Experiences of Veterans with ICD-11 Complex PTSD in Engaging with Services

Williamson, Victoria; Pearson, Emily; Shevlin, Mark; Karatzias, Thanos; MacManus, Deirdre; Murphy, Declan

doi:10.1080/15325024.2020.1749784

Cited by 7 publications

(4 citation statements)

References 18 publications

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“…Trauma-focused interventions have shown efficacy in reducing CPTSD distress and symptomology (Hébert & Amédée, 2020 ; Voorendonk, De Jongh, Rozendaal, & Van Minnen, 2020 ), including several specialised variants of cognitive behavioural therapy (CBT) (Eilers et al, 2021 ; Karatzias et al, 2019 ), a personalised approach utilising multiple practices to suit the individual is recommended (Cloitre, 2021 ). In veteran treatment-seeking populations, several phase-based interventions have shown positive results (Landes, Garovoy, & Burkman, 2013 ), though it has been noted that CPTSD symptomology may act as an additional barrier to help-seeking (Williamson et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Exploring complex-PTSD comorbidity in trauma-exposed Northern Ireland veterans

Spikol

Robinson

McGlinchey

et al. 2022

European Journal of Psychotraumatology

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Background Complex posttraumatic stress disorder (CPTSD) describes the results of complex, prolonged, and/or inescapable trauma, and is typified by avoidance, re-experiencing, sense of threat, affect dysregulation, negative self-concept, and interpersonal disturbances. Additionally, CPTSD is highly comorbid with other common psychopathologies. Objectives A study was conducted in a trauma-exposed UK Armed Forces Veteran population resident in Northern Ireland ( N = 638, NI) to determine the prevalence of CPTSD and comorbid associations. Methods Data from the Northern Ireland Veterans Health and Wellbeing Study (NIVHWS), including self-report data describing traumatic stress, depression, anxiety, and suicidality, were used in a latent class analysis to identify distinct profiles of symptomology in the sample, and in a multinomial logistic regression to identify comorbidities associated with class membership. Results Three distinct classes emerged: a low endorsement ‘baseline’ class (36%), a ‘Moderate Symptomatic’ class (27%), and a high endorsement ‘Probable CPTSD’ class (37%). Both the Moderate Symptomatic and CPTSD classes were predicted by cumulative trauma exposure. Depression was highly comorbid ( OR = .06 in CPTSD), as was anxiety ( OR = .05 in CPTSD) and suicidal ideation ( OR = .32 in CPTSD), with suicidal attempt associated with the CPTSD class ( OR = .51). Conclusions Cases of probable CPTSD were more prevalent than cases of probable posttraumatic stress disorder (PTSD) without Difficulties in Self-Organisation (DSO) symptoms in a UK Armed Forces veteran sample, were associated with repeated/cumulative trauma, and were highly comorbid across a range of psychopathologies. Findings validate previous literature on CPTSD and indicate considerable distress and thus need for support in UK Armed Forces veterans resident in NI.

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Section: Introductionmentioning

confidence: 99%

Exploring complex-PTSD comorbidity in trauma-exposed Northern Ireland veterans

Spikol

Robinson

McGlinchey

et al. 2022

European Journal of Psychotraumatology

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“…Research has found that clinicians' gender or ethnicity could also act as potential trauma triggers (Williamson et al. 2021), which could detrimentally impact the trust, detachment and disclosure of information. Previous papers have highlighted the importance of creating a calm and safe environment during the assessment process (Maercker et al.…”

Section: Discussionmentioning

confidence: 99%

“…Given histories of betrayal or not being believed by others, trauma survivors may be hesitant to disclose information during an assessment (Brewin 2020), may display detachment or have difficulties trusting professionals, as found in the current review. Research has found that clinicians' gender or ethnicity could also act as potential trauma triggers (Williamson et al 2021), which could detrimentally impact the trust, detachment and disclosure of information. Previous papers have highlighted the importance of creating a calm and safe environment during the assessment process (Maercker et al 2022) and taking a compassionate approach (Lee 2022) to improve trust and rapport.…”

Section: Clinical Considerationsmentioning

confidence: 99%

A Systematic Review of the Assessment of ICD‐11 Complex Post‐Traumatic Stress Disorder (CPTSD) in Young People and Adults

Sarr,

Quinton,

Spain

et al. 2024

Clin Psychology and Psychoth

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Complex post‐traumatic stress disorder (CPTSD) was introduced in the International Classification of Diseases (ICD) 11 in 2013 to simplify diagnosis and increase clinical utility. Given the recent ICD‐11 conceptualisation, there is no standard approach for its assessment, and a review of research is necessary. This systematic review focuses on ICD‐11 CPTSD assessment in young people aged 7 to 17 and adults aged 18 and above, examining measures, differentiating features and clinical considerations. Data from five databases are reviewed using a narrative synthesis approach and the quality of evidence is assessed and discussed. A total of 36 studies involving 5901 participants recruited from clinical settings and 1458 professionals with CPTSD assessment experience were included. Studies predominantly focused on adults, and the most used measure for assessment was the International Trauma Questionnaire. Papers focusing on differentiating features highlighted increased symptom severity, impairment and difficulties in individuals with CPTSD, compared to those with PTSD across various characteristics in both young people and adults. This review also identified the importance of a sensitive clinical approach with adaptations based on culture and age. Although gold‐standard recommendations cannot be made, this paper offers tentative clinical practice recommendations and considerations regarding ICD‐11 CPTSD assessment.

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“…Zerr (2020) commented that veterans commonly put the onus on System operatives to understand the veteran perspective, which is difficult when those within The System have no or little veteran experience or knowledge. Misunderstandings between veterans and healthcare professionals is one of the most regularly reported HS barriers across veteran health-related literature (Williamson et al, 2020). Yet, some System-level experiences did act as HS enablers.…”

Section: Discussionmentioning

confidence: 99%

A Qualitative Systematic Review of Enablers and Barriers to HelpSeeking for Veterans that have Completely Left the Military Within the Context of Mental Health and Alcohol

Hitch

Toner²,

Armour³

2023

Journal of Veterans Studies

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The variation in the definition of a veteran, and the preference for quantitative methods, has created mixed findings regarding the process of veteran help-seeking (HS) for mental health/alcohol issues. To understand HS enablers/barriers for those having ceased military employment, a systematic review of qualitative HS literature is warranted. Six databases were searched. Data were analysed thematically. From 1,154 titles/abstracts screened, six studies elicited four themes: military culture, problem severity, the system, and relationships/support. Enablers/barriers were individual and group specific. Alcohol was often an initial HS barrier whereas mental health symptomology and peer/community support were enablers. Themes collectively suggest HS is a progressive journey. Many studies had reporting issues so fully assessing study quality was challenging. Limited qualitative studies exist concerning those having ceased service altogether. A qualitative approach is advantageous as underlying processes can be explored. Interventions could improve the HS process/journey, at individual and group/community levels.

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Experiences of Veterans with ICD-11 Complex PTSD in Engaging with Services

Cited by 7 publications

References 18 publications

Exploring complex-PTSD comorbidity in trauma-exposed Northern Ireland veterans

Exploring complex-PTSD comorbidity in trauma-exposed Northern Ireland veterans

A Systematic Review of the Assessment of ICD‐11 Complex Post‐Traumatic Stress Disorder (CPTSD) in Young People and Adults

A Qualitative Systematic Review of Enablers and Barriers to HelpSeeking for Veterans that have Completely Left the Military Within the Context of Mental Health and Alcohol

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