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On February 6, 2023, an earthquake registering 7.8 on the Richter scale struck southeast Turkey, and this was followed by a second earthquake of magnitude 7.5. The earthquake resulted in widespread loss, devastation, and destruction, and is anticipated to bear a significant psychological toll on survivors. This study aimed to investigate the prevalence and correlates of ICD-11 posttraumatic stress disorder (PTSD) in those living in earthquake-affected areas of Turkey. The sample was a convenience sample of 527 adults living in earthquake-affected areas of Turkey. Prevalence rates and gender differences in exposure to earthquake-related traumatic events were investigated. Moreover, prevalence rates of ICD-11 PTSD were computed, and demographic and trauma-related correlates of ICD-11 PTSD were assessed using logistic regression analyses. Most of the sample (99.2%; n = 523) experienced at least one earthquake-related traumatic event, with the majority experiencing multiple events. Findings demonstrated high endorsement of the ICD-11 PTSD symptom clusters, with 54.1% meeting criteria for diagnosis of probable ICD-11 PTSD. Correlates associated with increased risk of PTSD include female gender, physical injury in the earthquake, physical injury of family or loved ones in the earthquake and being in the higher earthquake-related traumatic events exposure quartiles. These findings indicate high levels of trauma exposure and PTSD among survivors of the recent earthquakes which occurred in Turkey. The identification of correlates associated with increased risk of PTSD is useful for identifying Turkish earthquake survivors who are most likely to need psychological support. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Whether complex posttraumatic stress disorder (CPTSD) and borderline personality disorder (BPD) diagnoses differ substantially enough to warrant separate diagnostic classifications has been a subject of controversy for years. To contribute to the nomological network of cumulative evidence, the main goal of the present study was to explore, using network analysis, how the symptoms of ICD-11 PTSD and disturbances in self-organization (DSO) are interconnected with BPD in a clinical sample of polytraumatized individuals (N = 330). Participants completed measures of life events, CPTSD, and BPD. Overall, our study suggests that BPD and CPTSD are largely separated. The bridges between BPD and CPTSD symptom clusters were scarce, with "Affective Dysregulation" items being the only items related to BPD. The present study contributes to the growing literature on discriminant validity of CPTSD and supports its distinctiveness from BPD. Implications for treatment are discussed. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The present study aimed to report the prevalence of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) in the general adult Hong Kong population, and examine the validity of the Chinese International Trauma Questionnaire (ITQ). This descriptive cross-sectional population-based telephone survey included a representative sample of 1070 non-institutionalized permanent Hong Kong residents ages 18–64 years. Participants provided responses to the Chinese version of the ITQ, and measures of adverse childhood experiences (ACEs), depression, anxiety, and stress. Based on the diagnostic algorithm of the ITQ, 5.9% of the sample screened positive for either CPTSD or PTSD, with CPTSD (4.2%) being more common that PTSD (1.7%). Results of the confirmatory factor analysis indicated the first-order correlated 6-factor model to be the best fitting solution. Symptom cluster summed scores were all positively and significantly correlated with all criterion variables. This investigation established the prevalence rates of ICD-11 PTSD and CPTSD using a general adult population sample in Hong Kong. The Chinese ITQ demonstrated sound factorial validity and concurrent validity. Future research can further characterize ICD-11 PTSD and CPTSD in subgroups using the Chinese ITQ. • Prevalence of ICD-11 PTSD and CPTSD in Hong Kong is 1.7% and 4.2%, respectively. • The Chinese ITQ showed sound psychometric properties in a general adult sample. • First-order correlated 6-factor model best represented the sample data. • Symptom scores significantly correlated with mental health and childhood adversity. [ABSTRACT FROM AUTHOR]

Background: People with an intellectual disability are more vulnerable to psychological trauma compared with the general population. The aim of this scoping review was to identify the current status of the literature on trauma that is specific to the experiences of adults with an intellectual disability, living in community settings. Methods: A scoping review was conducted using the Arksey and O'Malley (International Journal of Social Research Methodology, 2005, 8, 19) framework. Forty‐one international papers were reviewed spanning 2000–2020, and their quality assessed using the MMAT. Findings: (1) Aggressive behaviours can be symptoms of trauma, (2) there are appropriate assessment tools for the impact of trauma, (3) evidence‐based interventions for trauma may be effective, and (4) factors associated with disability can be experienced as traumatic. Conclusion: There is a growing body of literature highlighting assessment needs and potential interventions for people with an intellectual disability who have experienced psychological trauma. Further research is needed to develop trauma‐informed pathways. [ABSTRACT FROM AUTHOR]

