C-PTSD, PDSD and Type 2 PTSD explained

As a general rule, PTSD is categorised to originate from one traumatic event, however, medical professionals now recognise that continuous exposure to very stressful situations can also cause symptoms of PTSD.

This type of repeated exposure PTSD is referred to in my different ways: complex PTSD (C-PTSD), Prolonged Duress Stress Disorder (PDSD), rolling PTSD, Chronic Post Traumatic Stress Disorder, Severe Post Traumatic Stress Disorder, Type 2 PTSD, Cumulative Stress Disorder, Complex Trauma Disorder, and Chronic Stress Disorder (but for the purposes of this page information, we’ll call it PDSD).

PDSD often results from any of the following experiences:

  • Repeated exposure to disaster, accidents, deaths or violent acts (police, firemen, paramedics)
  • Frequent need to deliver traumatic news to others e.g doctors
  • Living under severe threat for an extended period of time
  • Regular exposure to the abuse of children
  • Regular and repeated exposure to verbal abuse, emotional abuse or threats
  • Long-term exposure to bullying
  • Frequent sexual victimization or abuse
  • Regular, long-term feelings of captivation or powerlessness

How is PDSD caused?

Dr Hans Selye found that ‘chronic exposure to severe stressors produces a sequence of three physiological stages: (1) alarm, (2) resistance and (3) exhaustion (Carlson, et al. 2007). These three stages are collectively referred to as the general adaptation syndrome’.

‘The ‘alarm’ stage occurs when an individual is first confronted with a stressor. The individual may experience shock (i.e. arousal of the autonomous nervous system causing impairment of physiological functioning). If this is a reaction to a temporary event, the physiological state will return to normal within a short period.

However, with continued exposure to the stressor the individual enters the stage of resistance, causing the individual’s physiological functioning to continue at an extreme level. This stage reflects the individual’s adaptation to the stressor. Should the individual continue to be exposed to the stressor, the autonomous nervous system continues to function at the above normal level entering the exhaustion stage. During this stage the individual loses the ability to adapt, resistance decreases to below normal levels leaving the individual susceptible to illness.’

What are the symptoms of PDSD?

PTSD and PDSD have very similar symptoms and differ only with regard to the presence or absence of a singular “traumatic event” – with PDSD the trauma is cumulative rather than sudden.

What are the treatments of PDSD?

Both Post Traumatic Stress Disorder and Prolonged Duress Stress Disorder need the assistance of an experienced psychiatrist to diagnose and help treat the disorder, but just like PTSD, PDSD is treatable. You can read about the treatment options such as CBT and EMDR on our treatment and help page.


SOURCES: NoBullying.com, Counselling Connection,  A PSYCHO-PHYSIOLOGICAL COMPARISON OF POST-TRAUMATIC AND PROLONGED DURESS STRESS DISORDERS Behavioural and Cognitive Psychotherapy / Volume 31 / Issue 01 / January 2003, pp 109-112, PTSDTreatmentHelp,

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