Complex Trauma

The National Child Traumatic Stress Network (NCTSN), located at, has defined complex trauma, also called "chronic interpersonal trauma," as a child’s experiences of multiple and sequential traumatic events within the context of the caregiving system.  Typically, these traumatic events incorporate two or more types of child maltreatment that begin in early childhood. 

Complex trauma typically involves the lack of a secure bond, or attachment, between a child and his or her caregiver.  The relationship between complex trauma and attachment is complicated.  A disruptive attachment pattern can be the source of complex trauma; conversely, traumatic events can disrupt the normal attachment process.  Because a caregiver bond is normally the fundamental source of stability and security in a child’s life, the lack of a primary attachment can result in the child’s inability to self-regulate emotion and relate beneficially to others.

Children exposed to complex trauma often experience lifelong problems that place them at risk for multiple dysfunctions, including:

  • Substance abuse or other addictions
  • Psychiatric disorders
  • Chronic physical illnesses
  • Poor parenting of their own children
  • Relationship and workplace problems
  • Involvement with the criminal justice system

Needless to say, the impact of complex trauma can be severe, diverse, and persistent across several domains of functioning, with difficulties extending from childhood through adolescence and into adulthood.  It is also critically important to understand the negative impact that complex trauma can have upon a child's neurological development.  In his booklet, Effects of Traumatic Events on Children, Dr. Bruce Perry emphasizes the need for understanding how trauma affects brain development and subsequent cognitive, social, and emotional development, and the implications for assessment and treatment of maltreated children.