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Fung HW, Lee K, Wang EKS, Wong JYH. Trauma-related mental health problems among mothers in Taiwan and their relationship with children's emotional and behavioral problems. Eur J Psychotraumatol 2024; 15:2382554. [PMID: 39082192 PMCID: PMC11293261 DOI: 10.1080/20008066.2024.2382554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/18/2024] [Accepted: 07/10/2024] [Indexed: 08/03/2024] Open
Abstract
ABSTRACTBackground: Trauma can give rise to mental health problems and emotional and interpersonal difficulties, which in turn can perpetuate the cycle of trauma and adversity for future generations. However, little is known about the prevalence and potential effects of trauma and trauma-related mental health problems among parents.Objective: The primary goal of this study was to examine childhood and adulthood trauma and trauma-related symptoms among mothers of children aged between 6 and 18. We also conducted exploratory analyses of their potential relationship with children's emotional and behavioural problems.Method: A total of 817 mothers living with a child aged between 6 and 18 in Taiwan completed standardized self-report assessments of trauma exposure, trauma-related symptoms, and children's emotional and behavioural problems. A subsample (n = 256) also provided follow-up data after six months.Results: Most surveyed mothers reported at least one childhood traumatic event (74.79%) and one adulthood traumatic event (78.70%); 4.4% met the ICD-11 criteria for PTSD, and 12.1% for complex PTSD; 11.4% reported clinically significant dissociative symptoms. Mothers' complex PTSD and dissociative symptoms were cross-sectionally correlated with children's emotional and behavioural problem (rs = .186 to .239, p < .001). After controlling for possible confounding variables and baseline scores, mothers' childhood non-betrayal trauma reported at baseline was found to be a predictor of children's emotional and behavioural problems reported at follow up.Conclusion: This study is the first to provide data regarding childhood and adulthood trauma and trauma-related disorders, including ICD-11 complex PTSD, among mothers in the community. It calls for more studies to understand the potential effects of intergenerational trauma.
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Affiliation(s)
- Hong Wang Fung
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Hong Kong
| | - Kunhua Lee
- Department of Educational Psychology and Counseling, National Tsing Hua University, Hsinchu City, Taiwan
| | - Edward K. S. Wang
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Janet Yuen-Ha Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Hong Kong
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2
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Hyland P, Shevlin M, Martsenkovskyi D, Ben-Ezra M, Brewin CR. Testing predictions from the memory and identity theory of ICD-11 complex posttraumatic stress disorder: Measurement development and initial findings. J Anxiety Disord 2024; 105:102898. [PMID: 38991292 DOI: 10.1016/j.janxdis.2024.102898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 05/29/2024] [Accepted: 07/05/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND The 'Memory and Identity Theory' of ICD-11 Complex Posttraumatic Stress Disorder (CPTSD) was recently published but has not yet been subjected to empirical testing. The objective of this study was to evaluate newly developed measures of memory and identity disturbances and test hypothesized structural relations between these constructs and CPTSD symptoms. METHODS Self-report data were collected from a nationwide sample of adults living in Ukraine (N = 2050) in September 2023. Exploratory factor analysis was used to assess the latent structure of the newly developed measures, and structural equation modeling was used to test the associations between memory and identity disturbances and CPTSD symptoms. RESULTS 90 % of participants experienced a lifetime trauma, and 9.2 % screened positive for ICD-11 CPTSD. Results indicated that the newly developed measures of memory and identity problems possessed satisfactory psychometric properties, and all but one of the model-implied structural associations were observed. CONCLUSION This study provides initial empirical support for the Memory and Identity theory of ICD-11 CPTSD, indicating that the basis of this disorder lies in distinct memory and identity processes. Several effects not predicted by the theory were observed, and these can provide the basis for further model testing and refinement.
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Affiliation(s)
- Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland.
| | - Mark Shevlin
- School of Psychology, Ulster University, Derry, Northern Ireland, UK
| | - Dmytro Martsenkovskyi
- Department of Psychiatry and Narcology, Bogomolets National Medical University, Kyiv, Ukraine; SI Institute of Psychiatry, Forensic Psychiatric Examination and Drug Monitoring of Ministry of Health of Ukraine, Kyiv, Ukraine
| | | | - Chris R Brewin
- Division of Psychology and Language Sciences, University College London, London, England, UK
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3
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Bohus M, Vonderlin R. [Dialectical behavioral therapy for complex posttraumatic stress disorder (DBT-PTSD): an evidence-based disorder-specific treatment program]. DER NERVENARZT 2024; 95:630-638. [PMID: 38874612 DOI: 10.1007/s00115-024-01680-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 06/15/2024]
Abstract
Dialectical behavioral therapy for complex posttraumatic stress disorders (DBT-PTSD) is a modular treatment program that was developed at the Central Institute for Mental Health at the University of Heidelberg, Germany in 2005-2021. DBT-PTSD is designed to meet the needs of patients with complex PTSD related to sexual or physical trauma in childhood and adolescence. It is specifically designed for patients suffering from severe emotional dysregulation, persistent self-injury, chronic suicidal ideation, severe dissociative symptoms and a markedly negative self-concept with a high level of guilt, shame, self-loathing and interpersonal problems. To address these different core symptoms, DBT-PTSD combines evidence-based therapeutic strategies: principles, rules, and skills of DBT, trauma-specific cognitive and exposure-based techniques, imaginative interventions and procedures for behavioral change. The treatment program is designed to be carried out in an outpatient (45 weeks) or residential (12 weeks) setting. The results from two randomized controlled trials showed large effect sizes across very different symptom domains and a significant superiority of DBT-PTSD over Cognitive Processing Therapy (CPT). Based on these results, DBT-PTSD is currently a promising evidence-based treatment program for all features of a complex PTSD after sexual abuse in childhood and adolescence.
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Affiliation(s)
- Martin Bohus
- Klinik für Psychosomatik und Psychotherapeutische Medizin, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, J5, 68159, Mannheim, Deutschland.
- McLean Hospital, Harvard Medical School, Boston, MA, USA.
- Forschungs- und Behandlungszentrum für Psychische Gesundheit, Abteilung für Klinische Psychologie und Psychotherapie, Ruhr Universität Bochum, Bochum, Deutschland.
| | - Ruben Vonderlin
- Klinik für Psychosomatik und Psychotherapeutische Medizin, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, J5, 68159, Mannheim, Deutschland
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Ho GWK, Chan KL, Karatzias T, Hyland P, Fung HW, Shevlin M. Prevalence and validity of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD: A population-based survey of Hong Kong adults. Asian J Psychiatr 2024; 96:104045. [PMID: 38643682 DOI: 10.1016/j.ajp.2024.104045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 03/29/2024] [Accepted: 04/06/2024] [Indexed: 04/23/2024]
Abstract
The present study aimed to report the prevalence of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) in the general adult Hong Kong population, and examine the validity of the Chinese International Trauma Questionnaire (ITQ). This descriptive cross-sectional population-based telephone survey included a representative sample of 1070 non-institutionalized permanent Hong Kong residents ages 18-64 years. Participants provided responses to the Chinese version of the ITQ, and measures of adverse childhood experiences (ACEs), depression, anxiety, and stress. Based on the diagnostic algorithm of the ITQ, 5.9% of the sample screened positive for either CPTSD or PTSD, with CPTSD (4.2%) being more common that PTSD (1.7%). Results of the confirmatory factor analysis indicated the first-order correlated 6-factor model to be the best fitting solution. Symptom cluster summed scores were all positively and significantly correlated with all criterion variables. This investigation established the prevalence rates of ICD-11 PTSD and CPTSD using a general adult population sample in Hong Kong. The Chinese ITQ demonstrated sound factorial validity and concurrent validity. Future research can further characterize ICD-11 PTSD and CPTSD in subgroups using the Chinese ITQ.
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Affiliation(s)
- Grace W K Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, SAR China.
| | - Ko Ling Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR China
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, United Kingdom
| | - Philip Hyland
- Department of Psychology, Maynooth University, Ireland
| | - Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Hong Kong, SAR China
| | - Mark Shevlin
- School of Psychology, Ulster University, United Kingdom
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5
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Karsberg S, Elklit A, Pedersen MM, Pedersen MU, Vang ML. A nationally representative survey of ICD-11 PTSD among Danish adolescents and young adults aged 15-29. Scand J Psychol 2024. [PMID: 38812284 DOI: 10.1111/sjop.13032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 04/03/2024] [Accepted: 05/14/2024] [Indexed: 05/31/2024]
Abstract
Posttraumatic stress disorder (PTSD) is recognized as a debilitating psychiatric disorder affecting populations worldwide. This has inspired many countries to estimate the national prevalence rates of PTSD in Europe and beyond. At present, there are no published representative studies that have assessed the occurrence of trauma exposure and PTSD in Denmark using a valid measurement based on ICD-11 criteria. A national sample of the general population of young Danish residents, ranging in age between 15 to 29 years (n = 2,434), was surveyed cross-sectionally from April to October 2022. Data weights were applied to ensure representativity of the sample. Multiple regression was used to study the relationship between trauma exposure, sex, age, and PTSD. Accidents and violence were the most common types of trauma exposure with females being more likely to experience sexual violence. A total of 7.7% endorsed probable PTSD with women reporting higher rates of clinical and subclinical PTSD (12.3% and 12.7%, respectively) than men (3.5% and 7.3%, respectively). Findings from the multiple regression showed that female gender was associated with higher PTSD-severity, although the strongest predictor was trauma-type with other types of traumas, and sexual violence displaying the strongest relationship to PTSD-severity overall. A dose-response relationship between the number of trauma types and PTSD symptomatology was found. This is the first study of PTSD in a nationally representative Danish sample using a valid measure of ICD-11 PTSD. The identified PTSD rates were higher than Danish official estimates in a representative sample of the Danish adolescent and young adult population (7.7% weighted compared to 1%). The study replicated international findings of sex differences in probable PTSD endorsement.
