PTSD in ICD-10 and proposed ICD-11 in elderly with childhood trauma: prevalence, factor structure, and symptom profiles

Abstract

BackgroundThe proposal for ICD-11 postulates major changes for posttraumatic stress disorder (PTSD) diagnosis, which needs investigation in different samples.AimsTo investigate differences of PTSD prevalence and diagnostic agreement between ICD-10 and ICD-11, factor structure of proposed ICD-11 PTSD, and diagnostic value of PTSD symptom severity classes.MethodConfirmatory factor analysis and latent profile analysis were used on data of elderly survivors of childhood trauma (>60 years, N=399).ResultsPTSD rates differed significantly between ICD-10 (15.0%) and ICD-11 (10.3%, z=2.02, p=0.04). Unlike previous research, a one-factor solution of ICD-11 PTSD had the best fit in this sample. High symptom profiles were associated with PTSD in ICD-11.ConclusionsICD-11 concentrates on PTSD's core symptoms and furthers clinical utility. Questions remain regarding the tendency of ICD-11 to diagnose mainly cases with severe symptoms and the influence of trauma type and participant age on the factor structure.

PTSD and Complex PTSD: ICD-11 updates on concept and measurement in the UK, USA, Germany and Lithuania

“…The proposed three-factor structure of ICD-11 PTSD (Re, Av, Th) has been supported in a number of studies (e.g. Gluck, Knefel, Tran, & Lueger-Schuster, 2016; Hansen, Hyland, Armour, Shevlin, & Elklit, 2015; Tay et al, 2016). In addition, the second-order factorial structure of CPTSD in which the disorder is comprised of both PTSD and DSO has also been supported (e.g.…”

PTSD symptomics: network analyses in the field of psychotraumatology

“…Glück, Knefel, and Lueger-Schuster (2017) in their paper ‘A network analysis of anger, shame, proposed ICD-11 PTSD, and different types of childhood trauma in foster care settings in a sample of adult survivors’ utilized network analysis to examine the relationships between childhood abuse, anger, shame, and the proposed ICD-11 PTSD symptoms in a sample of 220 adult survivors of institutional abuse. Many participants met criteria for comorbid mental disorders, over half of the sample met ICD-11 PTSD criteria, and 16.9% met the criteria for complex PTSD.…”

“…One reason for this is that disorder-level data are often highly heterogeneous: patients suffering from mental disorders such as PTSD or depression have many different symptom presentations (Fried & Nesse, 2015a; Glück, Knefel, Tran, & Lueger-Schuster, 2016; Olbert, Gala, & Tupler, 2014; Young, Lareau, & Pierre, 2014). Heterogeneity has also led to ongoing discussions about reliability and validity of DSM and ICD diagnoses (Insel, 2013).…”

Differentiating PTSD from anxiety and depression: Lessons from the ICD‐11 PTSD diagnostic criteria

“…Previous research has also demonstrated that the ICD-11 PTSD criteria identify only a subset of the individuals previously identified as having PTSD by the ICD-10 criteria (Barbano et al, 2018;Gluck et al, 2016;Haravuori, Kiviruusu, Suomalainen, & Marttunen, 2016;Tay et al, 2017), allowing comparisons between participants identified by the ICD-11, the ICD-10, and the ICD-10 only. Previous research has also demonstrated that the ICD-11 PTSD criteria identify only a subset of the individuals previously identified as having PTSD by the ICD-10 criteria (Barbano et al, 2018;Gluck et al, 2016;Haravuori, Kiviruusu, Suomalainen, & Marttunen, 2016;Tay et al, 2017), allowing comparisons between participants identified by the ICD-11, the ICD-10, and the ICD-10 only.…”

“…Finally, because previous research suggests that the ICD-11 criteria identify individuals with more severe PTSD symptoms (Barbano et al, 2018;Gluck et al, 2016;Haravuori et al, 2016), we also examined the contribution of PTSD symptom severity to comorbid disorders' prevalence and depression severity. The sample included emergency department (ED) patients assessed shortly after trauma exposure with follow-up assessments at 3-8 months after exposure.…”