CPTSD RECOGNITION TIMELINE
1992
Judith Herman Coins the Term “Complex PTSD”
Psychiatrist and trauma researcher Dr. Judith Lewis Herman introduces the term Complex PTSD in her landmark paper, Complex PTSD: A Syndrome in Survivors of Prolonged and Repeated Trauma. Herman describes a broader pattern of psychological effects associated with prolonged and repeated trauma that was not fully captured by the existing PTSD diagnosis.
1993-1994
Proposal for a Complex Trauma Diagnosis During DSM-IV Development
As the DSM-IV was being developed, researchers proposed that the psychological effects of prolonged and repeated trauma required broader recognition than the existing PTSD diagnosis. This work led to the development and field testing of Disorders of Extreme Stress Not Otherwise Specified (DESNOS), a diagnosis that captured many of the symptoms now associated with Complex PTSD.
DESNOS was not adopted as a formal DSM diagnosis, and Complex PTSD remained absent from the DSM.
2013
DSM-5 is published without CPTSD
The American Psychiatric Association publishes DSM-5. PTSD criteria are revised and expanded, but Complex PTSD is not included as a separate diagnosis.
2018
CPTSD Officially Recognized by the World Health Organization
The World Health Organization includes Complex PTSD in the ICD-11, the global diagnostic manual used by most countries outside the U.S. CPTSD is defined as distinct from PTSD, with additional symptoms including: Emotional dysregulation, Negative self-concept, Disturbances in relationships, and others. Despite this global recognition, the DSM continues
to exclude CPTSD—leaving U.S. providers untrained and survivors unsupported.
2019
World Health Assembly Adopts ICD-11
The World Health Assembly formally adopts ICD-11, approving Complex PTSD as part of the World Health Organization's international classification of diseases. Countries begin preparing for implementation.
2020
First Annual CPTSD Awareness Day
Launched by The CPTSD Foundation, CPTSD Awareness Day was created to bring visibility to the lived experiences of Complex PTSD survivors. Founded by Athena Petersen, Sept 2nd serves as a powerful reminder of the need for recognition, understanding, & trauma-informed support for those impacted by prolonged, repeated, relational trauma. This day honors the resilience of survivors and advocates in support of a global shift in how CPTSD is seen, understood, & treated.
2021
Petition for CPTSD Inclusion in the DSM created
Founder of the Healing and CPTSD Community, Danielle Carpio organized and published a formal petition calling for CPTSD to be added to the DSM. This grassroots effort underscores the collective demand for recognition and reform—and becomes a foundational milestone in the survivor-led movement for change.
2022
Complex PTSD Becomes Part of the International Diagnostic Standard
On January 1, 2022, the World Health Organization's ICD-11 officially took effect, making Complex PTSD (CPTSD) part of the current international disease classification used by WHO Member States.
While many countries now have an international diagnostic framework that includes CPTSD, the United States primarily relies on the Diagnostic and Statistical Manual of Mental Disorders (DSM) for mental health diagnoses. Because CPTSD is not included as a separate diagnosis in the DSM, many people in the U.S. continue to face barriers to receiving a diagnosis specifically identified as Complex PTSD, even though it is recognized internationally.
2022
Complex PTSD Remains Absent from the DSM
The American Psychiatric Association publishes the DSM-5 Text Revision (DSM-5-TR)—a critical update to the 2013 manual. Once again, CPTSD is not included. Despite growing global recognition and increasing clinical use of the term, the U.S. diagnostic system remains silent, continuing to fail millions of survivors seeking accurate diagnosis and care.
2024
First Official CPTSD Awareness Month
Launched by The Healing and CPTSD Foundation, this marks the first-ever CPTSD Awareness Month, a survivor-led initiative dedicated to amplifying Complex PTSD education, increasing visibility, and sparking global dialogue. Throughout September, the Foundation leads media campaigns, hosts community events, and shares powerful survivor stories to challenge stigma, push for recognition, and build trauma-informed momentum across systems.
2024
American Psychological Association Releases Guidelines Naming CPTSD
The American Psychological Association (APA) publishes the official "APA Guidelines for Working with Adults with Complex Trauma Histories." In the very first section, the guidelines explicitly state that individuals may be assessed for both PTSD and Complex PTSD (CPTSD).
This is a major moment: It marks the first time the APA (psychology) formally acknowledges CPTSD by name in its national treatment standards—validating it as a distinct clinical reality. However: The APA that publishes the DSM (American Psychiatric Association) still does not
2024
U.S. Department of Veterans Affairs Publishes Clinical Guidance on Complex PTSD
The VA's National Center for PTSD published comprehensive clinical resources dedicated to Complex PTSD, including its history, definition, assessment, and treatment. The guidance explains that CPTSD is recognized in ICD-11 but not in DSM-5 and provides education for clinicians on how Complex PTSD differs from PTSD.
2024
WHO Expands Clinical Guidance for Diagnosing Complex PTSD
The World Health Organization releases its official Clinical Descriptions and Diagnostic Requirements (CDDR) manual for ICD-11, providing clinicians with comprehensive guidance on recognizing and diagnosing Complex PTSD. The manual expands on the ICD-11 diagnosis by offering detailed clinical descriptions, diagnostic requirements, developmental and cultural considerations, and guidance for distinguishing CPTSD from related conditions.
This milestone helps translate international recognition into clinical practice by giving mental health professionals clearer guidance for identifying Complex PTSD.
2025
Launch of the CPTSD Alliance + CPTSD Community Census
The Healing and CPTSD Foundation launches The CPTSD Alliance, a coalition of survivors, professionals, and advocates dedicated to systemic change. Alongside it, the first CPTSD Census is conducted, collecting real-time data from thousands of survivors to influence care standards, diagnostic reform, and policy change.
This formalizes a global movement to demand recognition, access, and dignity for those living with Complex PTSD.
2025
New Proposal for Complex PTSD Is Submitted to the DSM
The Healing and CPTSD Foundation developed and submitted a comprehensive proposal advocating for the inclusion of Complex PTSD (CPTSD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The proposal drew upon current scientific literature, international diagnostic developments, and survivor-informed perspectives to support formal recognition of CPTSD as a distinct diagnosis.
The submission followed communication indicating that a formal proposal for CPTSD had not previously been received through the DSM's proposal process. As of 2026, the Foundation's proposal is undergoing review through the American Psychiatric Association's internal review process.
2026
Development Begins on the Complex PTSD Recognition Act
The Healing and CPTSD Foundation begins developing the Complex PTSD Recognition Act of 2027, a proposed federal bill aimed at advancing the formal recognition of Complex PTSD within the United States.
The proposed legislation seeks to increase federal recognition of Complex PTSD and encourage greater awareness, education, research, and coordination across federal agencies. The initiative represents the Foundation's next step in advancing survivor-led advocacy beyond diagnostic recognition and toward broader systems change.
The Fight for Recognition Continues
As of August 2026, Complex PTSD has been recognized by the World Health Organization, incorporated into the international ICD-11 classification, and supported by expanding clinical guidance from leading professional organizations. Yet it remains absent as a separate diagnosis in the DSM-5-TR, meaning the United States has not formally recognized Complex PTSD as a distinct DSM diagnosis. Survivor-led advocacy, research, and policy efforts continue to advance recognition and systems change.
Please note: Recognition has developed differently across systems. CPTSD is formally classified in ICD-11, but it is not currently included as a separate diagnosis in DSM-5-TR. Professional guidance, clinical practice, research, public awareness, and legal or policy recognition may develop independently of one another.