Types of Posttraumatic Stress Disorder (PTSD.)

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Photo courtesy of Pixabay.com

Not all trauma and stressor-related disorders are the same.

Most people are familiar with Posttraumatic Stress Disorder (PTSD) the granddaddy of all the trauma and stressor-related disorders.  In addition to PTSD, there are a number of other trauma and stressor-related disorders.  There are two types of attachment disorders, Acute Stress Disorder, a number of varieties of adjustment disorders, and even a category for other specified or unspecified Trauma- and Stressor-Related Disorders that don’t fit these categories of disorders.  For more on these other disorders take a look at these related posts on counselorssoapbox.com

In Posttraumatic Stress Disorder, there are recognized and unrecognized subtypes.

Recognized PTSD subtypes or specifiers.

Two subtypes of PTSD dissociative symptoms are recognized.


Depersonalization, that is the experience of feeling like you’re outside of yourself looking in.  You may feel like you’re in a dream or are an outside observer watching yourself.  It may feel as if time is moving more slowly or as if you are not real.


Derealization is the experience of feeling like the world is unreal.  You may feel like you’re in a dream or that things are very distorted and different.

Delayed PTSD.

When someone experiences delayed PTSD we use the specifier “with delayed expression.” Delayed expression occurs when it takes more than six months after the event for the symptoms to become obvious.

PTSD subtypes used with children under six.

There are slightly different criteria used in diagnosing PTSD in children under the age of six.  As a result, we also have two additional subtypes for use with children.  All of the subtypes used with adults can also be applied to children.

PTSD with persistent avoidance of stimuli.

Children with this subtype go to great lengths to avoid anything that would remind them of the original traumatic event.

PTSD’s with negative alterations in cognitions.

Children with this subtype develop all kinds of negative thoughts about themselves and the world.  That may have high levels of fear, shame, and guilt, confusion, and sadness.  They may withdraw from other people and lose their interest in playing.

PTSD unrecognized subtypes.

Complex Trauma.

While not officially recognized in the DSM-5 a good deal has been written about a condition referred to as “complex trauma.”  Both research and practical experience suggest there is some validity to this idea.

This condition occurs when someone is repeatedly traumatized in a very similar way.  Think about somebody who breaks their leg and goes to the hospital.  They have it treated and the leg mends.  If they were to break the same leg again, in the same place, it is less likely to heal a second time.

These types of repeated traumatization are often the result of abuse or domestic violence.  Complex trauma also frequently coexists with substance use disorders or behavioral addictions.

Staying connected with David Joel Miller

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4 thoughts on “Types of Posttraumatic Stress Disorder (PTSD.)

    • Thanks for contacting me. Some considerations are finding somebody knowledgeable about this problem, and finding somebody close to where you live. If you will be using insurance to pay for this treatment you might want to call your insurance company for some suggested providers. The other possibility is to contact some providers close to where you live and then ask them if this is something they have experience treating. If not they may be able to give you a referral in your immediate area.


      • Most people, unless they had a reason, have ever tried to find such a person in South Dakota or nearby states. There are none. I can’t do this alone anymore, especially with my other health conditions.


      • Check with your insurance company. They may be able to connect you with a therapist that can do counseling over the internet. I have seen some adds for places that do distance counseling but do not know enough about them to make a recommendation. Self-help books and inspirational websites can also be helpful. I hope you are able to find some help.


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