Background: Although ICD-11 adjustment (AjD), posttraumatic stress (PTSD) and complex posttraumatic stress (CPTSD) are commonly diagnosed disorders following exposure to stressful or traumatic life events, their dimensional structure and co-occurrence has never been tested in a single study. The present study explored the latent structure of AjD, PTSD, and CPTSD symptoms and their relationship to stressful and traumatic life events to determine the degree of distinctiveness between these constructs. Methods: Participants were clinical patients (N = 331) who completed self-report measures of stressful and traumatic life events, AjD (The Adjustment Disorder – New Module 8 (ADNM-8)) and PTSD / CPTSD (The International Trauma Questionnaire – ITQ). Results: Using confirmatory factor analysis, a second-order model comprised of correlated latent variables of AjD, PTSD, and CPTSD provided the best fit of the data. It was also found that stressors and traumatic life events were positively associated with all of these conditions although childhood trauma was only associated with CPTSD. Conclusions: The current findings support the ICD-11 model of related-but-distinct stress-related disorders. We discuss the existence of a stress-response continuum and how the current findings impact the development of clinical interventions that may be shared across, or unique to, each stress-related disorder. [ABSTRACT FROM AUTHOR]

This study aimed to (a) identify posttraumatic stress disorder (PTSD) trajectories in a sample of Danish treatment-seeking childhood sexual abuse (CSA) survivors and (b) examine the roles of social support, coping style, and individual PTSD symptom clusters (avoidance, reexperiencing, and hyperarousal) as predictors of the identified trajectories. We utilized a convenience sample of 439 CSA survivors attending personalized psychotherapy treatment in Denmark. Four assessments were conducted on a six monthly basis over a period of 18 months. We used latent class growth analysis (LCGA) to test solutions with one to six classes. Following this, a logistic regression was conducted to examine predictors of the identified trajectories. Results revealed four distinct trajectories which were labeled high PTSD gradual response, high PTSD treatment resistant, moderate PTSD rapid response, and moderate PTSD gradual response. Emotional and detached coping and more severe pretreatment avoidance and reexperiencing symptoms were associated with more severe and treatment resistant PTSD. High social support and a longer length of time since the abuse were associated with less severe PTSD which improved over time. The findings suggested that treatment response of PTSD in CSA survivors is characterized by distinct patterns with varying levels and rates of PTSD symptom improvement. Results revealed that social support is protective and that emotional and detached coping and high pretreatment levels of avoidance and reexperiencing symptoms are risk factors in relation to PTSD severity and course. These factors could potentially identify patients who are at risk of not responding to treatment. Furthermore, these factors could be specifically addressed to increase positive outcomes for treatment-seeking CSA survivors. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. Posttraumatic stress disorder (PTSD) is traditionally understood as a disorder that occurs more commonly in women than in men, and in younger age groups than in older age groups. The objective of this study was to determine if these patterns are also observed in relation to International Classification of Diseases (ICD-11) PTSD and complex PTSD (CPTSD). Methods. Secondary data analysis was performed using data collected from three nationally representative samples from the Republic of Ireland (N = 1,020), the United States (N = 1,839), and Israel (N = 1,003), and one community sample from the United Kingdom (N = 1,051). Results. Estimated prevalence rates of ICD-11 PTSD were higher in women than in men in each sample, and at a level consistent with existing data derived from Diagnostic and Statistics Manual of Mental Disorders (DSM)-based models of PTSD. Furthermore, rates of ICD-11 PTSD were generally lower in older age groups for men and women. For CPTSD, there was inconsistent evidence of sex and age differences, and some indication of a possible interaction between these two demographic variables. Conclusions. Despite considerable revisions to PTSD in ICD-11, the same sex and age profile was observed to previous DSM-based models of PTSD. CPTSD, however, does not appear to show the same sex and age differences as PTSD. Theoretical models that seek to explain sex and age differences in trauma-related psychopathology may need to be reconsidered given the distinct effects for ICD-11 PTSD and CPTSD. [ABSTRACT FROM AUTHOR]

Background: War captivity and posttraumatic stress disorder (PTSD) are known to be associated with several poor health outcomes of an accelerated aging process. However, the contribution of personality protective factors to this phenomenon are rarely studied. The present 24-year prospective study examined associations between psychological hardiness and three health outcomes: C-reactive protein (CRP) levels, metabolic syndrome (MetS), and telomere length (TL). Method: Eighty-eight Israeli former prisoners of war (ex-POWs) were assessed 18 (T1) and 42 (T2) years after repatriation. Data on hardiness was collected at T1 while leukocyte TL, CRP, and MetS data was collected 42 years after the war. Results: While adjusting for age, body mass index (BMI), self-rated health, depressive and PTSD symptoms at T2, higher levels of hardiness at T1 predicted decreased CRP and longer TL at T2. Conclusions: Long-term health vulnerabilities of traumatized ex-POWs are manifested in an accelerated aging process and cellular senescence. Raising awareness of the importance of protective factors such as veterans' hardiness might be associated with improving their longevity and well-being. [ABSTRACT FROM AUTHOR]