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Affiliation(s)
- Sidsel Karsberg
- Centre for Alcohol and Drug Research, Department of Psychology, Aarhus University, Aarhus, Denmark
| | - Ask Elklit
- National Centre for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | | | - Mads U Pedersen
- Centre for Alcohol and Drug Research, Department of Psychology, Aarhus University, Aarhus, Denmark
| | - Maria L Vang
- National Centre for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
- Department for Occupational and Environmental Health, Odense University Hospital, Odense, Denmark
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Cohen M, Nakash O, Apter-Levy Y. Gender Differences in the Relationship between Lifetime Exposure to Trauma and the Development of Pathological Personality Traits. J Trauma Dissociation 2024; 25:394-407. [PMID: 38376101 DOI: 10.1080/15299732.2024.2320436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 11/20/2023] [Indexed: 02/21/2024]
Abstract
Gender differences in the prevalence, types and outcomes of traumas have consistently been reported in the literature. Other research has documented that exposure to trauma is associated with the development and maintenance of pathological personality traits. In the current study, we examined the moderating role of gender in the association between lifetime exposure to trauma and pathological personality traits. The sample included 148 clients who sought treatment at a community mental health clinic. All participants completed online questionnaires including demographic information, the Trauma History Questionnaire (THQ), and the Personality Inventory for DSM-5-Brief Form (PID-5-BF) at the entry to treatment. Our findings documented a significant association between exposure to trauma and pathological personality traits in men, but not in women. Furthermore, this pattern of results was specifically evident within two personality domains: antagonism and detachment. These findings contribute to the theoretical understanding of the interplay between trauma, gender, and the development of pathological personality traits. They expand upon the growing knowledge about the mental health crisis among boys and men by shedding light on the unique vulnerabilities that men face in response to traumatic experiences and how these experiences can have a lasting impact on their adaptive functioning. Consequently, at the clinical level, the current study emphasizes the importance of paying particular attention to men's trauma histories and explicitly exploring these during the intake session.
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Affiliation(s)
- Michal Cohen
- Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel
- School for Social Work, Smith College, Northampton, Massachusetts, USA
| | - Ora Nakash
- School for Social Work, Smith College, Northampton, Massachusetts, USA
| | - Yael Apter-Levy
- Baruch Ivcher School of Psychology, Reichman University, Herzliya, Israel
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Bressington D, Hyland P, Steele H, Byrne M, Mitchell D, Keane C, Shevlin M, Ho G, Murta JCD, Easpaig BNG, Liu X, Zhai J, Murphy D, Karatzias T. ICD-11 post-traumatic stress disorder and complex post-traumatic stress disorder in mental health support-seeking former-serving Australian defence force veterans. Aust N Z J Psychiatry 2024; 58:416-424. [PMID: 38332613 DOI: 10.1177/00048674241230197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
BACKGROUND ICD-11 complex post-traumatic stress disorder is a more severe condition than post-traumatic stress disorder, and recent studies indicate it is more prevalent among military samples. In this study, we tested the psychometric properties of the International Trauma Questionnaire, assessed the relative prevalence rates of post-traumatic stress disorder and complex post-traumatic stress disorder in the sample population and explored relationships between complex post-traumatic stress disorder and post-traumatic stress disorder and a range of risk factors. METHODS Survey participants (N = 189) were mental health support-seeking former-serving veterans of the Australian Defence Force (ADF) recruited from primary care. Confirmatory factor analysis was used to test the factorial validity of the International Trauma Questionnaire. RESULTS The latent structure of the International Trauma Questionnaire was best represented by a two-factor second-order model consistent with the ICD-11 model of complex post-traumatic stress disorder. The International Trauma Questionnaire scale scores demonstrated excellent internal reliability. Overall, 9.1% (95% confidence interval = [4.8%, 13.5%]) met diagnostic requirements for post-traumatic stress disorder and an additional 51.4% (95% confidence interval = [44.0%, 58.9%]) met requirements for complex post-traumatic stress disorder. Those meeting diagnostic requirements for complex post-traumatic stress disorder were more likely to have served in the military for 15 years or longer, had a history of more traumatic life events and had the highest levels of depression, anxiety and stress symptoms. CONCLUSION The International Trauma Questionnaire can effectively distinguish between post-traumatic stress disorder and complex post-traumatic stress disorder within primary care samples of Australian Defence Force veterans. A significantly greater proportion of Australian Defence Force veterans met criteria for complex post-traumatic stress disorder than post-traumatic stress disorder. Australian military mental health services should adopt the International Trauma Questionnaire to routinely screen for complex post-traumatic stress disorder and develop complex post-traumatic stress disorder specific interventions to promote recovery in Australian Defence Force veterans with complex post-traumatic stress disorder.
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Affiliation(s)
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | | | - Mitchell Byrne
- Faculty of Health, Charles Darwin University, Darwin, NT, Australia
| | - David Mitchell
- Faculty of Health, Charles Darwin University, Darwin, NT, Australia
- Department of Health, Office of the Chief Psychiatrist, Darwin, NT, Australia
| | - Carol Keane
- Faculty of Health, Charles Darwin University, Darwin, NT, Australia
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Grace Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China SAR
| | | | | | - Xianliang Liu
- Faculty of Health, Charles Darwin University, Darwin, NT, Australia
| | - Jianxia Zhai
- STEM College, RMIT University, Melbourne, VIC, Australia
| | - Dominic Murphy
- Department of Research, Combat Stress, Leatherhead, UK
- King's Centre for Military Health Research, King's College London, London, UK
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK
- Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, UK
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8
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Harris J, Loth E, Sethna V. Tracing the paths: a systematic review of mediators of complex trauma and complex post-traumatic stress disorder. Front Psychiatry 2024; 15:1331256. [PMID: 38510809 PMCID: PMC10951104 DOI: 10.3389/fpsyt.2024.1331256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/20/2024] [Indexed: 03/22/2024] Open
Abstract
Complex trauma is associated with complex-posttraumatic stress disorder (CPTSD). While dissociative processes, developmental factors and systemic factors are implicated in the development of CPTSD, there are no existing systematic reviews examining the underlying pathways linking complex trauma and CPTSD. This study aims to systematically review evidence of mediating factors linking complex trauma exposure in childhood (birth to eighteen years of age) and subsequent development of CPTSD (via self-reports and diagnostic assessments). All clinical, at-risk and community-sampled articles on three online databases (PsycINFO, MedLine and Embase) were systematically searched, along with grey literature from ProQuest. Fifteen articles were eligible for inclusion according to pre-determined eligibility criteria and a search strategy. Five categories of mediating processes were identified: 1) dissociative processes; 2) relationship with self; 3) emotional developmental processes; 4) social developmental processes; and 5) systemic and contextual factors. Further research is required to examine the extent to which targeting these mediators may act as mechanisms for change in supporting individuals to heal from complex trauma. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022346152.
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Affiliation(s)
- Joseph Harris
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England, United Kingdom
| | - Eva Loth
- Department of Forensic and Neurodevelopmental Science, School of Academic Psychiatry, King’s College London, London, England, United Kingdom
| | - Vaheshta Sethna
- Department of Social, Genetic & Developmental Psychiatry Centre, School of Mental Health & Psychological Sciences, King’s College London, London, England, United Kingdom
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Iazzolino AM, Valenza M, D’Angelo M, Longobardi G, Stefano VD, Visalli G, Steardo L, Scuderi C, Steardo L. The Impact of Complex PTSD on Suicide Risk in Patients with Bipolar Disorder: A Cross-Sectional Study. J Clin Med 2024; 13:673. [PMID: 38337367 PMCID: PMC10856776 DOI: 10.3390/jcm13030673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Patients with bipolar disorder (BD) are more likely than the general population to experience traumatic events, particularly during childhood, and these may predict and be a risk factor for the development of complex PTSD (cPTSD). The presence of multiple traumas plays a relevant role from a psychopathological point of view, but little is known about the effect this may have on suicide attempts in patients with BD. METHODS A cross-sectional study was conducted comparing socio-demographic and clinical characteristics, recruiting 344 patients diagnosed with BD I and II, screened for the presence (or absence) of cPTSD using the International Trauma Questionnaire (ITQ). Suicide attempts were assessed directly during the clinical interview and from the patient's medical record. RESULTS The results emerging from the study indicate that cPTSD can be considered a risk factor for suicide attempts in patients with BD. Furthermore, evidence is provided to support the idea that cPTSD is highly prevalent in patients with BD and is related to a higher psychopathological burden. CONCLUSIONS The results recommend an urgent and comprehensive assessment of suicidal risk in patients with comorbidity of both bipolar disorder and cPTSD. There is a crucial demand for early intervention initiatives and proactive prevention strategies to address the intricate intersection of these mental health challenges.
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Affiliation(s)
- Anna Maria Iazzolino
- Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (M.D.); (G.L.); (V.D.S.); (G.V.); (L.S.J.)
| | - Marta Valenza
- Department of Physiology and Pharmacology “Vittorio Erspamer”, Sapienza University of Rome, 00185 Rome, Italy; (M.V.); (L.S.); (C.S.)
| | - Martina D’Angelo
- Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (M.D.); (G.L.); (V.D.S.); (G.V.); (L.S.J.)
| | - Grazia Longobardi
- Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (M.D.); (G.L.); (V.D.S.); (G.V.); (L.S.J.)
| | - Valeria Di Stefano
- Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (M.D.); (G.L.); (V.D.S.); (G.V.); (L.S.J.)
| | - Giulia Visalli
- Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (M.D.); (G.L.); (V.D.S.); (G.V.); (L.S.J.)
| | - Luca Steardo
- Department of Physiology and Pharmacology “Vittorio Erspamer”, Sapienza University of Rome, 00185 Rome, Italy; (M.V.); (L.S.); (C.S.)
- University Giustino Fortunato, 82100 Benevento, Italy
| | - Caterina Scuderi
- Department of Physiology and Pharmacology “Vittorio Erspamer”, Sapienza University of Rome, 00185 Rome, Italy; (M.V.); (L.S.); (C.S.)
| | - Luca Steardo
- Psychiatry Unit, Department of Health Sciences, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (M.D.); (G.L.); (V.D.S.); (G.V.); (L.S.J.)
