ICD-11 complex PTSD among Israeli male perpetrators of intimate partner violence: Construct validity and risk factors

Abstract

The International Classification of Diseases 11th Version (ICD-11) will include Complex Posttraumatic Stress Disorder (CPTSD) as a unique diagnostic entity comprising core PTSD and DSO (disturbances in self-organization) symptoms. The current study had three aims: (1) assessing the validity of CPTSD in a unique population of male perpetrators of intimate partner violence; (2) examining whether exposure to different types of traumatic events would be associated with the two proposed CPTSD factors, namely PTSD or DSO; and (3) assessing the differential association of various sociodemographic and symptom characteristics with each factor. Participants were 234 males drawn randomly from a sample of 2600 men receiving treatment at 66 domestic violence centers in Israel. Data were collected using the International Trauma Questionnaire (ITQ) - Hebrew version. Confirmatory factor analysis supported the factorial validity of ICD-11 CPTSD. Cumulative lifetime trauma and physical childhood neglect were associated with PTSD and DSO, while cumulative childhood violence exposure was associated only with DSO. Anxiety was associated only with DSO; depression more strongly with DSO than PTSD. Religious level contributed only to PTSD; compulsory military service only to DSO. The study supports the distinction between PTSD and DSO in the CPTSD construct and introduces the role of cultural variables.

Distinguishing Complex PTSD from Borderline Personality Disorder among individuals with a history of sexual trauma: A latent class analysis

“…Cumulative childhood trauma and physical neglect predicted membership to the CPTSD class as compared to the low symptom class. This finding is consistent with research suggesting that interpersonal victimisation represents a key risk factor for the development of CPTSD (Ben-Ezra et al, 2018;Cloitre et al, 2013;Gilbar et al, 2018;Hyland et al, 2017;Karatzias et al, 2016;Shevlin et al, 2017) and literature illustrating that neglect plays a unique role in the development of psychopathology (e.g. Teicher & Samon, 2016).…”

“…ICD-11 CPTSD has been found to manifest following sustained interpersonal trauma exposure and cumulative trauma exposure in a dose-response manner, with trauma occurring during developmental periods creating a particular vulnerability (Ben-Ezra et al, 2018;Cloitre, Garvert, Brewin, Bryant, & Maercker, 2013;Gilbar, Hyland, Cloitre, & Dekel, 2018;Hyland et al, 2017;Karatzias et al, 2016;Maercker, Hecker, Augsburger, & Kliem, 2018;Shevlin et al, 2017). Literature concerning the prevalence of sexual violence consistently indicates that victimisation is likely to begin during early development (Basile & Smith, 2011).…”

Complex PTSD among treatment-seeking veterans with PTSD

“…Previous research indicated that depression was more strongly related to the DSO symptoms and CPTSD (Gilbar et al, 2018;Hyland, Shevlin, Fyvie, & Karatzias, 2018b;Nemčić-Moro et al, 2011) while anxiety disorders were more strongly related to PTSD (Hyland et al, 2016). Other studies revealed an essentially equivalent association of anxiety to the PTSD and DSO clusters of symptoms (Gilbar et al, 2018;Karatzias et al, 2016). These confounding results emphasize the need for further work in exploring the relationship between PTSD and CPTSD, as well as other psychiatric disorders particularly depression and anxiety.…”

“…The prevalence of the current comorbid disorders was similar in the PTSD and the CPTSD group, with the exception of GAD, which was significantly more likely to be present in the CPTSD group. Previous research indicated that depression was more strongly related to the DSO symptoms and CPTSD (Gilbar et al, 2018;Hyland, Shevlin, Fyvie, & Karatzias, 2018b;Nemčić-Moro et al, 2011) while anxiety disorders were more strongly related to PTSD (Hyland et al, 2016). Other studies revealed an essentially equivalent association of anxiety to the PTSD and DSO clusters of symptoms (Gilbar et al, 2018;Karatzias et al, 2016).…”

“…Although the differential diagnosis between the two disorders is determined by the symptom profile, the types of events associated with higher risk for ICD-11 CPTSD are expected to be sustained, repeated, or multiple forms of traumatic exposure (Cloitre et al, 2013;Ford & Courtois, 2014;Gilbar, Hyland, Cloitre, & Dekel, 2018;Herman, 1992a;Van der Kolk, 1987). Typically, CPTSD is associated with prolonged interpersonal trauma particularly with multiple forms of childhood interpersonal trauma (Cloitre et al, 2013(Cloitre et al, , 2014Frewen, Zhu, & Lanius, 2019;Karatzias et al, 2019Karatzias et al, , 2017Knefel, Garvert, Cloitre, & Lueger-Schuster, 2015;Van der Kolk, Ford, & Spinazzola, 2019).…”