Background: Veterans with post-traumatic stress disorder (PTSD) typically report a poorer treatment response than those who have not served in the Armed Forces. A possible explanation is that veterans often present with complex symptoms of PTSD. ICD-11 PTSD and complex PTSD (CPTSD) have not previously been explored in a military sample.Aims: This study aimed to validate the only measure of ICD-11 PTSD and CPTSD, the International Trauma Questionnaire, and assess the rates of the disorder in a sample of treatment-seeking UK veterans.Method: A sample of help-seeking veterans (N = 177) was recruited from a national charity in the UK that provides clinical services to veterans. Participants completed measures of ICD-11 PTSD and CPTSD as well as childhood and adult traumatic life events. Confirmatory factor analysis was used to assess the latent structure of PTSD and CPTSD symptoms, and rates of the disorders were estimated.Results: The majority of the participants (70.7%) reported symptoms consistent with a diagnosis of either PTSD or CPTSD. Results indicated the presence of two separate disorders, with CPTSD being more frequently endorsed (56.7%) than PTSD (14.0%). CPTSD was more strongly associated with childhood trauma than PTSD.Conclusions: The International Trauma Questionnaire can adequately distinguish between PTSD and CPTSD within clinical samples of veterans. There is a need to explore the effectiveness of existing and new treatments for CPTSD in military personnel. [ABSTRACT FROM AUTHOR]

There is very little work on the role of positive or benevolent childhood experiences and how such events might offer protection from the insidious effects of adverse experiences in childhood or later in life. We set out to test, using latent variable modelling, whether adverse and benevolent childhood experiences could be best described as a single continuum or two correlated constructs. We also modelled the relationship between adverse and benevolent childhood experiences and ICD-11 PTSD and Complex PTSD (CPTSD) symptoms and explored if these associations were indirect via psychological trauma. Data were collected from a trauma-exposed sample (N = 275) attending a specialist trauma care centre in the UK. Participants completed measures of childhood adverse and benevolent experiences, traumatic exposure, and PTSD and CPTSD symptoms. Findings suggested that adverse childhood experiences operate only indirectly on PTSD and CPTSD symptoms through lifetime trauma exposure, and with a stronger effect for PTSD. Benevolent childhood experiences directly predicted only CPTSD symptoms. Benevolent and traumatic experiences seem to form unique associations with PTSD and CPTSD symptoms. Future research is needed to explore how benevolent experiences can be integrated within existing psychological interventions to maximise recovery from traumatic stress. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Co-occurrence of psychosis and posttraumatic stress disorder (PTSD) symptoms has been demonstrated, but the ICD-11 marks a significant divergence in the formulation of PTSD with a focus on the core symptoms and the addition of complex PTSD (CPTSD). Objective: To evaluate the distribution of psychosis and traumatic stress symptoms using the ICD-11 conceptualisation of PTSD and CPTSD. Method: A latent class analysis was conducted on psychosis symptoms, PTSD and CPTSD among a random adult sample from the UK general population with a history of traumatic events (N = 1,051). Results: Six classes were identified; a low-symptom class, a PTSD-class, a CPTSD-class, a class characterized by disturbances in self-organization alone as well as two classes characterized by CPTSD and various levels of psychosis symptom endorsement. Cumulative childhood adversity predicted membership of the PTSD, CPTSD and comorbid classes in a dose-response manner with the strongest effects observed for classes characterised by comorbid symptoms. Conclusion: The present study confirms the co-occurrence of psychosis symptoms and ICD-11 PTSD and CPTSD. Psychosis symptoms did not emerge in isolation from traumatic stress symptoms, underpinning the need for a greater recognition of psychosis symptoms as part of the broader clinical picture among trauma-exposed populations. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization(WHO) International Classification of Diseases, 11th version (ICD-11), has proposed a new trauma-related diagnosis of complex posttraumatic stress disorder (CPTSD), separate and distinct from posttraumatic stress disorder (PTSD). However, to date, no study has examined CPTSD over time. Objectives: This prospective study aimed to examine predictors and outcomes of latent classes of PTSD and CPTSD following war captivity. Method: A sample of 183 Israeli former prisoners of the 1973 Yom Kippur War (ex-POWs) participated in a 24-year longitudinal study with three waves of measurements (T1: 1991, T2: 2008, and T3: 2015). Participants completed validated self-report measures, and their cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA). Results: A Latent Class Analysis (LCA) identified three main classes at T2: (1) a small class with low probability to meet PTSD and CPTSD clusters criteria (15.26%); (2) a class high only in PTSD symptoms (42.37%) and (3) a class high only in CPTSD symptoms (42.37%). Importantly, higher levels of psychological suffering in captivity at T1 were associated with higher odds of being in the CPTSD class at T2. In addition, CPTSD at T2 was more strongly associated with low self-rated health, functional impairment, and cognitive performance at T3, compared to the PTSD only class. Conclusions: Adulthood prolonged trauma of severe interpersonal intensity such as war captivity is related to CPTSD, years after the end of the war. Exposure to psychological suffering in captivity is a risk factor for future endorsement of CPTSD symptoms. CPTSD among ex-POWs is a marker for future dire mental health and functional consequences. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The current study sought to advance the existing literature by providing the first assessment of the factorial and discriminant validity of the ICD-11 proposals for posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) in a nationwide level.Methods: A nationally representative sample from Israel (n = 1,003) using a disorder-specific measure (ITQ; International Trauma Questionnaire) in order to assess PTSD and CPTSD along with the Life Events Checklist and the World Health Organization Well-Being Index.Results: Estimated prevalence rates of PTSD and CPTSD were 9.0 and 2.6%, respectively. The structural analyses indicated that PTSD and disturbances in self-organization symptom clusters were multidimensional, but not necessarily hierarchical, in nature and there were distinct classes that were consistent with PTSD and CPTSD.Conclusions: These results partially support the factorial validity and strongly support the discriminant validity of the ICD-11 proposals for PTSD and CPTSD in a nationally representative sample using a disorder-specific measure; findings also supported the international applicability of these diagnoses. Further research is required to determine the prevalence rates of PTSD and CPTSD in national representative samples across different countries and explore the predictive utility of different types of traumatic life events on PTSD and CPTSD. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Among the conditions following exposure to traumatic life events proposed by ICD-11 are Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). The primary aim of this study was to provide an assessment of the reliability and validity of a newly developed self-report measure of ICD-11 PTSD and CPTSD: the ICD-11 Trauma Questionnaire (ICD-TQ). Participants in this study were a sample of individuals who were referred for psychological therapy to a National Health Service (NHS) trauma centre in Scotland ( N = 193). Participants completed the ICD-TQ and measures of traumatic life events, DSM-5 PTSD, emotion dysregulation, self–esteem, and interpersonal difficulties. Confirmatory factor analysis results supported the factorial validity of the ICD-TQ with results in line with ICD-11 proposals. The ICD-TQ demonstrated satisfactory internal reliability, and correlation results indicated that the scale exhibited convergent and discriminant validity. Current results provide initial support for the psychometric properties of this initial version of the ICD-TQ. Future theoretical and empirical work will be required to generate a final version of the ICD-TQ that will match the diagnostic structure of PTSD and CPTSD when ICD-11 is published. [ABSTRACT FROM AUTHOR]

