In summary, the core PTSD criteria are as follows: (A) Exposure to a traumatic event; (B) persistent re-experiencing of the event; (C) persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness; (D) Persistent symptoms of increased arousal (not present before the trauma); (E) Duration of symptoms for more than one month; (F) Significant impairment in social, occupational, or other important areas of functioning. PTSD usefully describes a cluster of symptoms which are suffered by many victims of trafficking and it is therefore a helpful diagnosis for clinicians. However, many clinicians who are experienced in working in the trauma field believe that the PTSD diagnosis on its own fails to do justice to the complexity of symptoms and behaviours they frequently observe in survivors of repeated and/or prolonged interpersonal violence. The concept of Complex Post Traumatic Stress Disorder (Complex PTSD), which applies to people who have experienced multiple traumatic events or events of prolonged duration, was originally developed by Herman 78 and van der Kolk 79. As clinical practitioners, they were focusing upon the consequences of trauma in childhood and adolescence, particularly the aftermath of sexual abuse. Drawing upon the work of Herman and van der Kolk on Complex PTSD, the Diagnostic and Statistical Manual of Mental Disorders (DSM) delineated trauma symptoms of “Complex PTSD” (also known as Disorders of Extreme Stress Not Otherwise Specificed (DESNOS) or as “additional features of PTSD” rather than as a separate diagnostic entity. Complex PTSD/DESNOS as described in the DSM applied to people who had experienced multiple traumatic events or events of prolonged duration. Key clinical features of complex PTSD included impaired affect modulation, selfdestructive and impulsive behaviour, dissociative symptoms, hostility and social withdrawal, feelings of shame and of hopelessness, loss of previously held beliefs, and prominent somatic complaints. This clinical profile accords well with HBF’s observations of victims of trafficking for various forms of exploitation. The most recent iteration of the DSM, DSM-5, has moved further in the direction of incorporating the key clinical features of Complex PTSD. DSM-5 identifies “negative alterations in cognitions and mood” as a fourth “cluster” of PTSD symptoms in addition to the three clusters of intrusive thoughts, avoidant behaviours and alterations in arousal that were identified in DSM IV-TR. These “negative alterations in cognitions and mood” include persistent and distorted blame of self or others and persistent negative emotional state. In addition the “alterations in arousal and Features of Complex PTSD as defined in Judith Herman’s book, Trauma and Recovery 80 – – – – – Trauma and Recovery Journal of Traumatic Stress, 86 –