{
  "schema_version": "uw.editorial_geo.v1",
  "article_index": "WAR-004",
  "catalog_id": "WAR-004",
  "language": "en",
  "headline": "Complex PTSD and prolonged violence: features and limits of the concept",
  "description": "Complex PTSD, prolonged violence, diagnostic frameworks, and the limits of the concept without self-diagnosis.",
  "master_filename": "ARTICLE_EN.md",
  "master_sha256": "080331554e8e87e6155203167e2283b2fc1392f944dbc6531246856bbdd9a0e3",
  "short_answer": "A history of prolonged violence does not itself establish complex PTSD. The concept concerns professional assessment of particular symptoms and their effects; ICD-11 and DSM-5 address this area differently. Present protection, dignity, and access to help do not depend on choosing your own diagnosis.",
  "claims": [
    {
      "id": "C01",
      "type": "clinical_educational_boundary",
      "text": "A prolonged history of violence and a complex PTSD diagnosis are not interchangeable; history alone does not establish the disorder.",
      "source_ids": [
        "S1",
        "S2"
      ],
      "article_sections": [
        "I. Naming an experience and naming a disorder",
        "III. Duration does not determine whose suffering counts"
      ],
      "attribution": "VA institutional clinical explanations",
      "limitations": "No reader diagnosis, judgement of an account, or ranking of histories."
    },
    {
      "id": "C02",
      "type": "clinical_classification_information",
      "text": "VA explains ICD-11 complex PTSD through core PTSD symptoms and additional areas of difficulty; DSM-5 has no separate complex PTSD diagnosis.",
      "source_ids": [
        "S1"
      ],
      "article_sections": [
        "II. Why classifications use different language"
      ],
      "attribution": "VA secondary explanation; primary WHO entry not directly read",
      "limitations": "Not reproduction of both classifications, every-country implementation, or administrative promise."
    },
    {
      "id": "C03",
      "type": "clinical_educational_boundary",
      "text": "Emotional difficulties, negative self-concept, and relationship difficulties are discussed in complex PTSD; a single sign does not establish diagnosis.",
      "source_ids": [
        "S1",
        "S2"
      ],
      "article_sections": [
        "IV. Describing experience without judging character",
        "V. Negative self-concept is not a verdict",
        "VI. Relationships without compulsory immediate trust"
      ],
      "attribution": "VA descriptions with explicit authorial limits",
      "limitations": "No self-diagnosis from emotion, distance, or shame."
    },
    {
      "id": "C04",
      "type": "clinical_assessment_boundary",
      "text": "Screening differs from fuller assessment; interviews and questionnaires are not reproduced as a home instrument.",
      "source_ids": [
        "S3"
      ],
      "article_sections": [
        "VII. Assessment with room for questions"
      ],
      "attribution": "VA public assessment information",
      "limitations": "No scores, instrument items, or promise of identical process or confidentiality everywhere."
    },
    {
      "id": "C05",
      "type": "clinical_treatment_boundary",
      "text": "The review does not establish one mandatory treatment sequence for everyone with complex PTSD; a plan belongs in competent professional discussion.",
      "source_ids": [
        "S1"
      ],
      "article_sections": [
        "VIII. Complexity does not prescribe one treatment sequence"
      ],
      "attribution": "VA professional review and evidence limitations",
      "limitations": "No method selection, timetable, self-directed exposure, or prescription."
    },
    {
      "id": "C06",
      "type": "medical_boundary",
      "text": "Finding a psychological concept cannot assign every new medical difficulty to it; other and accompanying problems may need consideration.",
      "source_ids": [
        "S4"
      ],
      "article_sections": [
        "VII. Assessment with room for questions"
      ],
      "attribution": "NIMH general assessment context",
      "limitations": "The article performs no differential diagnosis."
    },
    {
      "id": "C07",
      "type": "authorial_ethical_practical_proposal",
      "text": "Present protection, limits of consent, and access to help require consideration separately from a medical label.",
      "source_ids": [],
      "article_sections": [
        "VI. Relationships without compulsory immediate trust",
        "IX. Continuing danger remains an external problem",
        "XI. A life exceeds its explanation",
        "What this means in practice"
      ],
      "attribution": "United Wisdom optional descriptive and ethical proposal",
      "limitations": "No universal exit instruction, legal guarantee, or requirement to keep records."
    },
    {
      "id": "C08",
      "type": "religious_philosophical_comparison",
      "text": "The psalm of nearness and Confucian reciprocity have different foundations; the authors compare them only as limits on coercive participation.",
      "source_ids": [
        "S5",
        "S6"
      ],
      "article_sections": [
        "X. Two traditions and the limits of comparison"
      ],
      "attribution": "Checked primary passages with explicit authorial interpretation",
      "limitations": "No unified trauma theory, faith healing, compulsory forgiveness, trust, or reconciliation."
