One implication of this finding is that clinicians could identify patients with complex PTSD and provide them with this augmented CBT. In this context, some have proposed that complex PTSD could be defined as a subtype of PTSD to facilitate targeted treatment planning. Complex PTSD is not formally recognized by DSM-IV, or the proposed DSM-5, as a distinct construct. Although DSM-IV lists emotion dysregulation as an associated feature of PTSD, the construct is generally conceptualized as a form of PTSD in which the patient has especially marked impairment in regulating their emotions, which results in maladaptive responses to extreme emotions, including self-harm, risky sexual or spending behavior, and chaotic interpersonal relationships (4). It shares certain properties with borderline personality disorder, but the latter is distinguished by its emphasis on severe behavioral and emotional dysregulation and fear of abandonment rather than PTSD symptoms. Whereas some studies of borderline personality report increased reactivity to stimuli, as would be expected in patients with PTSD (5), others have found that patients with borderline personality disorder are characterized by elevated tonic levels of emotional intensity but not increased reactivity (6). Complex PTSD is also conceptually similar to disorder of extreme stress not otherwise specified, which in addition to PTSD symptoms is often described as having alterations in self-identity, self-directed harm, and chaotic relationships (7).