Background: The International Classification of Diseases (ICD-11) is currently under development with proposed changes recommended for the posttraumatic stress disorder (PTSD) diagnosis and the inclusion of a separate complex PTSD (CPTSD) disorder. Empirical studies support the distinction between PTSD and CPTSD; however, less research has focused on non-western populations. Objective: The aim of this study was to investigate whether distinct PTSD and CPTSD symptom classes emerged and to identify potential risk factors and the severity of impairment associated with resultant classes. Methods: A latent class analysis (LCA) and related analyses were conducted on 314 young adults from Northern Uganda. Fifty-one percent were female and participants were aged between 18 and 25 years. Forty percent of the participants were former child soldiers (n=124) while the remaining participants were civilians (n=190). Results: The LCA revealed three classes: a CPTSD class (40.2%), a PTSD class (43.8%), and a low symptom class (16%). Child soldier status was a significant predictor of both CPTSD and PTSD classes (OR=5.96 and 2.82, respectively). Classes differed significantly on measures of anxiety/depression, conduct problems, somatic complaints, and war experiences. Conclusions: To conclude, this study provides preliminary support for the proposed distinction between PTSD and CPTSD in a young adult sample from Northern Uganda. However, future studies are needed using larger samples to test alternative models before firm conclusions can be made. [ABSTRACT FROM AUTHOR]

Background: In the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the symptom profile of posttraumatic stress disorder (PTSD) was expanded to include 20 symptoms. An alternative model of PTSD is outlined in the proposed 11th edition of the International Classification of Diseases (ICD-11) that includes just six symptoms. Objectives and method: The objectives of the current study are: 1) to independently investigate the fit of the ICD-11 model of PTSD, and three DSM-5-based models of PTSD, across seven different trauma samples (N=3,746) using confirmatory factor analysis; 2) to assess the concurrent validity of the ICD-11 model of PTSD; and 3) to determine if there are significant differences in diagnostic rates between the ICD-11 guidelines and the DSM-5 criteria. Results: The ICD-11 model of PTSD was found to provide excellent model fit in six of the seven trauma samples, and tests of factorial invariance showed that the model performs equally well for males and females. DSM-5 models provided poor fit of the data. Concurrent validity was established as the ICD-11 PTSD factors were all moderately to strongly correlated with scores of depression, anxiety, dissociation, and aggression. Levels of association were similar for ICD-11 and DSM-5 suggesting that explanatory power is not affected due to the limited number of items included in the ICD-11 model. Diagnostic rates were significantly lower according to ICD-11 guidelines compared to the DSM-5 criteria. Conclusions: The proposed factor structure of the ICD-11 model of PTSD appears valid across multiple trauma types, possesses good concurrent validity, and is more stringent in terms of diagnosis compared to the DSM-5 criteria. [ABSTRACT FROM AUTHOR]