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Rusmir M, Rohner SL, Maercker A, Salas Castillo AN, Thoma MV. Predictors and (in-)stability of ICD-11 complex posttraumatic stress disorder in older adults: findings from a longitudinal study in Switzerland. Eur J Psychotraumatol 2024; 15:2299618. [PMID: 38258813 PMCID: PMC10810634 DOI: 10.1080/20008066.2023.2299618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
Objective: There is a lack of research on complex post-traumatic stress disorder (CPTSD) in older individuals, with little known about the temporal course of CPTSD. Therefore, this study assessed and compared the demographic characteristics, adverse childhood experiences (ACE), and well-being of Swiss older adults with and without probable CPTSD. The (in-)stability of probable CPTSD was also examined in relation to the predictive value of various emotion-related factors.Methods: A longitudinal study was conducted in Switzerland with N = 213 participants (Mage = 69.98 years, SD = 10.61; 45.5% female). Data was collected via face-to-face assessments at baseline and follow-up, 21 months apart. The German version of the International Trauma Questionnaire was used to screen for (C)PTSD. Standardized instruments were used to assess ACE as well as the predictors anger, embitterment, emotion regulation, and meaning in life.Results: From the total sample, n = 16 participants (7.5%) were identified as having probable CPTSD, with only five of these (31.25%) having probable CPTSD at both baseline and follow-up. Individuals with and without probable CPTSD differed significantly regarding age and employment status. Significant predictors of probable CPTSD were anger (β = 0.16), embitterment (β = 0.06), cognitive reappraisal (β = -0.41), and the presence of meaning in life (β = -0.10).Conclusions: Probable CPTSD appears to be relatively unstable over the course of a 21-month period in older individuals. The links between CPTSD and emotion-related predictors highlight potential targets for intervention.
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Affiliation(s)
- Milan Rusmir
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Shauna L. Rohner
- Competence Centre for Mental Health, Department of Health, OST – University of Applied Sciences of Eastern Switzerland, St. Gallen, Switzerland
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland
| | - Andreas Maercker
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland
| | - Aileen N. Salas Castillo
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Myriam V. Thoma
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Zurich, Switzerland
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Posttraumatic stress disorder in Belgian police officers: prevalence and the effects of exposure to traumatic events. Eur J Psychotraumatol 2023; 14:2156558. [PMID: 37052090 PMCID: PMC9869988 DOI: 10.1080/20008066.2022.2156558] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background: Police officers are at considerable risk of developing posttraumatic symptoms because they frequently encounter violent or emotionally disturbing incidents. We investigate experiences with potentially traumatic events (PTE), traumatic exposure, and the prevalence of probable posttraumatic stress disorder (PTSD), complex PTSD and subclinical PTSD in a sample of Belgian police officers.Methods: In total, 1,465 police officers from 15 Belgian Local Police zones participated in a web-based survey, consisting of three segments: evaluating experiences with a list of 29 PTE, assessing if any of these PTE accounted for traumatic exposure, and evaluating 1-month probable PTSD, complex PTSD and subclinical PTSD prevalence using the International Trauma Questionnaire (ITQ).Results: Police officers frequently experience a wide range of PTE. A large majority of 93.0% reports traumatic exposure. Assessment with ITQ shows a 1-month prevalence of 5.87% for probable PTSD and 1.50% for probable complex PTSD, while an additional 7.58% report subclinical PTSD. No demographic variables influenced PTSD prevalence. Cumulative PTE experiences in itself did not predict PTSD, while the characteristics of certain PTE did entail a higher prevalence of probable PTSD and subclinical PTSD.Discussion: This study is the first to evaluate experiences with PTE, traumatic exposure and 1-month prevalence of probable PTSD, complex PTSD, and subclinical PTSD in Belgian police officers. Police officers are frequently confronted with a broad variety of PTE, and a large majority reports traumatic exposure. The 1-month prevalence of probable PTSD is significantly higher compared to previous international research in the general population, but lower than in similar international research involving police officers. In this study, cumulative PTE experiences in itself did not reliably predict PTSD, while the characteristics of certain PTE did. Posttraumatic symptoms are an important mental health challenge in Belgian police.
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Examination of ICD-11 PTSD and CPTSD using the International Trauma Questionnaire – Child and Adolescent version (ITQ-CA) in a sample of Danish children and adolescents exposed to abuse. Eur J Psychotraumatol 2023; 14:2178761. [PMID: 37052084 PMCID: PMC9980161 DOI: 10.1080/20008066.2023.2178761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Background: International research has established that children and adolescents are at risk for posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as defined by the WHO ICD-11. There is a need for a Danish language version of the International Trauma Questionnaire – Child and Adolescent (ITQ-CA) to assess symptoms of PTSD and CPTSD. Objective: To test the ICD-11 formulations of PTSD and DSO (Disturbances of Self-Organization) using the ITQ-CA version in a sample of children exposed to abuse. Additionally, to study the distribution of symptoms and probable prevalence of ICD-11 PTSD and CPTSD among the population of children exposed to violence or sexual abuse. Method: Confirmatory factor analysis of competing models of the dimensionality of the ITQ-CA was tested among a sample of 119 children and adolescents that were referred to the Danish Children Centres on suspicion of physical or sexual abuse or both. Latent class analysis (LCA) was used to study the distribution of symptoms and consequences of different operationalisations of functional impairment were explored. Results: Findings supported a two-factor second-order model corresponding to the operationalisation of CPTSD in ICD-11 as the best representation of the data. Findings from the LCA suggested that symptoms were distributed in a pattern consistent with the ICD-11 proposal for CPTSD. CPTSD was more prevalent than PTSD regardless of the operationalisation of functional impairment. Conclusion: ITQ-CA is a valid tool for identifying symptoms of ICD-11 PTSD and CPTSD among Danish children exposed to physical or sexual abuse. Further research is needed to study the relationship between ICD-11 C/PTSD symptomatology and anxiety and depression in this population. The International Trauma Questionnaire – Child and Adolescent version (ITQ-CA) is a valid measure of symptoms of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD among Danish children exposed to physical or sexual violence. The structure of the ITQ-CA in the Danish sample reflects the ICD-11 diagnostic algorithm. CPTSD is a more prevalent disorder among children recently exposed to violence than PTSD.
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Leiva-Bianchi M, Nvo-Fernandez M, Villacura-Herrera C, Miño-Reyes V, Parra Varela N. What are the predictive variables that increase the risk of developing a complex trauma? A meta-analysis. J Affect Disord 2023; 343:153-165. [PMID: 37802323 DOI: 10.1016/j.jad.2023.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 09/08/2023] [Accepted: 10/02/2023] [Indexed: 10/08/2023]
Abstract
In 2018, Complex Post Traumatic Stress Disorder (CPTSD) was officially recognized as a distinct syndrome in the International Classification of Diseases, 11th Revision (ICD-11). This recognition aimed to differentiate between neurotic disorders secondary to stressful situations and somatoform disorders, and disorders specifically associated with stress. The inclusion of CPTSD in the ICD-11 marked the culmination of two decades of research focused on understanding its symptoms, treatments, and risk factors. However, despite the progress made, a comprehensive meta-analysis to elucidate the specific risk factors and impact on the development of CPTSD is still lacking. The objective of this article is to conduct such a meta-analysis. A total of 24 studies were selected for analysis, and the findings revealed several key risk factors associated with the development of CPTSD. The main risk factor identified is having experienced sexual abuse in childhood (k = 12; OR = 2.880). In addition, childhood physical abuse (k = 11; OR = 2.841), experiencing emotional neglect during childhood (k = 5; OR = 2.510), physical abuse throughout life (k = 8; OR = 2.149) and being a woman (k = 13; OR = 1.726) were also significant risk factors.
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Affiliation(s)
- Marcelo Leiva-Bianchi
- Laboratory of Methodology, Behavioural Sciences and Neuroscience, Faculty of Psychology, Universidad de Talca, Chile
| | - Marcelo Nvo-Fernandez
- Laboratory of Methodology, Behavioural Sciences and Neuroscience, Faculty of Psychology, Universidad de Talca, Chile.
| | - César Villacura-Herrera
- Laboratory of Methodology, Behavioural Sciences and Neuroscience, Faculty of Psychology, Universidad de Talca, Chile; Centro de Investigación en Ciencias Cognitivas, Faculty of Psychology, Universidad de Talca, Chile
| | - Valentina Miño-Reyes
- Centro de Investigación en Ciencias Cognitivas, Faculty of Psychology, Universidad de Talca, Chile
| | - Nicol Parra Varela
- Laboratory of Methodology, Behavioural Sciences and Neuroscience, Faculty of Psychology, Universidad de Talca, Chile
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Fresno A, Ramos Alvarado N, Núñez D, Ulloa JL, Arriagada J, Cloitre M, Bisson JI, Roberts NP, Shevlin M, Karatzias T. Initial validation of the International Trauma Questionnaire (ITQ) in a sample of Chilean adults. Eur J Psychotraumatol 2023; 14:2263313. [PMID: 37815059 PMCID: PMC10566396 DOI: 10.1080/20008066.2023.2263313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 08/10/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND ICD-11 Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) are stress-related disorders. The International Trauma Questionnaire (ITQ) is a widely used instrument to assess PTSD and CPTSD. To date, there is no evidence of the psychometric characteristics of the ITQ in Latin American countries. OBJECTIVE The aim of this study was to assess the construct and concurrent validity of the Latin American Spanish adaptation of the ITQ in a sample of Chilean adults. METHODS A sample of 275 Chilean young adults completed the ITQ, a traumatic life events checklist, the Adverse Childhood Experiences Questionnaire, the Depression Anxiety Stress Scales-21, and the Columbia-Suicide Severity Rating Scale short version. Four alternative confirmatory factor analysis models were tested. Correlation analyses were performed to determine concurrent validity with associated measures (number of reported traumatic events, number of adverse childhood experiences, anxiety, depression, and suicidal risk). RESULTS The second-order two-factor (PTSD and DSO) and the correlated first-order six-factor model provided acceptable fit; however, the first model showed a better fit based on the BIC difference. The PTSD and DSO dimensions, as well as the six ITQ clusters showed positive correlations with reported number of traumatic life-events, reported number of adverse childhood experiences, levels of anxiety, depression, and suicidal risk. CONCLUSIONS The ITQ Latin American Spanish adaptation provides acceptable psychometric evidence to assess PTSD and CPTSD in accordance with the ICD-11.
