Complex PTSD assessments and reports

Independent psychiatric evidence where prolonged or repeated trauma, often from childhood, has led to complex post-traumatic stress disorder, with a clear opinion on diagnosis, causation, treatment and prognosis. Free initial screening call and fixed fees with no hidden charges.

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  • Section 12(2) approved
  • Claimant, defendant and SJE
  • ICD-11 diagnosis explained
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When trauma is prolonged or repeated

Complex PTSD is most often relied on in abuse claims, where the abuse was repeated, lasted for months or years, began in childhood or came from someone the claimant depended on. Dr Pradhan assesses whether the core symptoms of PTSD are present, and whether they come with the lasting difficulties with emotion, self-image and relationships that the diagnosis requires.

These cases need careful analysis of chronology, disclosure and earlier adversity. The report distinguishes complex PTSD from PTSD, from recurrent depression, and from personality-related difficulties, because the label affects the explanation of causation, the treatment needed and the prognosis.

Dr Pradhan is a Fellow of the Royal College of Psychiatrists and section 12(2) approved, and judges have commended her reports for clarity.

What the report covers

Complex PTSD reports commonly address:

  • Whether the core symptoms of PTSD are present
  • Emotional dysregulation, negative self-concept and relationship difficulties
  • Whether complex PTSD, PTSD or another diagnosis fits the evidence most closely
  • Overlap with depression, anxiety, dissociation and substance misuse
  • Overlap with personality-related difficulties
  • The trauma relied on, and other adversity in the history
  • Delayed disclosure and delayed-onset symptoms
  • Apportionment between the abuse relied on and other causes
  • The effect on education, work, relationships and parenting
  • Treatment needs, including phased trauma-focused therapy
  • Prognosis, future vulnerability and the risk of relapse
  • Supplementary questions, joint statements and second opinions

Send a short outline of the trauma relied on and the relevant dates, and Dr Pradhan will confirm the scope of opinion and a fixed fee.

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What complex PTSD requires

Complex PTSD is an ICD-11 diagnosis. It needs the core features of PTSD together with lasting disturbances in self-organisation, and the report examines each of them against the history and the records.

Re-experiencing and avoidance

Intrusive memories, flashbacks or nightmares, and avoidance of reminders of the trauma.

A sense of current threat

Hypervigilance or an exaggerated startle response, as in PTSD.

Emotional dysregulation

Difficulty managing emotions, such as intense reactions, emotional numbing or dissociation under stress.

Self-image and relationships

A persistent sense of being worthless, ashamed or guilty, and lasting difficulty in sustaining relationships.

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Complex PTSD or another diagnosis

Complex PTSD shares features with recurrent depression, emotionally unstable personality disorder and dissociative conditions, and the records may use several of these labels over the years. The report explains which diagnosis fits the evidence most closely, why the alternatives are less likely, and what difference the choice makes to causation and treatment.

In clinical negligence claims, complex PTSD can be in issue as an earlier condition that affected the response to negligent care, or as a diagnosis said to have been missed.

Where personality-related difficulties are in issue, the assessment considers when they began and how they developed against the history of abuse, and whether they are better explained as a consequence of the abuse or as a separate, pre-existing condition.

Commonly considered alongside

  • PTSD
  • Recurrent depressive disorder
  • Emotionally unstable personality disorder
  • Dissociative symptoms
  • Substance misuse
  • Self-harm

Questions often raised

  • Which diagnosis fits the evidence
  • Causation and other adversity
  • Delayed disclosure
  • Treatment and its likely benefit
  • Prognosis and future vulnerability
  • Effect on earning capacity
Submit an enquiry Call 0121 752 6065

Classification and the court

Complex PTSD is a separate diagnosis in ICD-11 but not in DSM-5-TR, where the same symptoms are usually described as PTSD with other conditions alongside. The report states which classification is used, so that the opinion can be compared with the other side’s expert evidence and with treating clinicians’ records.

For claims in England and Wales the report is structured for CPR Part 35 and Practice Direction 35. Reports for proceedings in Scotland and Northern Ireland are prepared to the requirements of those courts.

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Where the experts use different systems

The discussion between experts can still narrow the issues by agreeing the symptoms and their effect on the claimant, even where one works to ICD-11 and the other to DSM-5-TR.

Related pages

Trauma and PTSDPTSD and other trauma reactionsFind out more
Childhood traumaThe long-term psychiatric effects of childhood adversityFind out more
Impact of sexual abuseThe psychological effects of sexual abuse in childhood or adulthoodFind out more
Childhood sexual abusePsychiatric evidence in claims by adult survivorsFind out more

Complex PTSD questions

If your question is not answered here, call and Dr Pradhan will advise on scope and timescale.

Call 0121 752 6065
What is the difference between PTSD and complex PTSD?

Complex PTSD includes the core symptoms of PTSD, together with lasting difficulties in managing emotions, a persistent negative self-image and difficulty in sustaining relationships. It usually follows prolonged or repeated trauma from which escape was difficult.

The records say personality disorder. Can the diagnosis still be complex PTSD?

Possibly. The two can overlap, and records sometimes use different labels over time. The report explains which diagnosis fits the whole history most closely, and why.

What treatment does the report recommend?

Usually trauma-focused psychological therapy, often in phases, with medication or other support where the evidence justifies it. The report gives the likely duration and its effect on the prognosis.

How quickly can a report be delivered?

Usually 1–2 weeks from assessment, and urgent reports can often be provided in 2–5 working days where the papers and appointment can be arranged promptly.

Instruct Dr Pradhan on a complex PTSD claim

Send a short outline of the trauma relied on, the funding route and any limitation or hearing dates.

Please do not include medical records or a detailed personal history in this form. Dr Pradhan will confirm how to send the papers once the instruction is agreed.

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