BACKGROUND: The International Classification of Diseases, 11th version (ICD-11), proposes two related stress and trauma-related disorders, posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). A diagnosis of CPTSD requires that in addition to the PTSD symptoms, an individual must also endorse symptoms in three major domains: (1) affective dysregulation, (2) negative self-concepts, and (3) interpersonal problems. This study aimed to determine if the naturally occurring distribution of symptoms in three groups of traumatised individuals (bereavement, sexual victimisation, and physical assault) were consistent with the ICD-11, PTSD, and CPTSD specification. The study also investigated whether these groups differed on a range of other psychological problems. METHODS AND RESULTS: Participants completed self-report measures of each symptom group and latent class analyses consistently found that a three class solution was best. The classes were "PTSD only," "CPTSD," and "low PTSD/CPTSD." These classes differed significantly on measures of depression, anxiety, dissociation, sleep disturbances, somatisation, interpersonal sensitivity, and aggression. The "CPTSD" class in the three samples scored highest on all the variables, with the "PTSD only" class scoring lower and the "low PTSD/CPTSD" class the lowest. CONCLUSION: This study provides evidence to support the diagnostic structure of CPTSD and indicted that CPTSD is associated with a broad range of other psychological problems. [ABSTRACT FROM AUTHOR]

Abstract: Much of the debate surrounding the dimensionality of PTSD relates to three specific Hyperarousal symptoms (D1–D3) and whether they are appropriate indicators of one of two broad constructs that constitute PTSD: Dysphoria or Hyperarousal. This study addressed this issue by testing a series of confirmatory factor models to determine which factor, or factors, these symptoms measured the strongest. Data from individuals who satisfied the conditions for Criterion A of the diagnostic criteria for a DSM-IV diagnosis of PTSD (n =12,467) in the 2004–2005 NESARC were used in the analysis. The results revealed that the D1–D3 symptoms were not clear indicators of either factor, but measured both Dysphoria and Hyperarousal. Two symptoms, however, loaded more highly on the Dysphoria, rather than Hyperarousal, factor. The present findings lend support to the factor model proposed by Simms et al. [Simms, L. J., Watson, D., & Doebbeling, B. N. (2002). Confirmatory factor analyses of posttraumatic stress symptoms in deployed and non-deployed veterans of the Gulf War. Journal of Abnormal Psychology, 111, 637–647] but also question the use of symptoms that are not unique indicators of specific factors. [Copyright &y& Elsevier]

The aim of this study was to determine if there are meaningful clusters of individuals with similar experiences of adverse life events in a nationally representative sample of Danish adolescents. Latent class analysis (LCA) was used to identify such clusters or latent classes. In addition, the relationships between the latent classes and living arrangements and diagnosis of post-traumatic stress disorder (PTSD) were estimated. A four-class solution was found to be the best description of multiple adverse life events, and the classes were labelled “Low Risk”, “Intermediate Risk”, “Pregnancy” and “High Risk”. Compared with the Low Risk class, the other classes were found to be significantly more likely to have a diagnosis PTSD and live with only one parent. This paper demonstrated how trauma research can focus on the individual as the unit of analysis rather than traumatic events. [ABSTRACT FROM AUTHOR]

Objectives: The current study sought to further assess the nature of the affect dysregulation (AD) cluster of the International Classification of Diseases‐11 (ICD‐11) proposal for complex posttraumatic stress disorder (CPTSD) in a nonclinical sample. Methods: An online survey sample from Israel (n = 618) completed a disorder‐specific measure (International Trauma Questionnaire) of PTSD and CPTSD along with the Life Events Checklist and the World Health Organization Well‐Being Index. Results: Estimated prevalence rates of PTSD and CPTSD were 9.2% and 1.0%, respectively. Confirmatory factor analysis results indicated that AD symptoms are better conceived as two correlated dimensions of hyperactivation and hypoactivation symptoms. Latent class analysis results indicated that CPTSD was clearly distinguishable from PTSD. CPTSD class membership was associated with higher levels of traumatization and poorer psychological well‐being scores. Conclusions: Findings support the discriminant validity of the ICD‐11 proposals for PTSD and CPTSD in a nonclinical sample using a disorder‐specific measure. The results provide further evidence that the final symptom profile for CPTSD in ICD‐11 should model the AD cluster using both hyperactivation and hypoactivation symptoms. [ABSTRACT FROM AUTHOR]

