title: Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis.
abstract: BACKGROUND
  The WHO International Classification of Diseases, 11th version (ICD-11), has proposed two related diagnoses, posttraumatic stress disorder (PTSD) and complex PTSD within the spectrum of trauma and stress-related disorders.
  
  
  OBJECTIVE
  To use latent profile analysis (LPA) to determine whether there are classes of individuals that are distinguishable according to the PTSD and complex PTSD symptom profiles and to identify potential differences in the type of stressor and severity of impairment associated with each profile.
  
  
  METHODS
  An LPA and related analyses were conducted on 302 individuals who had sought treatment for interpersonal traumas ranging from chronic trauma (e.g., childhood abuse) to single-incident events (e.g., exposure to 9/11 attacks).
  
  
  RESULTS
  THE LPA REVEALED THREE CLASSES OF INDIVIDUALS: (1) a complex PTSD class defined by elevated PTSD symptoms as well as disturbances in three domains of self-organization: affective dysregulation, negative self-concept, and interpersonal problems; (2) a PTSD class defined by elevated PTSD symptoms but low scores on the three self-organization symptom domains; and (3) a low symptom class defined by low scores on all symptoms and problems. Chronic trauma was more strongly predictive of complex PTSD than PTSD and, conversely, single-event trauma was more strongly predictive of PTSD. In addition, complex PTSD was associated with greater impairment than PTSD. The LPA analysis was completed both with and without individuals with borderline personality disorder (BPD) yielding identical results, suggesting the stability of these classes regardless of BPD comorbidity.
  
  
  CONCLUSIONS
  Preliminary data support the proposed ICD-11 distinction between PTSD and complex PTSD and support the value of testing the clinical utility of this distinction in field trials. Replication of results is necessary.
authors.affiliation: National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA ; Department of Psychiatry and Child and Adolescent Psychiatry, New York University, Langone Medical Center, New York, NY, USA.
authors.forename: Marylène
authors.initials: M
authors.lastname: Cloitre
authors.forename: Donn W
authors.initials: DW
authors.lastname: Garvert
authors.forename: Chris R
authors.initials: CR
authors.lastname: Brewin
authors.forename: Richard A
authors.initials: RA
authors.lastname: Bryant
authors.forename: Andreas
authors.initials: A
authors.lastname: Maercker
keywords: Complex PTSD; ICD-11; WHO; posttraumatic stress disorder