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ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) in treatment seeking veterans: risk factors and comorbidity

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

Emerging evidence suggests that ICD-11 CPTSD is a more common condition than PTSD in treatment seeking samples although no study has explored risk factors and comorbidities of PTSD and CPTSD in veteran populations. In this study, risk factors and comorbidity between veterans meeting criteria for PTSD or CPTSD using the ICD-11 International Trauma Questionnaire (ITQ) were explored.

Methods

A sample of help-seeking veterans who had been diagnosed with a mental health difficulty (n = 177) was recruited. Participants completed a range of mental health and functioning measures. Multinomial logistic regression analysis was conducted to explore differences in the above factors between participants meeting case criteria for PTSD, CPTSD or another mental health disorder.

Results

Those with CPTSD appeared to have taken longer to seek help, reported higher rates of childhood adversity and more experiences of emotional or physical bullying during their military careers. Further, participants with CPTSD reported a greater burden of comorbid mental health difficulties including high levels of dissociation, anger, difficulties related to moral injury and common mental health difficulties and greater degree of impairment including social isolation, sleep difficulties and impaired functioning.

Conclusions

Considering that CPTSD is a more debilitating condition than PTSD, there is now an urgent need to test the effectiveness of new and existing interventions in veterans with CPTSD.

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Acknowledgements

We would like to thank the participants who took part in this study and Combat Stress staff who supported data collection.

Funding

This study was funded by a grant award by the Forces in Mind Trust.

Author information

Authors and Affiliations

  1. Combat Stress, Research Department, Tyrwhitt House, Oaklawn Rd, Leatherhead, KT22 0BX, UK

    Dominic Murphy & Walter Busuttil

  2. King’s Centre for Military Health Research, King’s College London, London, UK

    Dominic Murphy & Neil Greenberg

  3. School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK

    Thanos Karatzias

  4. NHS Lothian Rivers Centre for Traumatic Stress, Edinburgh, UK

    Thanos Karatzias

  5. School of Psychology, Ulster University, Derry, NI, UK

    Mark Shevlin

Authors
  1. Dominic Murphy
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  2. Thanos Karatzias
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  4. Neil Greenberg
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  5. Mark Shevlin
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Contributions

All authors made substantial contributions to the design of this research project, drafting and editing the manuscript, approving the final version and agreeing to the integrity of the work presented. DM was responsible for producing the first draft of the manuscript and MS for conducting the statistical analysis.

Corresponding author

Correspondence to Dominic Murphy.

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Murphy, D., Karatzias, T., Busuttil, W. et al. ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) in treatment seeking veterans: risk factors and comorbidity. Soc Psychiatry Psychiatr Epidemiol 56, 1289–1298 (2021). https://doi.org/10.1007/s00127-021-02028-6

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  • DOI: https://doi.org/10.1007/s00127-021-02028-6

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