With the publication of the International Statistical Classification of Diseases and Related Health Problems, 11th edition (ICD-11) due for release in 2018, a number of studies have assessed the factorial validity of the proposed post-traumatic stress disorder (PTSD) and complex (CPTSD) diagnostic criteria and whether the disorders are correlated but distinct constructs. As the specific nature of CPTSD symptoms has yet to be firmly established, this study aimed to examine the dimension of affect dysregulation as two separate constructs representing hyper-activation and hypo-activation. Seven alternative models were estimated within a confirmatory factor analytic framework using the International Trauma Questionnaire (ITQ). Data were analysed from a young adult sample from northern Uganda (n = 314), of which 51% were female and aged 18-25 years. Forty per cent of the participants were former child soldiers (n = 124) while the remainder were civilians (n = 190). The prevalence of CPTSD was 20.8% and PTSD was 13.1%. The results indicated that all models that estimated affective dysregulation as distinct but correlated constructs (i.e. hyper-activation and hypo-activation) provided satisfactory model fit, with statistical superiority for a seven-factor first-order correlated model. Furthermore, individuals who met the criteria for CPTSD reported higher levels of war experiences, symptoms of anxiety and depression, and somatic problems than those with PTSD only and no diagnosis. There was also a much larger proportion of former child soldiers that met the criteria for a CPTSD diagnosis. In conclusion, these results partly support the factorial validity of the ICD-11 proposals for PTSD and CPTSD in a non-Western culture exposed to mass violence. These findings highlight that more research is required across different cultural backgrounds before firm conclusions can be made regarding the factor structure of CPTSD using the ITQ. [ABSTRACT FROM AUTHOR]

The ICD-11 proposes different types of prolonged trauma as risk factors for complex PTSD (CPTSD). However, CPTSD's construct validity has only been examined in childhood abuse, and single trauma exposure samples. Thus, the extent to which CPTSD applies to other repeatedly traumatized populations is unknown. This study examined ICD-11's PTSD and CPTSD across populations with prolonged trauma of varying interpersonal intensity and ages of exposure, including: 1) childhood sexual abuse, 2) adulthood trauma of severe interpersonal intensity (refugees and ex-prisoners of war), and 3) adulthood trauma of mild interpersonal intensity (military veterans, and mental health workers). In support of the proposal, latent class analysis ( N = 820) identified, a 4-class solution representing “PTSD”, “CPTSD”, and “non-pathological” classes, but also an “Anxiety symptoms” class, and an alternative 5-class solution, with a “Dissociative PTSD-subtype” class. ICD-11's CPTSD was not exclusively associated with childhood abuse, but also with exposure to adulthood trauma of severe interpersonal intensity. Furthermore, all types of prolonged trauma were equally associated with the “Anxiety symptoms” class. Finally, of all the classes, the “CPTSD“ class was associated with the highest frequency of work-related functional impairment, indicating an association between the severity of prolonged trauma exposure and the level of posttraumatic residues. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) have various deleterious effects on mental health but few studies have been conducted in Ireland. The primary objective was to determine if there were significant differences in occurrences of ACEs in U.S. and Irish adults. We also sought to determine if there were unique associations between individual and multiple ACE events and mental health. Preexisting nationally representative adult samples from the U.S. (n = 1893) and Ireland (n = 1020) were utilized for analysis. To determine if there were significant differences in the occurrence of specific ACE events and the mean number of ACEs experienced by U.S. and Irish adults, chi-square difference tests and an independent samples t -test were used, respectively. Binary logistic regression was used to examine the unique associations between ACE events and major depressive disorder (MDD), generalized anxiety disorder (GAD), posttraumatic stress disorder (PTSD), and Complex PTSD (CPTSD). Nationality, sex, age, and educational level were included as covariates and adjusted odds ratios are reported. Irish respondents had a higher rate of ACEs, were more likely to experience specific ACEs, and to meet diagnostic requirements for MDD, GAD, and CPTSD than U.S. respondents. Emotional neglect was more strongly related to mental health than all other ACEs, and there was an exceptionally strong dose-response association between ACEs and CPTSD. ACEs seem to be more common in Ireland than the U.S., and efforts to minimize exposure to ACEs through public policies may lead to beneficial mental health effects. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this study was to assess the factorial structure of complicated grief (CG) and investigate the relationship between CG and posttraumatic stress disorder (PTSD) through the assessment of models combining both constructs. The questionnaire was completed by elderly, married respondents with a history of at least one significant, interpersonal loss (145 males and 147 females, 60–81 years). Confirmatory factor analysis (CFA) supported a two-factor model of separation and traumatic distress in CG. To investigate the relationship between CG and PTSD three combined models were specified and estimated using CFA. A model where all five factors, the two factors of CG and the three factors of PTSD, as defined by the DSM-IV, were allowed to correlate provided the best fit. The results indicated a considerable overlap between the dimensions of CG and PTSD, and complicated grief is construct that appears to be largely accounted for by especially the intrusive component of PTSD. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: This study first aimed to examine the structure of self-reported posttraumatic stress disorder (PTSD) symptoms using three different samples. The second aim of the paper was to test the robustness of the factor analytic model when depression scores were controlled for. Design: Based on previous factor analytic findings and the DSM-IV formulation, six confirmatory factor models were specified and estimated that reflected different symptom clusters. The best fitting model was subsequently re-fitted to the data after including a depression variable. Methods: The analyses were based on responses from 973 participants across three samples. Sample 1 consisted of 633 parents who were members of ‘The National Association of Infant Death’ and who had lost a child. Sample 2 consisted of 227 victims of rape, who completed a questionnaire within 4 weeks of the rape. Each respondent had been in contact with the Centre for Rape Victims (CRV) at the Aarhus University Hospital, Denmark. Sample 3 consisted of 113 refugees resident in Denmark. All participants had been referred to a treatment centre which focused on rehabilitating refugees through treatment for psychosocial integration problems (RRCF: Rehabliterings og Revliderings Centre for Flygtninge). In total 500 participants received a diagnosis of PTSD/sub-clinical PTSD (Sample 1, N =214; 2, N =176; 3, N =110). Results: A correlated four-factor model with re-experiencing, avoidance, dysphoria, and arousal factors provided the best fit to the sample data. The average attenuation in the factor loadings was highest for the dysphoria factor (M =−.26, SD=.11) compared to the re-experiencing (M =−.14, SD=.18), avoidance (M =−.10, SD=.21), and arousal (M =−.09, SD=.13) factors. Conclusions: With regards to the best fitting factor model these results concur with previous research findings using different trauma populations but do not reflect the current DSM-IV symptom groupings. The attenuation of dysphoria factor loadings suggests that dysphoria is a non-specific component of PTSD. [Copyright &y& Elsevier]

