title: Evidence for two different ICD-11 posttraumatic stress disorders in a community sample of adolescents and young adults.
abstract: For the 11th revision of the International classification of diseases, a general category of posttraumatic stress disorders has been proposed with two distinct sibling disorders: posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). General population data are examined on evidence for these two disorders. Data were drawn from a 10-year prospective longitudinal, epidemiological study with a representative community sample (N = 3021, 14-24 years at baseline) in Germany. Mixture modelling on latent classes was conducted in a subset of all reported episodes with exposure to interpersonal traumas. Associations between class membership, symptom criteria, and other mental disorders were investigated. Four distinctly interpretable latent classes were found. Class 1 episodes (N = 181) typically included core PTSD symptoms associated with strong impairment (OR 11.68; 95 % CI 4.54-30.05). 18.3 % of these episodes matched the criteria of ICD-11 PTSD. Class 2 episodes (N = 78) had a high probability of PTSD core symptoms and disturbances in self-organization and were associated with strong impairment (OR 38.47; 95 % CI 15.77-93.86). Half of them (49.4 %) matched the proposed ICD-11 criteria of CPTSD. Class 3 (N = 79) was typically characterized by episodes with disturbances in self-organization but a low probability of PTSD core symptoms and impairment. Class 4 (N = 633) was related to a relatively low probability of symptom reports. Membership in class 2 was associated with lower educational attainment, a lower social class, and more other mental disorders. Findings support the ICD-11 proposal to differentiate between PTSD and CPTSD. Further studies should extend exploration to other types of traumatic events in samples covering the full age range.
authors: Division of Psychopathology and Clinical Intervention, Department of Psychology, University of Zurich, Binzmühlestr. 14/17, 8050, Zurich, Switzerland. a.perkonigg@psychologie.uzh.ch.
authors: Axel
authors: A
authors: Perkonigg
authors: Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Straße 46, 01187, Dresden, Germany.
authors: Michael
authors: M
authors: Höfler
authors: National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.|Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA.
authors: Marylène
authors: M
authors: Cloitre
authors: Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Straße 46, 01187, Dresden, Germany.
authors: Hans-Ulrich
authors: HU
authors: Wittchen
authors: Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Straße 46, 01187, Dresden, Germany.
authors: Sebastian
authors: S
authors: Trautmann
authors: Division of Psychopathology and Clinical Intervention, Department of Psychology, University of Zurich, Binzmühlestr. 14/17, 8050, Zurich, Switzerland.
authors: Andreas
authors: A
authors: Maercker
mesh_terms: D000293:Adolescent; D000367:Age Factors; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D007398:Interpersonal Relations; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D011569:Psychiatric Status Rating Scales; D012111:Residence Characteristics; D013313:Stress Disorders, Post-Traumatic / Q000145:classification* / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult
keywords: Complex PTSD; ICD-11; Posttraumatic stress disorder; Traumatic events