The purpose of this descriptive non-empirical dissertation was to examine the utility of the concept of complex posttraumatic stress disorder (CPTSD) to conceptualize, assess, and treat veterans returning from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) who have been exposed to traumatic event(s). Many have been exposed to unique traumatic factors, such as frequent deployments of greater length, urban combat theaters, and guerilla warfare. The prevalence of mental health disorders within this veteran population is high while utilization of services remains low. This body of work explores to what extent veterans present with trauma symptoms that may be different from PTSD as historically defined in the DSM system, and that more closely resemble CPTSD symptoms. CPTSD is a subset of psychological trauma that has a unique and broad range of disturbances affecting self-regulation, systems of meaning, and self-perception. The body of work presented here synthesizes the current literature on this veteran population, traumatic stress disorders and treatments, moral injury and moral distress, and betrayal trauma theory to present an argument in favor of the utility of the CPTSD concept. This dissertation may be used in the following ways: (a) to enhance the relevance and understanding of CPTSD specific to the returning veteran population, and (b) to serve as a framework for future research and implementation of a phase-based treatment. While available PTSD treatments may be applicable for these veterans, they do not account for emotion regulation deficits and, in some cases, may be contraindicated. Following a critical review of the literature, the researcher developed phase-based and skills-focused treatment protocol as a creative solution to bridge the gap between PTSD and CPTSD treatments. The potential limitations of the protocol are assessed and opportunities for future directions are presented.

Library of Congress Subject Headings

Dissertations (PsyD) -- Psychology; Post-traumatic stress disorder -- Treatment; War -- Psychological aspects; Veterans -- Mental health; Soldiers -- Mental health; Iraq War, 2003-2011 -- Psychological aspects; Operation Enduring Freedom, 2001- -- Psychological aspects

Date of Award


School Affiliation

Graduate School of Education and Psychology



Degree Type


Degree Name


Faculty Advisor

Woo, Stephanie;