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Affiliation(s)
- Andrés Fresno
- Programa de Investigación Asociativa (PIA) en Ciencias Cognitivas, Centro de Investigación en Ciencias Cognitivas (CICC), Facultad de Psicología, Universidad de Talca, Talca, Chile
- Centro de Derecho de las Minorías y Gestión de la Diversidad, Universidad de Talca, Talca, Chile
| | - Nadia Ramos Alvarado
- Programa de Investigación Asociativa (PIA) en Ciencias Cognitivas, Centro de Investigación en Ciencias Cognitivas (CICC), Facultad de Psicología, Universidad de Talca, Talca, Chile
- Centro de Derecho de las Minorías y Gestión de la Diversidad, Universidad de Talca, Talca, Chile
| | - Daniel Núñez
- Programa de Investigación Asociativa (PIA) en Ciencias Cognitivas, Centro de Investigación en Ciencias Cognitivas (CICC), Facultad de Psicología, Universidad de Talca, Talca, Chile
- Núcleo Milenio para Mejorar la Salud Mental de Adolescentes y Jóvenes (IMHAY), Santiago, Chile
| | - José Luis Ulloa
- Programa de Investigación Asociativa (PIA) en Ciencias Cognitivas, Centro de Investigación en Ciencias Cognitivas (CICC), Facultad de Psicología, Universidad de Talca, Talca, Chile
- Núcleo Milenio para Mejorar la Salud Mental de Adolescentes y Jóvenes (IMHAY), Santiago, Chile
| | - Jessica Arriagada
- Programa de Investigación Asociativa (PIA) en Ciencias Cognitivas, Centro de Investigación en Ciencias Cognitivas (CICC), Facultad de Psicología, Universidad de Talca, Talca, Chile
| | - Marylene Cloitre
- National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Jonathan I. Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Neil P. Roberts
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
- Psychology and Psychological Therapies Directorate, Cardiff & Vale University Health Board, Cardiff, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK
- Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, UK
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Carbone EA, Menculini G, de Filippis R, D’Angelo M, Zebi L, Steardo L. Sleep Disturbances in Panic Disorder with Comorbid Complex PTSD: A Possible Relationship and Different Psychopathology? Life (Basel) 2023; 13:1636. [PMID: 37629493 PMCID: PMC10455867 DOI: 10.3390/life13081636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/13/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Several studies have shown the possible link between trauma and sleep disturbances, particularly in anxiety disorders. This issue could be because sympathetic hyperarousal is central to both disorders, probably caused by a dysregulation of the noradrenergic system. This study aimed to establish if the comorbidity with complex post-traumatic stress disorder (cPTSD) is associated with sleep disturbances in panic disorder (PD) and if the presence of poor sleep quality is associated with a higher psychopathological burden. METHODS Participants (N = 211) with PD completed the International Trauma Questionnaire concerning their most troubling experience, the Hamilton Anxiety Rating Scale (HAM-A), and the Pittsburgh Sleep Quality Index (PSQI) to assess anxiety symptoms and sleep disturbances, respectively. RESULTS The sample was divided into two subgroups based on the presence of cPTSD. No significant differences emerged in the bivariate analyses for what concerns sociodemographic features. As for the scores of the psychopathological scales, the analysis highlighted statistically significant differences between the subgroups. Subjects with cPTSD reported significantly higher HAM-A total scores. As for the disturbances in self-organization (DSO) and PSQI scores, these were all significantly higher in the cPTSD subsample. At the logistic regression, the presence of cPTSD was inserted as the dependent variable, while the PSQI scores of the subscales evaluating subjective sleep quality, sleep duration, sleep efficacy, and the use of hypnotics were used as independent variables. The presence of cPTSD was significantly associated with the PSQI subscores for subjective sleep quality and use of hypnotics. CONCLUSIONS Patients with PD exhibit more severe sleep disturbances and a higher anxiety burden when experiencing prolonged trauma. Therapeutic advances are needed in this field to target these symptomatologic domains.
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Affiliation(s)
- Elvira Anna Carbone
- Department of Medical and Surgical Sciences, University “Magna Græcia”, 88100 Catanzaro, Italy;
| | - Giulia Menculini
- Department of Psychiatry, University of Perugia, Piazzale Lucio Severi, 1, 06132 Perugia, Italy; (G.M.); (L.Z.)
| | - Renato de Filippis
- Department of Health Sciences, University “Magna Græcia”, 88100 Catanzaro, Italy; (R.d.F.); (M.D.)
| | - Martina D’Angelo
- Department of Health Sciences, University “Magna Græcia”, 88100 Catanzaro, Italy; (R.d.F.); (M.D.)
| | - Leonardo Zebi
- Department of Psychiatry, University of Perugia, Piazzale Lucio Severi, 1, 06132 Perugia, Italy; (G.M.); (L.Z.)
| | - Luca Steardo
- Department of Health Sciences, University “Magna Græcia”, 88100 Catanzaro, Italy; (R.d.F.); (M.D.)
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Frewen P, Wong S, Bailey T, Courtois C, Lanius R. As simple as possible, but not simpler: Revisiting the International Trauma Questionnaire (ITQ) complex PTSD items omitted in the shortened version. CHILD ABUSE & NEGLECT 2023; 141:106207. [PMID: 37148710 DOI: 10.1016/j.chiabu.2023.106207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/12/2023] [Accepted: 04/19/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND The risks of oversimplification of the symptomatology of Complex PTSD (CPTSD) have been highlighted in the literature. OBJECTIVE To re-examine 10 items representing disturbances in self-organization (DSO) that were deleted from the original 28-item version of the International Trauma Questionnaire (ITQ) when creating the current 12-item version. PARTICIPANTS AND SETTING An online convenience sample of 1235 MTurk users. METHODS Online survey comprising the fuller 28-item previous version of the ITQ, Adverse Childhood Experiences (ACEs) questionnaire, and PTSD Checklist for DSM-5 (PCL-5). RESULTS First, averaged endorsement of the 10 omitted items was lower than the 6 retained DSO items (d' = 0.34). Second, the 10 omitted DSO items accounted for incremental variance over and correlated equivalently to the 6 retained items with the PCL-5. Third, only the 10 omitted DSO items (r-part = 0.12) while not the 6 retained DSO items (r-part = -0.01) independently predicted ACE scores and, eight of these ten omitted DSO items differentiated higher ACE scores even among the subset of 266 participants who endorsed all 6 of the retained DSO items, most with medium effect sizes. Fourth, exploratory principal axis factor analysis differentiated two latent variables within the fuller set of 16 DSO symptoms, with the strongest indicators of the second factor, namely uncontrollable anger, recklessness, derealization, and depersonalization, being unmeasured within the 6 retained DSO items. Moreover, scores on both factors independently predicted both PCL-5 and ACE scores. CONCLUSIONS There are conceptual and pragmatic advantages to revisiting a more content-valid and comprehensive conceptualization of CPTSD and DSO, partially as may be measured by the recently deleted items from the original and fuller length ITQ.
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Affiliation(s)
- Paul Frewen
- Department of Psychiatry, Western University, 1151 Richmond St, London, ON N6A 3K7, Canada; Department of Psychology, Western University, 1151 Richmond St, London, ON N6A 3K7, Canada.
| | - Serena Wong
- Department of Psychology, Parkwood Institute Mental Healthcare, 550 Wellington Rd, London, ON N6C 5J1, Canada
| | - Tyson Bailey
- Spectrum Psychological Associates of Washington, 1728 W Marine View Dr, Suite 109 Everett, WA 98201
| | - Christine Courtois
- Private Practice, Trauma Psychology and Treatment PO Box 1326 Bethany Beach, DE. 19930
| | - Ruth Lanius
- Department of Psychiatry, Western University, 1151 Richmond St, London, ON N6A 3K7, Canada
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Peraud W, Hebrard L, Lavandier A, Brockbanck-Chasey S, Brennstuhl MJ, Quintard B. French cross-cultural adaptation and validation of the International Trauma Questionnaire (ITQ) in a French community sample. Eur J Psychotraumatol 2022; 13:2152109. [PMID: 38872594 PMCID: PMC9754015 DOI: 10.1080/20008066.2022.2152109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/17/2022] [Indexed: 12/15/2022] Open
Abstract
Aims: In 2018, the 11th version of the International Classification of Diseases (ICD-11) recognized a new diagnosis in addition to Posttraumatic Stress Disorder (PTSD), that of Complex Posttraumatic Stress Disorder (C-PTSD). A new measurement tool was developed to assess both disorders: the International Trauma Questionnaire. The objectives of this study were (a) to conduct a French translation of the tool, (b) to confirm the factorial structure of the tool, (c) to verify its convergent and divergent validity, (d) and finally to ensure its temporal stability.Method: The ITQ was translated into French using a committee approach, bringing together experts and bilingual individuals with a dual French-English culture. It was then completed by 750 people residing in France and having been exposed to potentially traumatic events, recruited from the general population. Other measures were also completed (HADS, ITEM, PCL-5, WHO-5, DERS).Results: Confirmatory factor analysis confirmed that the French version of the ITQ had the same factor structure as the original version. The scale showed satisfactory convergent and divergent validity, as well as good stability over time.Conclusion: Our study suggests that the French version of the ITQ is a good measurement tool for assessing PTSD and C-PTSD according to the ICD-11 diagnostic criteria.HIGHLIGHTS This study provides the first translation and validation of the International Trauma Questionnaire in the French population.Confirmatory factor analysis confirmed that the French version of the ITQ had the same factor structure as the original version.The French version of the ITQ showed good convergent and divergent validity, as well as good test-retest reliability.
