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Variation in post-traumatic response: the role of trauma type in predicting ICD-11 PTSD and CPTSD symptoms

  • Philip HylandEmail author
  • Jamie Murphy
  • Mark Shevlin
  • Frédérique Vallières
  • Eoin McElroy
  • Ask Elklit
  • Mogens Christoffersen
  • Marylène Cloitre
Original Paper

Abstract

Purpose

The World Health Organization’s 11th revision to the International Classification of Diseases manual (ICD-11) will differentiate between two stress-related disorders: PTSD and Complex PTSD (CPTSD). ICD-11 proposals suggest that trauma exposure which is prolonged and/or repeated, or consists of multiple forms, that also occurs under circumstances where escape from the trauma is difficult or impossible (e.g., childhood abuse) will confer greater risk for CPTSD as compared to PTSD. The primary objective of the current study was to provide an empirical assessment of this proposal.

Methods

A stratified, random probability sample of a Danish birth cohort (aged 24) was interviewed by the Danish National Centre for Social Research (N = 2980) in 2008–2009. Data from this interview were used to generate an ICD-11 symptom-based classification of PTSD and CPTSD.

Results

The majority of the sample (87.1%) experienced at least one of eight traumatic events spanning childhood and early adulthood. There was some indication that being female increased the risk for both PTSD and CPTSD classification. Multinomial logistic regression results found that childhood sexual abuse (OR = 4.98) and unemployment status (OR = 4.20) significantly increased risk of CPTSD classification as compared to PTSD. A dose–response relationship was observed between exposure to multiple forms of childhood interpersonal trauma and risk of CPTSD classification, as compared to PTSD.

Conclusions

Results provide empirical support for the ICD-11 proposals that childhood interpersonal traumatic exposure increases risk of CPTSD symptom development.

Keywords

Posttraumatic stress disorder (PTSD) Complex-PTSD (CPTSD) ICD-11 Childhood trauma Childhood sexual abuse 

Notes

Compliance with ethical standards

Conflict of interest

Marylène Cloitre participated as a member of the World Health Organization Working Group on the Classification of Disorders Specifically Associated with Stress, reporting to the International Advisory Group for the Revision of ICD-10 Mental and Behavioural Disorders. However, the views expressed reflect the opinions of the author and not necessarily the Working Group or Advisory Group and the content of this article does not represent WHO policy. No conflict of interest associated with other authors.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.School of BusinessNational College of IrelandDublin 1Ireland
  2. 2.Centre for Global Health, School of PsychologyTrinity College DublinDublin 2Ireland
  3. 3.Psychology Research Institute, School of PsychologyUlster UniversityLondonderryIreland
  4. 4.National Centre for Psychotraumatology, Institute for PsychologyUniversity of Southern DenmarkOdense MDenmark
  5. 5.The Danish National Centre for Social ResearchCopenhagenDenmark
  6. 6.National Centre for PTSD Division of Dissemination and Training, Department of Psychiatry and Behavioural SciencesStanford UniversityStanfordUSA
  7. 7.Department of Psychiatry and Behavioral ScienceStanford UniversityPalo AltoUSA

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