The structure of ICD-11 PTSD and Complex PTSD in adolescents exposed to potentially traumatic experiences

Kazlauskas, Evaldas; Želvienė, Paulina; Daniunaite, Ieva; Hyland, Philip; Kvedaraitė, Monika; Shevlin, Mark; Cloitre, Marylène

doi:10.1016/j.jad.2020.01.061

Cited by 63 publications

(107 citation statements)

References 19 publications

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“…Our findings contrast with research showing that differences between PTSD and CPTSD are related to symptom severity only, with CPTSD representing a more severe form of PTSD (Wolf et al, 2015). These findings are also consistent with those of several previous studies (Barbieri et al, 2019;Hyland et al, 2018;Karatzias et al, 2017;Kazlauskas et al, 2020;Murphy et al, 2016).…”

Section: Discussionsupporting

confidence: 93%

“…Another study, by Cloitre et al (2014), also reported similar results. Our findings dovetail with those of Kazlauskas et al (2020) because of some similarities in our recruited sample. Although we did not recruit adolescents, our sample consisted of young adults (Mdn = 20 years) who would have been facing significant life changes and instability.…”

Section: Discussionsupporting

confidence: 84%

“…Most previous studies have not found evidence of this class (Barbieri et al, 2019;Hyland et al, 2018;Jowett et al, 2019;Karatzias et al, 2017;Kazlauskas et al, 2018;Murphy et al, 2016). However, Kazlauskas et al (2020) also reported a DSO class in their study examining the validity of PTSD and CPTSD in adolescents, albeit with an adapted version of the ITQ best suited to their sample. They noted that the DSO class may represent individuals who are experiencing symptoms that overlap with those from other psychiatric disorders (e.g.…”

Section: Discussionmentioning

confidence: 88%

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Evidence of distinct profiles of ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD in a South African sample

Rink

Lipinska

2020

European Journal of Psychotraumatology

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Background: Both post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD) have been included in the 11th edition of the International Classification of Diseases (ICD-11). Although the validity of CPTSD has been controversial, a growing number of studies support the distinction between PTSD and CPTSD. However, the majority of this research has originated in high-income countries (HICs), whereas the prevalence of trauma experience associated with PTSD/CPTSD diagnosis is significantly higher in low- and middle-income countries (LMICs). Objective: This study assessed whether a sample from an LMIC setting produced distinct classes that reflect ICD-11 criteria for PTSD and CPTSD. Furthermore, this study investigated whether childhood trauma distinguished between PTSD and CPTSD. Method: International Trauma Questionnaire responses from a sample of South African university undergraduates were used as indicator variables in a latent class analysis (LCA). Chi-squared tests of independence and Kruskal–Wallis H tests were used to assess between-class differences. Results: The LCA identified four distinct classes: a PTSD class with elevated symptoms of PTSD, but low endorsement of disturbances in self-organization (DSO; symptoms that are specific to CPTSD); a CPTSD class with elevated symptoms of PTSD and DSO; a DSO class with low symptoms of PTSD, but elevated symptoms of DSO; and a Low class with low endorsements on all symptoms. Regarding childhood trauma, participants in the CPTSD class had more severe childhood abuse and neglect, specifically emotional abuse and neglect, than participants in the PTSD class. Conclusions: Findings were consistent with the distinction between PTSD and CPTSD symptom profiles in the ICD-11. Our findings support a similar qualitative distinction between PTSD and CPTSD in our LMIC context, as previously reported in HICs. This distinction is especially relevant in LMICs because of the significant number of individuals vulnerable to these disorders.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 88%

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Evidence of distinct profiles of ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD in a South African sample

Rink

Lipinska

2020

European Journal of Psychotraumatology

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“…It has been hypothesized that symptom structure in children and adolescents (hereafter referred to as ‘children’, unless otherwise specified) may be different from that in adults owing to developmental changes taking place during this life stage (Kazlauskas et al, 2020 ) and that diagnostic criteria of ICD-11 CPTSD for children may hence be specified in the future (Brewin et al, 2017 ). Two studies have investigated this issue to date using precise descriptions of ICD-11 symptom content, reporting diverging results.…”

Section: Introductionmentioning

confidence: 99%

“…Two studies have investigated this issue to date using precise descriptions of ICD-11 symptom content, reporting diverging results. One study, conducted in a sample of foster children, identified the two-factor higher-order model as best fitting (Haselgruber, Sölva, & Lueger-Schuster, 2020b ), while another study conducted in the general population identified the correlated six-factor model as best fitting (Kazlauskas et al, 2020 ), evidencing the need for further research.…”