    }
  ],
  "questions": [
    {
      "id": "F01",
      "q": "Does prolonged violence automatically mean complex PTSD?",
      "a": "No. History matters, but diagnosis involves professional consideration of particular symptoms and their effects; lacking a name does not diminish the experience.",
      "claim_ids": [
        "C01"
      ],
      "source_ids": [
        "S1",
        "S2"
      ],
      "article_sections": [
        "I. Naming an experience and naming a disorder",
        "III. Duration does not determine whose suffering counts"
      ]
    },
    {
      "id": "F02",
      "q": "Can shame or difficulty trusting establish diagnosis?",
      "a": "No. A single experience or decision about distance does not identify its cause or replace assessment.",
      "claim_ids": [
        "C03",
        "C04"
      ],
      "source_ids": [
        "S1",
        "S2",
        "S3"
      ],
      "article_sections": [
        "V. Negative self-concept is not a verdict",
        "VI. Relationships without compulsory immediate trust",
        "VII. Assessment with room for questions"
      ]
    },
    {
      "id": "F03",
      "q": "Does everyone need the same preparatory treatment phase?",
      "a": "The VA review read here does not justify declaring one sequence mandatory for everyone. The question belongs to an individually justified professional plan.",
      "claim_ids": [
        "C05"
      ],
      "source_ids": [
        "S1"
      ],
      "article_sections": [
        "VIII. Complexity does not prescribe one treatment sequence"
      ]
    },
    {
      "id": "F04",
      "q": "Must I tell my whole history before first contact?",
      "a": "The optional proposal starts with a present difficulty and process question, without self-diagnosis; required information can then be clarified with the service.",
      "claim_ids": [
        "C04",
        "C07"
      ],
      "source_ids": [
        "S3"
      ],
      "article_sections": [
        "VII. Assessment with room for questions",
        "What this means in practice"
      ]
    }
  ],
  "sources": [
    {
      "rights_status": "UNKNOWN",
      "read_date": "2026-10-18",
      "search_executor": "Codex web.run / branch A author",
      "id": "S1",
      "author": "Sadie E. Larsen, PhD / VA National Center for PTSD",
      "title": "Complex PTSD: Assessment and Treatment",
      "url": "https://www.ptsd.va.gov/professional/treat/txessentials/complex_ptsd_assessment.asp",
      "edition": "Last updated September 3, 2025",
      "read_scope": "Complete main written review, web lines 363–434, and update label line 547; individual linked studies not independently read",
      "role": "Clinical terminology, diagnostic frameworks and uncertainty about mandatory treatment sequencing",
      "limitations": "Institutional professional review, not a directly read WHO classification or primary experiment; no personalised diagnosis or prescription",
      "rights_notes": "Bounded original paraphrase and citation; no copied article, test items or scoring. No explicit reuse licence separately established."
    },
    {
      "rights_status": "UNKNOWN",
      "read_date": "2026-10-18",
      "search_executor": "Codex web.run / branch A author",
      "id": "S2",
      "author": "VA National Center for PTSD",
      "title": "Complex PTSD",
      "url": "https://www.ptsd.va.gov/understand/what/complex_ptsd.asp",
      "edition": "Body: Last Updated October 2026; footer: September 29, 2026. Both retained, discrepancy not resolved by inference.",
      "read_scope": "Complete main written patient article, web lines 363–408, and footer date line 489; no linked instruments or individual studies examined",
      "role": "Accessible explanation of complex PTSD and limits of event-type inference",
      "limitations": "Same institution as S1, not independent empirical corroboration; no rates, universal duration or self-treatment conclusions used",
      "rights_notes": "Concise own paraphrase and link; no full text or questionnaire copied; specific licence not separately established."