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Affiliation(s)
- W Peraud
- LabPsy, EA4139, University of Bordeaux, Bordeaux, France
| | - L Hebrard
- Inserm, Bordeaux Population Health Research Center, UMR 1219, University of Bordeaux, Bordeaux, France
- National Institute of Cancer INCA_16673, France
| | - A Lavandier
- University of Lorraine, UR4360, APEMAC, Équipe EPSAM, Metz, France
| | | | - M J Brennstuhl
- University of Lorraine, UR4360, APEMAC, Équipe EPSAM, Metz, France
| | - B Quintard
- LabPsy, EA4139, University of Bordeaux, Bordeaux, France
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Which complex PTSD symptoms predict functional impairment in females with comorbid personality disorder needs? Research and treatment implications. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022. [DOI: 10.1016/j.ejtd.2022.100285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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19
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McCutchen C, Hyland P, Maercker A, Thoma MV, Rohner SL. The Effects of Social Support on ACEs and Mental Health in Ireland. JOURNAL OF LOSS & TRAUMA 2022. [DOI: 10.1080/15325024.2022.2124264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Andreas Maercker
- Department of Psychopathology and Clinical Intervention, Institute of Psychology, University of Zürich, Zürich, Switzerland
- University Research Priority Program “Dynamics of Healthy Aging,” University of Zürich, Zürich, Switzerland
| | - Myriam V. Thoma
- Department of Psychopathology and Clinical Intervention, Institute of Psychology, University of Zürich, Zürich, Switzerland
- University Research Priority Program “Dynamics of Healthy Aging,” University of Zürich, Zürich, Switzerland
| | - Shauna L. Rohner
- Department of Psychopathology and Clinical Intervention, Institute of Psychology, University of Zürich, Zürich, Switzerland
- University Research Priority Program “Dynamics of Healthy Aging,” University of Zürich, Zürich, Switzerland
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20
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Kairyte A, Kvedaraite M, Kazlauskas E, Gelezelyte O. Exploring the links between various traumatic experiences and ICD-11 PTSD and Complex PTSD: A cross-sectional study. Front Psychol 2022; 13:896981. [PMID: 36186396 PMCID: PMC9521547 DOI: 10.3389/fpsyg.2022.896981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background The 11th revision of the International Classification of Diseases (ICD-11) included two distinct trauma-related diagnoses—Posttraumatic Stress Disorder (PTSD) and Complex Posttraumatic Stress Disorder (CPTSD). The initial diagnostic factor for both disorders is exposure to a traumatic event. This study aimed to explore whether exposure to different traumatic experiences distinguish risk for PTSD and CPTSD. Methods The study sample comprised 158 trauma-exposed participants, M(SD)age = 33.61(9.73). The Life Events Checklist-Revised (LEC-R) was used to evaluate trauma exposure, and the International Trauma Questionnaire (ITQ) was used to assess risk for ICD-11 PTSD and CPTSD. Multinomial logistic regression was used to determine traumatic events as predictors of risk for PTSD and CPTSD. Results Analysis revealed that sexual abuse experienced in childhood or adulthood was associated with both PTSD and CPTSD. History of other unwanted sexual experiences and childhood physical abuse predicted CPTSD compared to PTSD, whereas exposure to natural disasters predicted PTSD compared to CPTSD. Conclusions The results showed that experiences of certain traumatic events, such as sexual trauma, childhood physical abuse or natural disasters, might help distinguish risk for PTSD and CPTSD. Nevertheless, future studies on specific aspects of trauma exposure are necessary.
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Lewis C, Lewis K, Roberts A, Edwards B, Evison C, John A, Meudell A, Parry P, Pearce H, Richards N, Jones I, Bisson JI. Trauma exposure and co-occurring ICD-11 post-traumatic stress disorder and complex post-traumatic stress disorder in adults with lived experience of psychiatric disorder. Acta Psychiatr Scand 2022; 146:258-271. [PMID: 35752949 PMCID: PMC9543812 DOI: 10.1111/acps.13467] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To establish factors associated with ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD) in a large sample of adults with lived experience of psychiatric disorder and examine the psychiatric burden associated with the two disorders. METHODS One thousand three hundred and five adults were recruited from the National Centre for Mental Health (NCMH) cohort. ICD-11 PTSD/CPTSD were assessed with the International Trauma Questionnaire (ITQ). Binary logistic regression was used to determine factors associated with both PTSD and CPTSD. One-way between-groups analysis of variance was conducted to examine the burden associated with the two disorders in terms of symptoms of anxiety, depression, and psychological wellbeing. For post-hoc pairwise comparisons, the Tukey HSD test was used, and the magnitude of between-group differences assessed using Cohen's d. RESULTS Probable ICD-11 CPTSD was more common than PTSD within the sample (PTSD 2.68%; CPTSD 12.72%). We found evidence that PTSD was associated with interpersonal trauma and household income under £20,000 a year. CPTSD was also associated with interpersonal trauma, higher rates of personality disorder, and lower rates of bipolar disorder. Those with probable-CPTSD had higher levels of current anxiety and depressive symptoms and lower psychological wellbeing in comparison to those with probable-PTSD and those with neither disorder. CONCLUSIONS CPTSD was more prevalent than PTSD in our sample of people with lived experience of psychiatric disorder. Our findings indicate a need for routine screening for trauma histories and PTSD/CPTSD in clinical settings and a greater focus on the need for interventions to treat CPTSD.
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Affiliation(s)
- Catrin Lewis
- National Centre for Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Katie Lewis
- National Centre for Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Alice Roberts
- National Centre for Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Bethan Edwards
- National Centre for Mental Health, PÂR, Cardiff University School of Medicine, Cardiff, UK
| | - Claudia Evison
- National Centre for Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Ann John
- National Centre for Mental Health, Population Data Science, Swansea University Medical School, Swansea, UK
| | - Alan Meudell
- National Centre for Mental Health, PÂR, Cardiff University School of Medicine, Cardiff, UK
| | - Patrick Parry
- National Centre for Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Holly Pearce
- National Centre for Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Natalie Richards
- National Centre for Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Ian Jones
- National Centre for Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Jonathan I Bisson
- National Centre for Mental Health, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
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Ferreira F, Gysi D, Castro D, Ferreira TB. The nosographic structure of posttraumatic stress symptoms across trauma types: An exploratory network analysis approach. J Trauma Stress 2022; 35:1115-1128. [PMID: 35246860 DOI: 10.1002/jts.22818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/06/2021] [Accepted: 01/11/2022] [Indexed: 11/12/2022]
Abstract
The nosographic structure of posttraumatic stress disorder (PTSD) remains unclear, and attempts to determine its symptomatic organization have been unsatisfactory. Several explanations have been suggested, and the impact of trauma type is receiving increasing attention. As little is known about the differential impact trauma type in the nosographic structure of PTSD, we explored the nosology of PTSD and the effect of trauma type on its symptomatic organization. We reanalyzed five cross-sectional psychopathological networks involving different trauma types, encompassing a broad range of traumatic events in veterans, war-related trauma in veterans, sexual abuse, terrorist attacks, and various traumatic events in refugees. The weighted topological overlap was used to estimate the networks and attribute weights to their links. Coexpression differential network analysis was used to identify the common and specific network structures of the connections across different trauma types and to determine the importance of symptoms across the networks. We found a set of symptoms with more common connections with other symptoms, suggesting that these might constitute the prototypical nosographic structure of PTSD. We also found a set of symptoms that had a high number of specific connections with other symptoms; these connections varied according to trauma type. The importance of symptoms across the common and specific networks was ascertained. The present findings offer new insights into the symptomatic organization of PTSD and support previous research on the impact of trauma type on the nosology of this disorder.
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Affiliation(s)
- Filipa Ferreira
- Social Sciences Department, University Institute of Maia, Maia, Portugal.,Centre for Psychology at University of Porto, Porto, Portugal
| | - Deisy Gysi
- Center for Complex Network Research, Northeastern University, Boston, Massachusetts, USA
| | - Daniel Castro
- Social Sciences Department, University Institute of Maia, Maia, Portugal.,Centre for Psychology at University of Porto, Porto, Portugal
| | - Tiago Bento Ferreira
- Social Sciences Department, University Institute of Maia, Maia, Portugal.,Centre for Psychology at University of Porto, Porto, Portugal
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Maercker A, Cloitre M, Bachem R, Schlumpf YR, Khoury B, Hitchcock C, Bohus M. Complex post-traumatic stress disorder. Lancet 2022; 400:60-72. [PMID: 35780794 DOI: 10.1016/s0140-6736(22)00821-2] [Citation(s) in RCA: 71] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 04/19/2022] [Accepted: 04/27/2022] [Indexed: 12/21/2022]
Abstract
Complex post-traumatic stress disorder (complex PTSD) is a severe mental disorder that emerges in response to traumatic life events. Complex PTSD is characterised by three core post-traumatic symptom clusters, along with chronic and pervasive disturbances in emotion regulation, identity, and relationships. Complex PTSD has been adopted as a new diagnosis in the ICD-11. Individuals with complex PTSD typically have sustained or multiple exposures to trauma, such as childhood abuse and domestic or community violence. The disorder has a 1-8% population prevalence and up to 50% prevalence in mental health facilities. Progress in diagnostics, assessment, and differentiation from post-traumatic stress disorder and borderline personality disorder is reported, along with assessment and treatment of children and adolescents. Studies recommend multicomponent therapies starting with a focus on safety, psychoeducation, and patient-provider collaboration, and treatment components that include self-regulatory strategies and trauma-focused interventions.
