Complex PTSD Test (CPTSD) — 18 Questions, ITQ Modelled

Complex PTSD (CPTSD) is the trauma response that arises from sustained, repeated, or developmental trauma — typically prolonged childhood abuse, sustained interpersonal violence, captivity, or repeated traumatic exposure — rather than from a single discrete event. It was formally added to the ICD-11 (2018) but is not in the DSM-5 (where it overlaps with PTSD + dissociative subtypes + Borderline Personality Disorder). CPTSD includes all PTSD symptoms (intrusion, avoidance, hyperarousal) plus three additional symptom domains known as 'Disturbances in Self-Organisation' (DSO): persistent negative self-concept, difficulty regulating emotions, and difficulty maintaining relationships.

PTSD typically follows a single discrete traumatic event (assault, accident, combat exposure) and is dominated by intrusion symptoms, avoidance, and hyperarousal. CPTSD follows sustained or developmental trauma (typically over months or years, often in childhood) and adds three additional symptom domains: deep negative self-concept (pervasive shame and worthlessness), affective dysregulation (intense and prolonged emotional reactions, often mistaken for BPD), and relational difficulties (chronic withdrawal from intimacy, mistrust, sense of being fundamentally separate from others). CPTSD typically requires longer-term and more relationship-focused treatment than PTSD.

The International Trauma Questionnaire (ITQ) is the validated self-report screening tool for ICD-11 PTSD and CPTSD, developed by Marylene Cloitre, Mark Shevlin, Chris Brewin, and colleagues in 2018. It is the standard instrument in CPTSD research and clinical practice worldwide. The ITQ has 18 items: 6 for PTSD core symptoms and 12 for the 3 DSO clusters (4 items each). The Mindshape CPTSD test is modelled on the ITQ structure. For formal clinical use, the validated ITQ itself should be administered.

CPTSD treatment typically requires longer-term and more phase-based work than PTSD. The standard framework (Judith Herman, 1992) involves three phases: (1) safety and stabilisation — building somatic regulation, supportive relationships, daily structure; (2) trauma processing — typically EMDR, sensorimotor psychotherapy, or trauma-focused IFS; (3) reconnection — integrating the work, rebuilding relationships, finding meaning. Specific evidence-based approaches include STAIR (Skills Training in Affective and Interpersonal Regulation — Cloitre), EMDR, sensorimotor psychotherapy, and IFS. The typical healing arc is 2-5 years of sustained work. The relationship with a skilled trauma therapist often becomes the corrective attachment experience that childhood didn't provide.

No — but the overlap is significant and clinically important. Both conditions involve emotion regulation difficulties, relational instability, and trauma history. Many adults previously diagnosed with BPD actually meet CPTSD criteria; in some clinical settings, CPTSD has substantially replaced BPD as the working diagnosis when childhood trauma is clearly present. The major differences: BPD typically includes identity disturbance, more dramatic interpersonal patterns, and self-harm at higher rates; CPTSD is more directly anchored in trauma history and typically shows the PTSD core symptoms (intrusion, avoidance, hyperarousal) more clearly. A skilled trauma-informed clinician can usually distinguish them.

Yes — the long-arc finding is consistent across CPTSD research. Adults who complete sustained trauma-focused therapy (typically 2-5 years) often report substantially different quality of life — relationships that feel safe, emotion regulation that works, and a sense of self that includes but isn't dominated by the trauma history. The healing is rarely complete in the sense of erasing the past, but the trauma stops driving daily life. The most important predictors of healing are access to a skilled trauma therapist + sufficient time + willingness to do the difficult work + safe-enough current relationships.

The Mindshape CPTSD test takes most people 4-6 minutes to complete. It is 18 items based on the ITQ framework. Results appear instantly with a per-cluster breakdown and explicit threshold indication for PTSD and CPTSD per ICD-11 criteria.