Abstract: Recent studies into the underlying factor structure of posttraumatic stress symptoms often report factor structures that do not replicate the three symptom cluster of re-experiencing, avoidance and arousal symptoms as classified within the Diagnostic and Statistical Manual of Mental disorders (American Psychiatric Association, 1994, 2000). Data from 485 emergency service personnel who had experienced an occupational trauma were submitted to confirmatory factor analysis to test seven alternative factor models of posttraumatic stress symptoms. This study is one of the most comprehensive structural analyses of posttrauma symptoms to date. The model of best fit comprised four first-order factors including intrusion, avoidance, numbing and arousal alongside a general PTSD factor. This study highlighted the difference between the current DSM symptom groupings and those derived empirically. [Copyright &y& Elsevier]

Symptom network analysis has become an essential tool for researchers and clinicians investigating the structure of mental disorders. Two methods have been used; one relies on partial correlations, and the second relies on zero order correlations with forced-directed algorithm. This combination was used to examine symptom connections for ICD-11 Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) as the symptoms for these disorders have been known to be organized in a multi-dimensional and hierarchical fashion. We aimed to examine whether networks of ICD-11 CPTSD symptoms reproduced across samples from three African countries. We produced network models based on data from 2524 participants in Nigeria (n = 1018), Kenya (n = 1006), and Ghana (n = 500). PTSD and CPTSD symptoms were measured using the International Trauma Questionnaire (Cloitre et al., 2018). The CPTSD network analysis using force-directed method alongside partial correlations based on Gaussian Graphical Models (GGM) revealed the multidimensional-hierarchal structure of CPTSD. The within-cluster symptoms of Disturbances in Self Organization (DSO) and PTSD were strongly correlated with each other in all networks, and the cross-cluster symptoms were lower. The most central symptom was 'feelings of worthlessness', a symptom of Negative Self-Concept that is part of the CPTSD cluster. The networks were very similar across the three countries. Findings support the ICD-11 model of PTSD and CPTSD in three African countries. [ABSTRACT FROM AUTHOR]

A recent study in this journal by Frewen et al. (2023) provided a critical analysis of the most widely used measure of ICD-11 Complex Posttraumatic Stress Disorder (CPTSD), the International Trauma Questionnaire (ITQ). The article was a thoughtful review and gave voice to several widely held concerns about the nature of CPTSD as it is represented in ICD-11 and measured by the ITQ. The primary concern expressed by Frewen et al. was that the symptom profile of ICD-11 CPTSD, as represented in the ITQ, is too simple and fails to provide adequate coverage of the construct. Despite its quality, the article included several misunderstandings about the nature of ICD-11 CPTSD, and the function of the ITQ, that we wish to clarify. Not applicable. Not applicable. In this article, we provide a description of what ICD-11 PTSD and CPTSD are, a review of the process that led to their inclusion in ICD-11 , how the ITQ was developed and refined to measure these constructs. We then provide responses to several of the most important concerns raised by Frewen et al. We highlight the clinical utility of the ICD-11 descriptions of PTSD and CPTSD and discuss how the ITQ can be used as part of a suite of clinical assessments to accurately describe and understand common experiences of psychological distress that often result from exposure to traumatic life events. [ABSTRACT FROM AUTHOR]