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Affiliation(s)
- Andreas Maercker
- Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland.
| | - Marylene Cloitre
- National Center for PTSD Division of Dissemination and Training and Department of Psychiatry and Behavioural Sciences, Stanford University, CA, USA
| | - Rahel Bachem
- Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
| | | | | | - Caitlin Hitchcock
- MRC Cognition and Brain Science Unit, University of Cambridge, Cambridge, UK; Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Martin Bohus
- Heidelberg University, Heidelberg Germany and Ruhr University, Bochum, Germany
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Abstract
AIMS Current information about the prevalence of various mental health disorders in the general adult population of the Republic of Ireland is lacking. In this study, we examined the prevalence of 12 common mental disorders, the proportion of adults who screened positive for any disorder, the sociodemographic factors associated with meeting criteria for a disorder and the associations between each disorder and history of attempted suicide. METHODS A non-probability nationally representative sample (N = 1110) of adults living in Ireland completed self-report measures of 12 mental health disorders. Effect sizes were calculated using odds ratios from logistic regression models, and population attributable risk fractions (PAFs) were estimated to quantify the associations between each disorder and attempted suicide. RESULTS Prevalence rates ranged from 15.0% (insomnia disorder) to 1.7% (histrionic personality disorder). Overall, 42.5% of the sample met criteria for a mental health disorder, and 11.1% had a lifetime history of attempted suicide. Younger age, being a shift worker and trauma exposure were independently associated with a higher likelihood of having a mental health disorder, while being in university was associated with a lower likelihood of having a disorder. ICD-11 complex posttraumatic stress disorder, borderline personality disorder and insomnia disorder had the highest PAFs for attempted suicide. CONCLUSIONS Mental health disorder prevalence in Ireland is relatively high compared to international estimates. The findings are discussed in relation to important mental health policy implications.
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McCutchen C, Hyland P, Shevlin M, Cloitre M. The occurrence and co-occurrence of ACEs and their relationship to mental health in the United States and Ireland. CHILD ABUSE & NEGLECT 2022; 129:105681. [PMID: 35643057 DOI: 10.1016/j.chiabu.2022.105681] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 05/05/2022] [Accepted: 05/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have various deleterious effects on mental health but few studies have been conducted in Ireland. OBJECTIVE The primary objective was to determine if there were significant differences in occurrences of ACEs in U.S. and Irish adults. We also sought to determine if there were unique associations between individual and multiple ACE events and mental health. PARTICIPANTS AND SETTING Preexisting nationally representative adult samples from the U.S. (n = 1893) and Ireland (n = 1020) were utilized for analysis. METHOD To determine if there were significant differences in the occurrence of specific ACE events and the mean number of ACEs experienced by U.S. and Irish adults, chi-square difference tests and an independent samples t-test were used, respectively. Binary logistic regression was used to examine the unique associations between ACE events and major depressive disorder (MDD), generalized anxiety disorder (GAD), posttraumatic stress disorder (PTSD), and Complex PTSD (CPTSD). Nationality, sex, age, and educational level were included as covariates and adjusted odds ratios are reported. RESULTS Irish respondents had a higher rate of ACEs, were more likely to experience specific ACEs, and to meet diagnostic requirements for MDD, GAD, and CPTSD than U.S. RESPONDENTS Emotional neglect was more strongly related to mental health than all other ACEs, and there was an exceptionally strong dose-response association between ACEs and CPTSD. CONCLUSIONS ACEs seem to be more common in Ireland than the U.S., and efforts to minimize exposure to ACEs through public policies may lead to beneficial mental health effects.
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Affiliation(s)
| | - Philip Hyland
- Maynooth University, Department of Psychology, Kildare, Ireland
| | - Mark Shevlin
- Ulster University, School of Psychology, Derry, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Marylène Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, USA; Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, CA, USA
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26
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Cyr G, Bélanger C, Godbout N. French translation and validation of the International Trauma Questionnaire in a Canadian community sample. CHILD ABUSE & NEGLECT 2022; 128:105627. [PMID: 35413547 DOI: 10.1016/j.chiabu.2022.105627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/18/2022] [Accepted: 03/31/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The diagnosis of complex post-traumatic stress disorder (CPTSD) was recently included into the 11th edition of the International Classification of Diseases (ICD-11). Recognizing the need for a brief and specific measure CPTSD symptoms as defined by the ICD-11, Cloitre and her team (2018) developed the original English version of the International Trauma Questionnaire (ITQ). The ITQ is composed of two scales-'post-traumatic stress disorder (PTSD)' and 'disturbances in self-organization' (DSO), respectively subdivided into three subscales. It was found to be psychometrically valid but has yet to be available in French. OBJECTIVE The purpose of this study was to provide a French version of the ITQ and to examine its factorial validity, internal consistency, and convergent validity in a French-speaking Canadian sample. PARTICIPANTS The sample included 335 French-Canadian adults from the community. METHODS The ITQ was translated in French, back translated into English, and deemed equivalent by the original ITQ's author. Participants answered the French version of the ITQ, as well as measures of convergent validity, via phone interview. RESULTS Confirmatory factorial analyses revealed that the French ITQ presented the same factor structure as the original ITQ. Composite reliability scores revealed good internal consistency for both scales, and all but one subscale. Pearson's correlation and Steiger's Z test revealed good convergent validity. CONCLUSION This study supports the factorial validity, internal consistency, and convergent validity of the French version of the ITQ, suggesting that it is a psychometrically sound measure of CPTSD.
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Affiliation(s)
- Gaëlle Cyr
- Department of Psychology, University of Quebec in Montreal, 100, Sherbrooke O., Montreal, Quebec H2X 3P2, Canada.
| | - Claude Bélanger
- Department of Psychology, University of Quebec in Montreal, 100, Sherbrooke O., Montreal, Quebec H2X 3P2, Canada.
| | - Natacha Godbout
- Department of Sexology, University of Quebec in Montreal, 455 René-Levesque E., Room W-R165, Montreal, Quebec H2L 4Y2, Canada.
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27
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Fox R, Hyland P, Coogan AN, Cloitre M, Power JM. Posttraumatic stress disorder, complex PTSD and subtypes of loneliness among older adults. J Clin Psychol 2022; 78:321-342. [PMID: 34287862 PMCID: PMC8770684 DOI: 10.1002/jclp.23225] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 05/19/2021] [Accepted: 06/23/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Research examining the relationship between loneliness and Complex Posttraumatic Stress Disorder (CPTSD) is scarce, particularly among older adults. CPTSD includes the core symptoms of PTSD along with additional symptoms reflecting "disturbances in self-organisation" (DSO). This study examined the cross-sectional relationships between loneliness (emotional and social loneliness) and CPTSD symptoms (i.e., PTSD and DSO symptoms) in older adults. METHODS Structural equation modelling was used to examine these relationships in a nationally representative sample of US adults aged 60-70 years (n = 456). RESULTS Controlling for covariates, emotional loneliness was associated with PTSD (β = 0.31) and DSO (β = 0.57) symptoms whereas social loneliness was only associated with DSO symptoms (β = 0.25). The model explained 35.0% of the variance in PTSD symptoms and 71.3% in DSO symptoms. CONCLUSION These findings have important implications for treating and understanding PTSD/CPTSD and their correlates among older adults.
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Affiliation(s)
- Robert Fox
- Department of Psychology, Maynooth University, Kildare, Ireland,Centre for Interdisciplinary Research, Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery & Health Systems, University College Dublin
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | | | - Marylène Cloitre
- National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA,Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California, USA
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28
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Spikol E, Robinson M, McGlinchey E, Ross J, Armour C. Exploring complex-PTSD comorbidity in trauma-exposed Northern Ireland veterans. Eur J Psychotraumatol 2022; 13:2046953. [PMID: 35386731 PMCID: PMC8979541 DOI: 10.1080/20008198.2022.2046953] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
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 = 23.06 in CPTSD), as was anxiety (OR = 22.05 in CPTSD) and suicidal ideation (OR = 4.32 in CPTSD), with suicidal attempt associated with the CPTSD class (OR = 2.51). 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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Affiliation(s)
- Eric Spikol
- Stress Trauma and Related Conditions (STARC) Research Centre, School of Psychology, Queen's University Belfast, Belfast, UK
| | - Martin Robinson
- Stress Trauma and Related Conditions (STARC) Research Centre, School of Psychology, Queen's University Belfast, Belfast, UK
| | - Emily McGlinchey
- Stress Trauma and Related Conditions (STARC) Research Centre, School of Psychology, Queen's University Belfast, Belfast, UK
| | - Jana Ross
- Stress Trauma and Related Conditions (STARC) Research Centre, School of Psychology, Queen's University Belfast, Belfast, UK
| | - Cherie Armour
- Stress Trauma and Related Conditions (STARC) Research Centre, School of Psychology, Queen's University Belfast, Belfast, UK
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29
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Gelezelyte O, Roberts NP, Kvedaraite M, Bisson JI, Brewin CR, Cloitre M, Kairyte A, Karatzias T, Shevlin M, Kazlauskas E. Validation of the International Trauma Interview (ITI) for the Clinical Assessment of ICD-11 Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) in a Lithuanian Sample. Eur J Psychotraumatol 2022; 13:2037905. [PMID: 35222840 PMCID: PMC8881058 DOI: 10.1080/20008198.2022.2037905] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND The 11th revision of the International Classification of Diseases (ICD-11) includes a new diagnosis of complex posttraumatic stress disorder (CPTSD). The International Trauma Interview (ITI) is a novel clinician-administered diagnostic interview for the assessment of ICD-11 PTSD and CPTSD. OBJECTIVE The aim of this study was to evaluate the psychometric properties of the ITI in a Lithuanian sample in relation to interrater agreement, latent structure, internal reliability, as well as convergent and discriminant validity. METHOD In total, 103 adults with a history of various traumatic experiences participated in the study. The sample was predominantly female (83.5%), with a mean age of 32.64 years (SD = 9.36). For the assessment of ICD-11 PTSD and CPTSD, the ITI and the self-report International Trauma Questionnaire (ITQ) were used. Mental health indicators, such as depression, anxiety, and dissociation, were measured using self-report questionnaires. The latent structure of the ITI was evaluated using confirmatory factor analysis (CFA). In order to test the convergent and discriminant validity of the ITI we conducted a structural equation model (SEM). RESULTS Overall, based on the ITI, 18.4% of participants fulfilled diagnostic criteria for PTSD and 21.4% for CPTSD. A second-order two-factor CFA model of the ITI PTSD and disturbances in self-organization (DSO) symptoms demonstrated a good fit. The associations with various mental health indicators supported the convergent and discriminant validity of the ITI. The clinician-administered ITI and self-report ITQ had poor to moderate diagnostic agreement across different symptom clusters. CONCLUSION The ITI is a reliable and valid tool for assessing and diagnosing ICD-11 PTSD and CPTSD.
