“…Because a history of exposure to multiple, often early-onset interpersonal traumas and other adverse events is associated with a range of symptoms that are experienced simultaneously by the same individual (e.g., emotional dysregulation and dissociation), there has been clinical interest in defining a disorder or syndrome that summarized these complex outcomes. Citing research linking complex trauma exposure to affect dysregulation, relational disturbance, identity problems, cognitive distortions, somatization, and avoidance responses such as dissociation, substance abuse, and tension-reduction behaviors, clinical researchers have specified disorders such complex PTSD (Courtois & Ford, 2009), disorders of extreme stress not otherwise specified (van der Kolk, Roth, Pelcovitz, Sunday, & Spinazzola, 2005), developmental trauma disorder (Stolbach et al, 2013), and enduring personality change after catastrophic events (EPCACE; Beltran, Llewellyn, & Silove, 2008). In fact, the proposed International Classification of Diseases,, is slated to replace EPCACE with the diagnosis complex PTSD.…”