    },
    {
      "id": "S3",
      "author": "VA National Center for PTSD",
      "title": "How Is PTSD Assessed?",
      "url": "https://www.ptsd.va.gov/understand/isitptsd/measured_how.asp",
      "edition": "Last updated September 25, 2026",
      "read_scope": "Complete main written article, web lines 363–425, and update line 507; video and actual diagnostic instruments not examined",
      "role": "Screening versus fuller assessment; interview and questions about process",
      "limitations": "US patient education; no instrument questions, scoring cutoffs, administrative promises or universal confidentiality rights",
      "rights_status": "UNKNOWN",
      "rights_notes": "Original bounded paraphrase and link; no full page, instrument or video copied; specific licence not separately established",
      "read_date": "2026-10-18",
      "search_executor": "Codex web.run / branch A author"
    },
    {
      "id": "S4",
      "author": "National Institute of Mental Health",
      "title": "Post-Traumatic Stress Disorder",
      "url": "https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd",
      "edition": "NIH publication 23-MH-8124; revised 2023",
      "read_scope": "Full relevant written sections: definition, reactions, assessment, ongoing trauma and Reprints; web lines 21–154",
      "role": "General medical context for assessment and possible accompanying conditions; not a separate complex PTSD standard",
      "limitations": "No individual diagnosis, symptom scale, local pathway or treatment plan",
      "rights_status": "TEXT_REUSE_ALLOWED_WITH_ATTRIBUTION",
      "rights_notes": "Exact publication Reprints permits text reuse with NIMH attribution; images excluded.",
      "read_date": "2026-10-18",
      "search_executor": "Codex web.run / branch A author"
    },
    {
      "rights_status": "KJV_PAGE_MARKED_PUBLIC_DOMAIN; GLOBAL_JURISDICTIONS_NOT_ASSESSED",
      "read_date": "2026-10-18",
      "search_executor": "Codex web.run / branch A author",
      "id": "S5",
      "author": "Psalms / King James Version",
      "title": "Psalm 34:17–22, specifically first clause of 34:18",
      "url": "https://www.biblegateway.com/passage/?search=Psalm%2034%3A17-22&version=KJV",
      "edition": "KJV displayed by Bible Gateway; read October 18, 2026",
      "read_scope": "Complete selected verses 17–22, web lines 45–66; public-domain label visible",
      "role": "Primary religious passage; epigraph and explicitly limited ethical reading",
      "limitations": "Not clinical evidence, guaranteed deliverance in medical terms, or a requirement to believe; Russian numbering distinction stated",
      "rights_notes": "Only a short first clause quoted in English; Russian own translation. Page marks KJV Public Domain. No full chapter or modern Russian translation copied."
    },
    {
      "rights_status": "UNKNOWN_GLOBAL; PROJECT_GUTENBERG_TERMS_READ",
      "read_date": "2026-10-18",
      "search_executor": "Codex web.run / branch A author",
      "id": "S6",
      "author": "Confucius / James Legge (translator)",
      "title": "The Chinese Classics, Volume 1: Confucian Analects, Book XV, chapter XXIII in this edition",
      "url": "https://www.gutenberg.org/cache/epub/4094/pg4094-images.html",
      "edition": "Project Gutenberg ebook 4094; checked edition heading and numbering, not silently equated with other chapter numbering",
      "read_scope": "Book XV heading lines 3222–3224; complete chosen dialogue lines 3379–3382; edition terms lines 4482–4515; other chapters not claimed fully read",
      "role": "Primary philosophical passage on reciprocity, applied expressly to helper conduct",
      "limitations": "No trauma mechanism, diagnostic evidence, compulsory trust or reconciliation inferred; authorial comparison marked",
      "rights_notes": "Short attributed English sentence and explicitly own Russian translation; no ebook republication. Gutenberg US framing and licence/trademark conditions read; worldwide public-domain status not asserted."
    }
  ],
  "entities": [
    {
      "name": "Complex PTSD",
      "type": "Clinical concept; reader not diagnosed"
    },
    {
      "name": "ICD-11",
      "type": "Classification described via VA review"
    },
    {
      "name": "DSM-5",
      "type": "Classification described via VA review"
    },
    {
      "name": "Psalms",
      "type": "Primary religious text"
    },
    {
      "name": "Confucius",
      "type": "Philosopher"
    },
    {
      "name": "James Legge",
      "type": "Named translator"
    }
  ],
  "retrieval_limits": [
    "History alone does not diagnose complex PTSD.",
    "No self-administered instrument, score or treatment protocol.",
    "No mandatory universal treatment sequence or recovery timetable.",
    "Current protection and access need separate consideration.",
    "No uniform privacy, administrative or legal guarantees.",
    "Spiritual texts are not medical evidence; no compulsory belief, growth, forgiveness or trust.",
    "Elena is fictional."
  ],
  "schema_org": {
    "@context": "https://schema.org",
    "@type": "Article",
    "identifier": "UW:WAR-004:en",
    "headline": "Complex PTSD and prolonged violence: features and limits of the concept",
    "inLanguage": "en",
    "author": [
      {
        "@type": "Person",
        "name": "Andrey Zarinsh"
      },
      {
        "@type": "Person",
        "name": "Maria Evilkut"
      }
    ]
  }
}