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Affiliation(s)
- Odeta Gelezelyte
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Neil P Roberts
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK.,Psychology and Psychological Therapies Directorate, Cardiff & Vale University Health Board, Cardiff, UK
| | - Monika Kvedaraite
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Jonathan I Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Chris R Brewin
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Marylene Cloitre
- National Center for PTSD Dissemination and Training Division, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Agniete Kairyte
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Thanos Karatzias
- School of Health and Social Care, Edinburgh Napier University, Scotland, UK & Nhs Lothian Rivers Centre for Traumatic Stress, Edinburgh, Scotland
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
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30
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Levin Y, Bachem R, Palgi Y, Hyland P, Karatzias T, Shevlin M, Ben-Ezra M, Maercker A. Fatalism and ICD-11 CPTSD and PTSD diagnoses: results from Nigeria, Kenya & Ghana. Eur J Psychotraumatol 2021; 12:1988452. [PMID: 34777713 PMCID: PMC8583916 DOI: 10.1080/20008198.2021.1988452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/26/2021] [Accepted: 09/21/2021] [Indexed: 11/11/2022] Open
Abstract
Background Existing research on post-traumatic sequelae suggests a positive association between fatalism and symptoms of post-traumatic stress disorder (PTSD). However, the associations between fatalism and the new ICD-11 diagnosis of complex PTSD (CPTSD) have never been explored before. Objective The current study explored the association between fatalism and PTSD and CPTSD in samples from three African countries. Methods A total of 2,524 participants from Nigeria (n = 1018), Kenya (n = 1006), and Ghana (n = 500) completed measures of fatalism (non-judgemental fatalism, current fatalism, pessimistic fatalism, prospective fatalism) and the International Trauma Questionnaire (ITQ). A combination of a multinomial regression and path analysis was used to identify fatalism predictors of PTSD and CPTSD versus no diagnosis, and CPTSD versus PTSD, adjusted for demographic variables and trauma exposure. Results While PTSD was not predicted by any of the fatalism types, compared to no diagnosis, CPTSD was significantly predicted by pessimistic, non-judgemental and current fatalism, both compared to no diagnosis and PTSD. Conclusions The results broaden the knowledge on potential correlates of the new diagnosis of CPTSD. Addressing fatalistic beliefs by empowering people to think that they can choose their fate should be further explored as a possible target for intervention in the treatment of CPTSD.
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Affiliation(s)
- Yafit Levin
- Department of Education, Ariel University, Ariel, Israel
| | - Rahel Bachem
- Department of Psychology, Psychopathology and Clinical Intervention, University of Zürich, Zurich, Switzerland
| | - Yuval Palgi
- Department of Gerontology, University of Haifa, Haifa, Israel
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Thanos Karatzias
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, Scotland, UK
- Nhs Lothian, Rivers Centre for Traumatic Stress, Edinburgh, Scotland, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | | | - Andreas Maercker
- Department of Psychology, Psychopathology and Clinical Intervention, University of Zürich, Zurich, Switzerland
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31
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Koirala R, Iyer Søegaard EG, Kan Z, Ojha SP, Hauff E, Thapa SB. Exploring complex PTSD in patients visiting a psychiatric outpatient clinic in Kathmandu, Nepal. J Psychiatr Res 2021; 143:23-29. [PMID: 34438200 DOI: 10.1016/j.jpsychires.2021.08.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 07/25/2021] [Accepted: 08/19/2021] [Indexed: 12/01/2022]
Abstract
Decades of research on trauma patients have shown that a post-traumatic stress disorder (PTSD) diagnosis does not always cover the full spectrum of symptoms after severe trauma. Complex PTSD (CPTSD) was recently introduced in the International Classification of Diseases 11th Revision. There have been no published studies on CPTSD in the South Asian region to date. The objective of this study was to evaluate CPTSD in a sample of trauma patients in Nepal. We also examined quality of life (QOL) and mental health comorbidities and their association with CPTSD caseness. One hundred patients with a history of trauma who visited the outpatient psychiatry clinic at a hospital in Kathmandu from 2017 to 2018 were assessed. The Composite International Diagnostic Interview Version 2.1 was used to evaluate PTSD, major depressive disorder, and generalized anxiety disorder (GAD). Disturbance of self-organization symptoms from the Structured Interview for Disorders of Extreme Stress (SIDES) together with the PTSD diagnosis was used to confirm CPTSD caseness. The World Health Organization (WHO) QOL Scale Brief Version (WHOQOL-BREF) was used to assess QOL in four domains. Among the 83 patients who had PTSD, 42 also had CPTSD. CPTSD was significantly associated with major depressive disorder, GAD, female gender, and lower QOL in all four domains. CPTSD was prevalent among these patients. Having CPTSD was significantly associated with worse outcomes in terms of QOL and comorbid mental disorders, even with similar trauma. There is a need to explore CPTSD symptoms and to address trauma patients with CPTSD in this region.
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Affiliation(s)
- Rishav Koirala
- Department of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway; Brain and Neuroscience Center, Nepal.
| | - Erik Ganesh Iyer Søegaard
- Department of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway; Department of Mental Health and Addiction, Oslo University Hospital, Norway
| | - Zhanna Kan
- Department of Mental Health and Addiction, Oslo University Hospital, Norway
| | | | - Edvard Hauff
- Department of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway; Department of Mental Health and Addiction, Oslo University Hospital, Norway
| | - Suraj Bahadur Thapa
- Department of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway; Department of Mental Health and Addiction, Oslo University Hospital, Norway
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32
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McGinty G, Fox R, Ben-Ezra M, Cloitre M, Karatzias T, Shevlin M, Hyland P. Sex and age differences in ICD-11 PTSD and complex PTSD: An analysis of four general population samples. Eur Psychiatry 2021; 64:e66. [PMID: 34602122 PMCID: PMC8581703 DOI: 10.1192/j.eurpsy.2021.2239] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is traditionally understood as a disorder that occurs more commonly in women than in men, and in younger age groups than in older age groups. The objective of this study was to determine if these patterns are also observed in relation to International Classification of Diseases (ICD-11) PTSD and complex PTSD (CPTSD). METHODS Secondary data analysis was performed using data collected from three nationally representative samples from the Republic of Ireland (N = 1,020), the United States (N = 1,839), and Israel (N = 1,003), and one community sample from the United Kingdom (N = 1,051). RESULTS Estimated prevalence rates of ICD-11 PTSD were higher in women than in men in each sample, and at a level consistent with existing data derived from Diagnostic and Statistics Manual of Mental Disorders (DSM)-based models of PTSD. Furthermore, rates of ICD-11 PTSD were generally lower in older age groups for men and women. For CPTSD, there was inconsistent evidence of sex and age differences, and some indication of a possible interaction between these two demographic variables. CONCLUSIONS Despite considerable revisions to PTSD in ICD-11, the same sex and age profile was observed to previous DSM-based models of PTSD. CPTSD, however, does not appear to show the same sex and age differences as PTSD. Theoretical models that seek to explain sex and age differences in trauma-related psychopathology may need to be reconsidered given the distinct effects for ICD-11 PTSD and CPTSD.
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Affiliation(s)
- Grainne McGinty
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Robert Fox
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | | | - Marylène Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA.,Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, California, USA
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, United Kingdom.,Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, United Kingdom
| | - Mark Shevlin
- School of Psychology, Ulster University, Derry, Northern Ireland
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
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Spikol E, McBride O, Vallières F, Butter S, Hyland P. Tracking the Irish adult population during the first year of the COVID-19 pandemic: A methodological report of the COVID-19 psychological research consortium (C19PRC) study in Ireland. Acta Psychol (Amst) 2021; 220:103416. [PMID: 34517260 PMCID: PMC8431969 DOI: 10.1016/j.actpsy.2021.103416] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/26/2021] [Accepted: 09/08/2021] [Indexed: 12/14/2022] Open
Abstract
The COVID-19 Psychological Research Consortium (C19PRC) study was established to determine the impact of the COVID-19 pandemic on the population of multiple countries. Here, we provide a methodological overview, cohort profile, data access, and summary of key findings from the Republic of Ireland arm of the C19PRC study. A longitudinal internet panel survey was designed to collect data from a nationally representative sample of Irish adults (N = 1041) who were tracked from March/April 2020 to March/April 2021. Quota sampling methods were used to produce a sample that was representative of the population with respect to sex, age, and regional distribution. Data were collected in five waves, and new participants were recruited at follow-up waves to cover sample attrition and produce nationally representative samples at various points during the first year of the pandemic. A comprehensive battery of measures was used throughout the project to assess an array of sociodemographic, political, social, psychological, physical health, COVID-19, and mental health variables. Analyses were conducted to compare sample characteristic to known population parameters from available census data. These analyses showed that the sample was representative of the general adult population of Ireland on the three quota variables and was reasonable representative of the population across a diverse range of sociodemographic variables. These data representative the first and only nationally representative, longitudinal survey of the mental health of the Irish population. These data are made freely available to interested users (https://osf.io/2huzd/files/) and the findings of this study provide a methodological basis for the future use of these data.
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Affiliation(s)
- Eric Spikol
- Department of Psychology, Maynooth University, Ireland
| | - Orla McBride
- School of Psychology, Ulster University, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | | | - Sarah Butter
- Department of Psychology, The University of Sheffield, England, United Kingdom of Great Britain and Northern Ireland
| | - Philip Hyland
- Department of Psychology, Maynooth University, Ireland.
