention providing skills training in core areas of functioning (e.g., emotion regulation) and memory processing, with treatment as usual in veterans with CPTSD. Anke Ehlers will present results of a randomized controlled trial comparing a phased and a nonphased version of trauma-focused cognitive therapy for CPTSD following a wide range of traumas. The phased version included training in compassionate resilience. Deborah Morris will discuss evidence that borderline personality disorder and CPTSD are distinct disorders, but may be comorbid, and the need to develop evidence-based treatments for patients with dual diagnosis. Richard Bryant will be the discussant.

Learning Objectives:

  • Describe diagnostic criteria and assessment instruments for ICD-11 complex PTSD (CPTSD)
  • Explain the evidence that led to the introduction of the partnered diagnoses PTSD and CPTSD in ICD-11 (World Health Organisation).
  • Discuss the clinical utility of having two distinct diagnoses
  • Describe the results of recent randomised clinical trials focusing on the treatment of CPTSD.
  • Discuss the relationship between CPTSD and borderline (emotionally unstable) personality disorder

Presentations:

  • 4:06 PM - 4:27 PM PDT
    (SYM 21) ICD-11 Complex PTSD: Evidence and Clinical Utility

    Speaker: Marylene Cloitre, Ph.D. (she/her/hers) – New York University Silver School Of Social Work

  • 4:27 PM - 4:48 PM PDT
    (SYM 21) Enhanced Skills Training in Affective and Interpersonal Regulation (ESTAIR): A New Treatment for ICD-11 Complex Post Traumatic Stress Disorder

    Speaker: Thanos Karatzias, Ph.D. (he/him/his) – Edinburgh Napier University

    Co-Author: Mark Shevlin, Ph.D. (he/him/his) – University of Ulster

    Co-Author: Marylene Cloitre, Ph.D. (she/her/hers) – New York University Silver School Of Social Work

  • 4:48 PM - 5:09 PM PDT
    (SYM 21) Does a Phased Approach Enhance Outcomes for Trauma-focused Cognitive Therapy for ICD-11 Complex Posttraumatic Stress Disorder?

    Speaker: Anke Ehlers, Ph.D. (she/her/hers) – University of Oxford

    Co-Author: Michael Duffy, Ph.D. (he/him/his) – Queens University Belfast

    Co-Author: Deborah Lee, ph.D. (she/her/hers) – Berkshire Healthcare NHS Foundation Trust

    Co-Author: Nick Grey, DClinPsy (he/him/his) – Sussex Partnership NHS Foundation Trust

    Co-Author: Ly-Mee Yu, Ph.D. (she/her/hers) – University of Oxford

  • 5:09 PM - 5:30 PM PDT
    (SYM 21) Characterising the Relationship and Treatment Needs of CPTSD and BPD: Implications for Cognitive Behavioural Treatment Approaches of Those Who Meet Both Diagnoses

    Speaker: Deborah J. Morris, Psy.D. (she/her/hers) – Centre for Developmental and Complex Trauma, UK