Potentially traumatic experiences are a major risk factor for mental disorders in children and adolescents. Posttraumatic psychopathology includes trauma-specific disorders such as posttraumatic stress disorder (PTSD) as well as other psychiatric disorders. Developmental Trauma Disorder (DTD) has been proposed as a developmentally sensitive diagnosis. We aimed to further illuminate the co-occurrence of psychiatric conditions with DTD and PTSD. In a convenience sample of families of 507 children and adolescents (mean age = 12.11 years old, SD = 2.92; 48.5% female), we assessed DTD, PTSD, and screened for psychiatric disorders. We estimated network models including DTD, PTSD and ten psychiatric conditions. We found that DTD and PTSD share both common and differential comorbidity features on disorder-, domain-, and symptom-level. The differential comorbidity patterns of the DTD and PTSD domains placed DTD close to both externalizing and internalizing psychopathology while PTSD was primarily linked to internalizing conditions. Our study provides evidence for the complex clinical presentation of posttraumatic psychopathology over and above PTSD in children. DTD and PTSD provide useful and distinct diagnostic categories for children who are also experiencing internalizing conditions, and DTD may be especially relevant for children who are experiencing externalizing psychopathology. • Posttraumatic psychopathology features complex clinical presentations beyond PTSD. • DTD has been proposed as a developmentally sensitive diagnosis for children. • DTD and PTSD share common and differential comorbidity presentations. • DTD and PTSD provide useful and distinct diagnostic categories. [ABSTRACT FROM AUTHOR]

Abstract: DSM-IV''s three-factor model of posttraumatic stress disorder (PTSD) is rarely empirically supported, whereas other four-factor models () have proven to be better representations of PTSD''s latent structure. To date, a clear consensus as to which model provides the best representation of PTSD''s underlying dimensions has yet to be reached. The current study investigated whether gender is associated with factor structure differences using the model of reexperiencing, avoidance, numbing, and hyperarousal PTSD symptoms. Participants were war-exposed Bosnian secondary/high school boys and girls (N =1572) assessed nearly two years after the 1992–1995 Bosnian conflict. Confirmatory factor analytic tests of measurement invariance across PTSD model parameters revealed many significant sex-linked differences. Implications regarding the potential role of gender as a moderator of the model''s factor structure are discussed. [Copyright &y& Elsevier]

Abstract: Posttraumatic stress disorder''s (PTSD) tripartite factor structure proposed by the DSM-IV is rarely empirically supported. Other four-factor models () have proven to better account for PTSD''s latent structure; however, results regarding model superiority are conflicting. The current study assessed whether endorsement of PTSD''s Criterion A2 would impact on the factorial invariance of the model. Participants were 1572 war-exposed Bosnian secondary students who were assessed two years following the 1992–1995 Bosnian conflict. The sample was grouped by those endorsing both parts of the DSM-IV Criterion A (A2 Group) and those endorsing only A1 (Non-A2 Group). The factorial invariance of the model was not supported between the A2 vs. Non-A2 Groups; rather, the groups significantly differed on all model parameters. The impact of removing A2 on the factor structure of PTSD model is discussed in light of the proposed removal of Criterion A2 for the DSM-V. [Copyright &y& Elsevier]

The ICD-11 reconceptualized Posttraumatic Stress Disorder (PTSD) as a narrowly defined fear-based disorder, and introduced Complex PTSD (CPTSD) as a new diagnosis comprised of PTSD symptoms and symptoms of 'Disturbances in Self-Organization' (DSO) that are more reflective of general dysphoria. Previous research suggests that PTSD symptoms mediate the association between childhood trauma and physical health problems, including cardiovascular disease. No study has yet assessed how posttraumatic stress symptoms, as outlined in the ICD-11, influence the association between childhood trauma and somatic problems in adulthood.Objective: This cross-sectional descriptive study examined whether PTSD and DSO symptoms mediated the associations between childhood physical and sexual abuse and childhood emotional abuse and neglect and somatic problems and cardiovascular diseases (CVD) load in adulthood.Methods: General adult population samples from Ireland (N = 1020) and the United Kingdom (N = 1051) completed self-report questionnaires online.Results: Structural equation modelling results indicated that PTSD and DSO symptoms fully mediated the association between both forms of childhood trauma and somatic problems, and that PTSD symptoms but not DSO symptoms fully mediated the association between childhood trauma and CVD load.Conclusion: Psychological interventions that effectively treat CPTSD symptoms may have the added benefit of reducing risk of physical health problems. [ABSTRACT FROM AUTHOR]