Evidence of symptom profiles consistent with posttraumatic stress disorder and complex posttraumatic stress disorder in different trauma samples

The International Classification of Diseases, 11th version (ICD-11), proposes two related stress and trauma-related disorders, posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). A diagnosis of CPTSD requires that in addition to the PTSD symptoms, an individual must also endorse symptoms in three major domains: (1) affective dysregulation, (2) negative self-concepts, and (3) interpersonal problems. This study aimed to determine if the naturally occurring distribution of symptoms in three groups of traumatised individuals (bereavement, sexual victimisation, and physical assault) were consistent with the ICD-11, PTSD, and CPTSD specification. The study also investigated whether these groups differed on a range of other psychological problems. Participants completed self-report measures of each symptom group and latent class analyses consistently found that a three class solution was best. The classes were “PTSD only,” “CPTSD,” and “low PTSD/CPTSD.” These classes differed significantly on measures of depression, anxiety, dissociation, sleep disturbances, somatisation, interpersonal sensitivity, and aggression. The “CPTSD” class in the three samples scored highest on all the variables, with the “PTSD only” class scoring lower and the “low PTSD/CPTSD” class the lowest. This study provides evidence to support the diagnostic structure of CPTSD and indicted that CPTSD is associated with a broad range of other psychological problems.

《国际疾病分类第11版》（International Classification of Diseases, 11th version, ICD-11）提出了两种关联的应激相关与创伤相关障碍：创伤后应激障碍（posttraumatic stress disorder, PTSD）以及复杂性创伤后应激障碍（complex PTSD, CPTSD）。复杂性创伤后应激障碍的诊断标准要求，除创伤后应激障碍症状外，个体还需存在三大核心症状域：(1) 情感失调（affective dysregulation），(2) 消极自我认知（negative self-concepts），以及(3) 人际问题（interpersonal problems）。本研究旨在明确三类创伤人群（丧亲、性侵害与躯体攻击受害者）的症状自然分布是否符合《国际疾病分类第11版》中创伤后应激障碍与复杂性创伤后应激障碍的诊断标准框架。本研究同时探究了这三类人群在一系列其他心理问题上的差异。受试者完成了各症状域的自评量表，潜在类别分析（latent class analysis）一致显示，三类别模型为最优拟合方案。所得类别分别为"仅创伤后应激障碍组"、"复杂性创伤后应激障碍组"以及"低症状创伤后应激障碍/复杂性创伤后应激障碍组"。三类别在抑郁、焦虑、解离（dissociation）、睡眠障碍、躯体化（somatisation）、人际敏感（interpersonal sensitivity）以及攻击性（aggression）等量表得分上均存在显著差异。在三个研究样本中，"复杂性创伤后应激障碍组"在所有观测变量上的得分均最高，"仅创伤后应激障碍组"得分次之，"低症状创伤后应激障碍/复杂性创伤后应激障碍组"得分最低。本研究为复杂性创伤后应激障碍的诊断结构提供了实证支持，并表明该障碍与广泛的其他心理问题存在关联。