Section: Introductionmentioning

confidence: 99%

Symptom structure of ICD-11 Complex Posttraumatic Stress Disorder (CPTSD) in trauma-exposed foster children: examining the International Trauma Questionnaire – Child and Adolescent Version (ITQ-CA)

Haselgruber

Sölva

Lueger‐Schuster

2020

European Journal of Psychotraumatology

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Background: The 11th edition of the International Classification of Diseases (ICD-11) introduces Posttraumatic Stress Disorder (PTSD) and Complex Posttraumatic Stress Disorder (CPTSD) as two distinct trauma-related disorders. Numerous studies support the proposed symptom structure of ICD-11 CPTSD in adults, but only a few studies have examined CPTSD symptom structure in children, reporting diverging results. To assess ICD-11 CPTSD in children, the International Trauma Questionnaire (ITQ) was recently adapted for children and adolescents (ITQ-CA), with no validated German version available yet. Objective: This study aimed (1) to test the symptom structure of ICD-11 CPTSD in a sample of trauma-exposed foster children using the ITQ-CA, and (2) to examine the concurrent, convergent and discriminant validity of the German ITQ-CA. Method: Altogether, 161 Austrian foster children completed a set of standardized measures, resulting in a final sample of 135 trauma-exposed foster children meeting the inclusion criteria. Psychometric properties of the ITQ-CA were assessed using confirmatory factor analysis (CFA), bivariate correlations and multivariate regression. Results: CFA supported ICD-11 CPTSD symptom structure in children as a two-factor higherorder model with PTSD and Disturbances in Self-Organization (DSO) as correlated factors with very good model fit, while a one-factor higher-order model also fitted the data very well. High factor loadings and excellent levels of internal reliability evidenced the psychometric adequacy of the ITQ-CA. Concurrent and convergent validity were evidenced by high correlations between ITQ-CA scales and criterion variables (PTSD symptoms, depression, anxiety, dissociation, lifetime traumatization). Discriminant validity was partly supported by PTSD and DSO being differently predicted by exogenous criterion variables. Conclusions: CPTSD symptom structure in children is in support of the ICD-11 conceptualization. The reliability and validity of the German ITQ-CA are evidenced for the first time, identifying it as an easy-to-use screening instrument to assess ICD-11 PTSD and CPTSD in children. Further implications and areas for upcoming studies are discussed. Estructura de los síntomas del TEPT complejo de la CIE-11 en niños de crianza temporal expuestos a traumas: Revisión del Cuestionario Internacional sobre Traumatismos-Versión para niños y adolescentes (ITQ-CA)-Antecedentes: La CIE-11 recientemente publicada presenta el trastorno de estrés postraumático (TEPT) y el trastorno de estrés postraumático complejo (TEPT-C) como dos trastornos distintos relacionados con trauma. Numerosos estudios apoyaron la estructura de síntomas propuesta de TEPT-C en adultos de la CIE-11, pero solo unos pocos estudios examinaron la estructura de síntomas de TEPT-C en niños, reportando resultados divergentes. Para evaluar TEPT-C en niños según la CIE-11, el Cuestionario Internacional de Trauma (ITQ) fue adaptado recientemente para niños y adolescentes (ITQ-CA), sin una versión alemana validada disponible tod...

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Compassion and complex interpersonal trauma in adolescence: An early systematic review

Amari

Mahoney

2021

Clin Psychology and Psychoth

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Background Whilst childhood trauma has been identified as a transdiagnostic risk factor for poly‐psychopathology, compassion‐focused interventions have emerged as transdiagnostic treatment modality. However, no previous systematic review has specifically explored the relationship between complex interpersonal trauma and compassion in adolescence. The aim of this early systematic review was to evaluate the existing evidence on the role of compassion in adolescents with complex interpersonal trauma. Methods A systematic search of electronic databases was undertaken to identify cross‐sectional and intervention studies that examined the role of compassion in the amelioration of psychopathology in adolescence. Results Nine studies, including three intervention studies and six cross‐sectional studies, met the inclusion criteria. The findings suggested a mediating role of compassion in trauma‐specific and overall psychopathology. Conclusion Despite the dearth of research, this review suggests that integrating compassion might mediate the relationship between complex trauma and psychopathology in adolescents.

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The structure of ICD-11 PTSD and Complex PTSD in adolescents exposed to potentially traumatic experiences

Cited by 63 publications

References 19 publications

Evidence of distinct profiles of ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD in a South African sample

Evidence of distinct profiles of ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD in a South African sample

Symptom structure of ICD-11 Complex Posttraumatic Stress Disorder (CPTSD) in trauma-exposed foster children: examining the International Trauma Questionnaire – Child and Adolescent Version (ITQ-CA)

Compassion and complex interpersonal trauma in adolescence: An early systematic review

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