Academic journal article European Journal of Psychotraumatology

Evidence for Proposed ICD-11 PTSD and Complex PTSD: A Latent Profile Analysis

Academic journal article European Journal of Psychotraumatology

Evidence for Proposed ICD-11 PTSD and Complex PTSD: A Latent Profile Analysis

Article excerpt

CLINICAL RESEARCH ARTICLE

Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis

Marylène Cloitre1,2*, Donn W. Garvert1, Chris R. Brewin3, Richard A. Bryant4 and Andreas Maercker5

1National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; 2Department of Psychiatry and Child and Adolescent Psychiatry, New York University, Langone Medical Center, New York, NY, USA; 3University College London, UK; 4School of Psychology, University of New South Wales, Sydney, New South Wales, Australia; 5Department of Psychopathology and Clinical Intervention, University of Zurich, Switzerland

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.

Method : 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.

Conclusion : 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.

Keywords: Complex PTSD; posttraumatic stress disorder; WHO; ICD-11

*Correspondence to: Marylène Cloitre, National Center for PTSD Dissemination and Training Division VAPAHCS, 795 Willow Road, Menlo Park, CA 94025, USA, Tel: +1-001-650-493-5000 x28353, Email: marylene.cloitre@nyumc.org

For the abstract or full text in other languages, please see Supplementary files under Article Tools online

Received: 25 February 2013; Revised: 5 April 2013; Accepted: 10 April 2013; Published: 15 May 2013

European Journal of Psychotraumatology 2013. © 2013 Marylène Cloitre et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Citation: European Journal of Psychotraumatology 2013, 4: 20706 - http://dx.doi.org/10.3402/ejpt.v4i0.20706

The World Health Organization (WHO) is responsible for developing the International Classification of Diseases, 11th version (ICD-11), which is expected to be completed in 2015. Within the spectrum of stress and trauma disorders, the WHO ICD-11 has proposed two related diagnoses, posttraumatic stress disorder (PTSD) and complex PTSD (Maercker et al. …

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