An evaluation of ICD-11 PTSD and complex PTSD criteria in a sample of adult survivors of childhood institutional abuse

Matthias Knefel · Brigitte Lueger‐Schuster

105 citations0/0 files storedEuropean Journal of Psychotraumatology

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Posttraumatic Stress Disorder Research Psychoanalysis and Psychopathology Research Child Abuse and Trauma

Abstract

BACKGROUND: The WHO recently launched the proposal for the 11th version of the International Classification of Diseases (ICD-11) that also includes two diagnoses related to traumatic stress. In contrast to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), ICD-11 will probably, in addition to posttraumatic stress disorder (PTSD), also define a new diagnosis termed "complex posttraumatic stress disorder" (CPTSD). OBJECTIVE: We aimed to apply the proposed ICD-11 criteria for PTSD and CPTSD and to compare their prevalence to the ICD-10 (International Classification of Diseases [10th revision]) PTSD prevalence. In addition, we compiled a list of symptoms for CPTSD based on subthreshold PTSD so as to include a wider group of individuals. METHODS: To evaluate the appropriateness of the WHO ICD-11 proposal compared to the criteria of ICD-10, we applied the newly introduced criteria for PTSD and CPTSD deriving from the Posttraumatic Stress Disorder Checklist - Civilian Version (PCL-C) and the Brief Symptom Inventory (BSI) scales, to a sample of adult survivors (N=229) of childhood institutional abuse. We evaluated the construct validity of CPTSD using confirmatory factor analysis (CFA). RESULTS: More individuals fulfilled the criteria for PTSD according to ICD-10 (52.8%) than the ICD-11 proposal (17% for PTSD only; 38.4% if combined with complex PTSD). The new version of PTSD neutralized the gender effects. The prevalence of CPTSD was 21.4%, and women had a significantly higher rate of CPTSD than men (40.4 and 15.8%, respectively). Those survivors who were diagnosed with CPTSD experienced institutional abuse for a longer time. CFA showed a strong model fit. CONCLUSION: CPTSD is a highly relevant classification for individuals with complex trauma history, but surprisingly, effects of gender were apparent. Further research should thus address gender effects.

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References

2013Diagnostic and Statistical Manual of Mental Disorders 2013Diagnostic and Statistical Manual of Mental Disorders 2014Diagnostic and Statistical Manual of Mental Disorders, 5th ed.2000Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)1995Posttraumatic Stress Disorder in the National Comorbidity Survey 2006Reporting Structural Equation Modeling and Confirmatory Factor Analysis Results: A Review 1983The Brief Symptom Inventory: an introductory report 2000Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults.

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2017The impacts of institutional child sexual abuse: A rapid review of the evidence 2016Evidence of complex posttraumatic stress disorder (CPTSD) across populations with prolonged trauma of varying interpersonal intensity and ages of exposure 2015Update to an evaluation of ICD-11 PTSD and complex PTSD criteria in a sample of adult survivors of childhood institutional abuse by Knefel & Lueger-Schuster (2013): a latent profile analysis 2016Does one size fit all? Nosological, clinical, and scientific implications of variations in PTSD Criterion A

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