How do clinicians conceptualise negative self-concept in complex post-traumatic stress disorder (CPTSD)?

Negative self-concept (NSC) is one of the core ‘disturbances in self-organisation’ (DSO) symptoms of CPTSD. It is characterised by persistent negative beliefs about the self and is common in traumatised populations who have endured crises such as childhood sexual abuse survivors, refugee groups, and military veterans. However, there is limited research on how NSC is conceptualised and managed in CPTSD and other related disorders. This qualitative study explores how clinicians conceptualise NSC in these populations. Semi-structured interviews were conducted with 15 clinicians (clinical psychologists, psychiatrists and psychotherapists) and data was analysed using thematic analysis. Clinicians described NSC as involving a persistent negative view encompassing feelings of self-blame, shame, guilt, and worthlessness. Early childhood attachments and systemic responses following traumatic experiences were identified as influential in shaping self-concept. Facilitators to healing included self-compassion, the therapeutic relationship and social re-integration. These findings aim to offer insights for clinicians supporting traumatised populations.