[Internalization and externalization as features of a shared clinical dimension in traumatized patients]

In patients with complex posttraumatic stress disorder (complex PTSD; Herman, 1992) as well as in those with borderline personality disorder (BPD) traumata are often found anamnestically. Besides high comorbidity were found between both disorders. Thus it was examined whether internalizing and externalizing subtypes can be distinguished in chronic traumatized patients (N = 266) accounting for personality accentuations. Item parameters of a 2-class solution of the dichotomous Mixed Rasch Model were consistent with hypothesized patterns. χ²-tests indicated that patients subsumed to the internalizing group showed twice as much the diagnosis of complex PTSD. However an information criterion favored a one-class solution. Given that the analysis did not reveal 2 subtypes, a one-dimensional approach is suggested, that helps to describe internalizing and externalizing symptoms in chronic traumatized patients.