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Intense and prolonged exposure to traumatic events combined with other risk factors (some of the risk factors for PTSD are older age, female gender, pre-trauma mental health issues, early life trauma and lack of social support) can lead to significant changes in personality development.

This long-term effect of trauma is called complex PTSD and it encompasses alterations in:

• regulation of affect and impulses
• relations with others
• systems of meaning

Trauma can alter the sense of identity, one’s self-worth and core believes

about the world. Some of typical cognitive distortions are:

• persistent negative beliefs about themselves/the world (“I am no good”; “I cannot trust anyone”)
• an exaggerated blame of self or others for causing the trauma (“I deserved this to happen to me”).