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Ford JD, Courtois CA. Complex PTSD and borderline personality disorder. Borderline Personal Disord Emot Dysregul 2021; 8:16. [PMID: 33958001 PMCID: PMC8103648 DOI: 10.1186/s40479-021-00155-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/09/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND This article builds on a previous review (Ford and Courtois, Borderline Personal Disord Emot Dysregul 1:9, 2014) which concluded that complex posttraumatic stress disorder (cPTSD) could not be conceptualized as a sub-type of either PTSD or BPD. Recent research is reviewed that extends and clarifies the still nascent understanding of the relationship between cPTSD and BPD. MAIN BODY The circumscribed formulation of adult cPTSD that has been developed, validated, and included in the 11th Edition of the International Classification of Diseases has spurred research aimed at differentiating cPTSD and BPD both descriptively and empirically. A newly validated Developmental Trauma Disorder (DTD) syndrome for children and adolescents provides a basis for systematic research on the developmental course and origins of adult cPTSD and BPD. This review summarizes recent empirical findings regarding BPD, PTSD, and cPTSD in terms of: (1) prevalence and comorbidity; (2) clinical phenomenology; (3) traumatic antecedents; (4) psychobiology; (5) emotion dysregulation; (6) dissociation; and (7) empirically supported approaches to clinical assessment and psychotherapeutic treatment. CONCLUSION The evidence suggests that PTSD, cPTSD, and BPD are potentially comorbid but distinct syndromes. A hypothesis is advanced to stimulate scientific research and clinical innovation defining and differentiating the disorders, positing that they may represent a continuum paralleling the classic conceptualization of the stress response, with dissociation potentially involved in each disorder.
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Affiliation(s)
- Julian D Ford
- University of Connecticut Health Center MC1410, 263 Farmington Avenue, Farmington, CT, 06030-1410, USA.
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35
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Hyland P, Vallières F. Assessing and protecting the mental health of the nation: A study protocol. HRB Open Res 2021. [DOI: 10.12688/hrbopenres.13207.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19) and the public health measures enacted to control its spread may affect the mental health of the general population of Ireland. Funded under the Health Research Board’s COVID-19 Pandemic Rapid Response Funding Call, this protocol outlines the aims of a project to assess and protect the mental health of the population of Ireland during this pandemic. We will determine (i) the prevalence of common mental health disorders at various times during the first year of the pandemic, (ii) changes in the prevalence of mental health disorders during the first year of the pandemic, (iii) if there are distinct groups of people experiencing different mental health responses to the pandemic, and (iv) the factors associated with different mental health reactions. Methods: This quantitative study uses cross-sectional and longitudinal designs. Data have been collected from a nationally representative sample of Irish adults at four assessments: Wave 1 (N = 1,041) occurred during the first week of lockdown in March 2020, Wave 2 in May, Wave 3 in August, and Wave 4 in December. Wave 5 is planned for March 2021. Participants from Wave 1 have been recontacted at each wave to produce a longitudinal dataset. New participants were recruited using quota sampling to ensure the availability of nationally representative samples at each wave. Self-report measures of demographic, economic, psychological, and mental health variables were completed. Conclusion: This design will allow us to determine whether there has been a change in mental health disorders in the general population during the first year of the pandemic, and if so, what variables are associated with changes in mental health. Results will be used to inform the government’s ongoing response to this crisis, to better protect the mental health of the nation during this and any future public health emergency.
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Murphy J, Vallières F, Bentall RP, Shevlin M, McBride O, Hartman TK, McKay R, Bennett K, Mason L, Gibson-Miller J, Levita L, Martinez AP, Stocks TVA, Karatzias T, Hyland P. Psychological characteristics associated with COVID-19 vaccine hesitancy and resistance in Ireland and the United Kingdom. Nat Commun 2021; 12:29. [PMID: 33397962 PMCID: PMC7782692 DOI: 10.1038/s41467-020-20226-9] [Citation(s) in RCA: 688] [Impact Index Per Article: 229.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 11/13/2020] [Indexed: 12/30/2022] Open
Abstract
Identifying and understanding COVID-19 vaccine hesitancy within distinct populations may aid future public health messaging. Using nationally representative data from the general adult populations of Ireland (N = 1041) and the United Kingdom (UK; N = 2025), we found that vaccine hesitancy/resistance was evident for 35% and 31% of these populations respectively. Vaccine hesitant/resistant respondents in Ireland and the UK differed on a number of sociodemographic and health-related variables but were similar across a broad array of psychological constructs. In both populations, those resistant to a COVID-19 vaccine were less likely to obtain information about the pandemic from traditional and authoritative sources and had similar levels of mistrust in these sources compared to vaccine accepting respondents. Given the geographical proximity and socio-economic similarity of the populations studied, it is not possible to generalize findings to other populations, however, the methodology employed here may be useful to those wishing to understand COVID-19 vaccine hesitancy elsewhere.
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Affiliation(s)
- Jamie Murphy
- School of Psychology, Ulster University, Coleraine, BT52 1SA, Northern Ireland.
| | - Frédérique Vallières
- Centre for Global Health, Trinity College Dublin, Dublin, D02 PN40, Republic of Ireland
| | - Richard P Bentall
- Department of Psychology, University of Sheffield, Sheffield, S10 2TN, England
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, BT52 1SA, Northern Ireland
| | - Orla McBride
- School of Psychology, Ulster University, Coleraine, BT52 1SA, Northern Ireland
| | - Todd K Hartman
- Department of Psychology, University of Sheffield, Sheffield, S10 2TN, England
| | - Ryan McKay
- Department of Psychology, Royal Holloway, University of London, London, TW20 0EX, England
| | - Kate Bennett
- Department of Psychology, University of Liverpool, Liverpool, L69 3BX, England
| | - Liam Mason
- Division of Psychology and Language Sciences, University College London, London, WC1E 6BT, England
| | - Jilly Gibson-Miller
- Department of Psychology, University of Sheffield, Sheffield, S10 2TN, England
| | - Liat Levita
- Department of Psychology, University of Sheffield, Sheffield, S10 2TN, England
| | - Anton P Martinez
- Department of Psychology, University of Sheffield, Sheffield, S10 2TN, England
| | - Thomas V A Stocks
- Department of Psychology, University of Sheffield, Sheffield, S10 2TN, England
| | - Thanos Karatzias
- School of Health and Social Care, Napier University, Edinburgh, EH14 1DJ, Scotland
| | - Philip Hyland
- Department of Psychology, Maynooth University, County Kildare, W23 F2K8, Republic of Ireland
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Ford JD, Spinazzola J, van der Kolk B. Psychiatric comorbidity of developmental trauma disorder and posttraumatic Stress disorder: findings from the DTD field trial replication (DTDFT-R). Eur J Psychotraumatol 2021; 12:1929028. [PMID: 34249242 PMCID: PMC8245086 DOI: 10.1080/20008198.2021.1929028] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
Background: Developmental Trauma Disorder (DTD) has extensive comorbidity with internalizing and externalizing disorders distinct from posttraumatic stress disorder (PTSD). Objective: To replicate findings of DTD comorbidity and to determine whether this comorbidity is distinct from, and extends beyond, comorbidities of PTSD. Method: DTD was assessed by structured interview, and probable DSM-IV psychiatric disorders were identified with KSADS-PL screening modules, in a multi-site sample of 271 children (ages 8-18 years old; 47% female) in outpatient or residential mental health treatment for multiple (M = 3.5 [SD = 2.4]) psychiatric diagnoses other than PTSD or DTD. Results: DTD (N = 74, 27%) and PTSD (N = 107, 39%) were highly comorbid and shared several DSM-IV internalizing and externalizing disorder comorbidities. Children with DTD with or without PTSD had more comorbid diagnoses (M = 5.7 and 5.2 [SD = 2.4 and 1.7], respectively) than children with PTSD but not DTD (M = 3.8[SD = 2.1]) or neither PTSD nor DTD (M = 2.1[SD = 1.9]), F[3,267] = 55.49, p < .001. Further, on a multivariate basis controlling for demographics and including all potential comorbid disorders, DTD was associated with separation anxiety disorder, depression, and oppositional defiant disorder after controlling for PTSD, while PTSD was associated only with separation anxiety disorder after controlling for DTD. Both DTD and PTSD were associated with suicidality. Conclusions: DTD is associated with psychiatric comorbidity beyond that of PTSD, and DTD warrants assessment for treatment planning with children in intensive psychiatric services.
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Affiliation(s)
- Julian D Ford
- University of Connecticut School of Medicine, Farmington, CT, USA
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Hyland P, Karatzias T, Shevlin M, Cloitre M, Ben-Ezra M. A longitudinal study of ICD-11 PTSD and complex PTSD in the general population of Israel. Psychiatry Res 2020; 286:112871. [PMID: 32143066 DOI: 10.1016/j.psychres.2020.112871] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 02/11/2020] [Accepted: 02/18/2020] [Indexed: 11/23/2022]
Abstract
The ICD-11 includes two trauma disorders: Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). CPTSD is a disorder comprised of PTSD and Disturbance in Self-Organization (DSO) symptoms. Evidence supports the construct validity of PTSD and CPTSD, however, the temporal stability of these constructs has rarely been tested. This study examined the diagnostic stability of PTSD and CPTSD, and the temporal associations between PTSD and DSO symptoms over a period of one-year. Data were collected from a nationally representative sample of Israeli adults (n = 1,003) and one year later a random half of this sample were reassessed (n = 543). There were no statistically significant changes in rates of PTSD (6.7%, 5.3%) and CPTSD (4.9%, 3.7%) over time. Latent variable cross-lagged analysis indicated that PTSD and DSO symptoms were stable over time and that DSO symptoms predicted subsequent PTSD symptoms. Results suggest that ICD-11 PTSD and CPTSD are stable constructs in the general population over a period of one year. We discuss the possibility that these findings are influenced by the specific cultural context of Israel. Additionally, given the stability and influence of DSO symptoms we discuss the potential value of psychological therapies that directly address these symptoms.
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Affiliation(s)
- Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland.
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, United Kingdom; NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, United Kingdom
| | - Mark Shevlin
- School of Psychology, Ulster University, Derry, Northern Ireland United Kingdom
| | - Marylène Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, United States; Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, CA, United States
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