title: Evidence of complex posttraumatic stress disorder (CPTSD) across populations with prolonged trauma of varying interpersonal intensity and ages of exposure.
abstract: The ICD-11 proposes different types of prolonged trauma as risk factors for complex PTSD (CPTSD). However, CPTSD's construct validity has only been examined in childhood abuse, and single trauma exposure samples. Thus, the extent to which CPTSD applies to other repeatedly traumatized populations is unknown. This study examined ICD-11's PTSD and CPTSD across populations with prolonged trauma of varying interpersonal intensity and ages of exposure, including: 1) childhood sexual abuse, 2) adulthood trauma of severe interpersonal intensity (refugees and ex-prisoners of war), and 3) adulthood trauma of mild interpersonal intensity (military veterans, and mental health workers). In support of the proposal, latent class analysis (N = 820) identified, a 4-class solution representing "PTSD", "CPTSD", and "non-pathological" classes, but also an "Anxiety symptoms" class, and an alternative 5-class solution, with a "Dissociative PTSD-subtype" class. ICD-11's CPTSD was not exclusively associated with childhood abuse, but also with exposure to adulthood trauma of severe interpersonal intensity. Furthermore, all types of prolonged trauma were equally associated with the "Anxiety symptoms" class. Finally, of all the classes, the "CPTSD" class was associated with the highest frequency of work-related functional impairment, indicating an association between the severity of prolonged trauma exposure and the level of posttraumatic residues.
authors.affiliation: National Centre of Psychotraumatology, University of Southern Denmark, Odense, Denmark; Competence Center for Transcultural Psychiatry, Psychiatric Center Ballerup, The Mental Health Services of the Capital Region of Denmark, Copenhagen, Denmark.
authors.forename: Sabina
authors.initials: S
authors.lastname: Palic
authors.affiliation: Department of Behavioral Sciences, Ariel University, Ariel, Israel.
authors.forename: Gadi
authors.initials: G
authors.lastname: Zerach
authors.affiliation: University of Ulster, Derry, Northern Ireland, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Shevlin
authors.affiliation: Sorosky Medical Center, Tel Aviv, Israel.
authors.forename: Zevia
authors.initials: Z
authors.lastname: Zeligman
authors.affiliation: National Centre of Psychotraumatology, University of Southern Denmark, Odense, Denmark.
authors.forename: Ask
authors.initials: A
authors.lastname: Elklit
authors.affiliation: Center of Excellence for Mass Trauma Research, Tel Aviv University, Israel.
authors.forename: Zahava
authors.initials: Z
authors.lastname: Solomon
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology; D000069586:Adult Survivors of Child Adverse Events / Q000523:psychology*; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D007398:Interpersonal Relations; D008297:Male; D008503:Medical Staff / Q000523:psychology*; D008875:Middle Aged; D000067073:Psychological Trauma / Q000503:physiopathology*; D012036:Refugees / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology*; D014728:Veterans / Q000523:psychology*
keywords: Anxiety; Childhood sexual abuse; Complex PTSD; Dossiciative PTSD-subtype; ICD-11; Mental health professionals; POWs; PTSD; Prolonged trauma; Refugees; Veterans