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Examining the factor structure of ICD-11 posttraumatic stress disorder (PTSD) and complex-PTSD among prison staff exposed to potentially traumatic experiences.

ABSTRACT: The recently released 11th edition of the International Classification of Diseases (ICD-11) classifies posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as distinct, yet related, disorders within the spectrum of trauma and stress-related disorders. This study aimed to explore the construct validity of the International Trauma Questionnaire (ITQ), a measure of ICD-11 PTSD and CPTSD symptoms among prison governors (i.e., wardens in the U.S. and Canada). Trauma-exposed prison governors (N = 409) aged 26 to 82 years (M = 50.04, SD = 7.97) provided their data online anonymously. Confirmatory factor analyses were performed to evaluate the construct validity of ITQ scores. When using the five-point item response scale, our five first-order factor model produced the best fit to the data; however, when using a dichotomous item scale, the first-order two-factor PTSD and disturbances of self-organization (DSO) model produced the best fit to the data. These results indicate that item-coding and estimation methods can significantly impact conclusions about the best-fitting model for this measure among trauma-exposed prison governors.

SUBMITTER: Dhingra K

PROVIDER: S-EPMC8519163 | biostudies-literature | 2021 Sep

REPOSITORIES: biostudies-literature

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Examining the factor structure of ICD-11 posttraumatic stress disorder (PTSD) and complex-PTSD among prison staff exposed to potentially traumatic experiences.

Dhingra Katie K Mitchell Sean M SM Davies Bill B Taylor Peter J PJ

Psychiatry research 20210629

The recently released 11th edition of the International Classification of Diseases (ICD-11) classifies posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as distinct, yet related, disorders within the spectrum of trauma and stress-related disorders. This study aimed to explore the construct validity of the International Trauma Questionnaire (ITQ), a measure of ICD-11 PTSD and CPTSD symptoms among prison governors (i.e., wardens in the U.S. and Canada). Trauma-exposed prison governors ...[more]

PMID: 34247058

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Project description:BackgroundThe 11th edition of the International Classification of Diseases (ICD-11) made a number of significant changes to the diagnostic criteria for post-traumatic stress disorder (PTSD). We sought to determine the prevalence and 3-month predictive values of the new ICD-11 PTSD criteria relative to ICD-10 PTSD, in children and adolescents following a single traumatic event. ICD-11 also introduced a diagnosis of Complex PTSD (CPTSD), proposed to typically result from prolonged, chronic exposure to traumatic experiences, although the CPTSD diagnostic criteria do not require a repeated experience of trauma. We therefore explored whether children and adolescents demonstrate ICD-11 CPTSD features following exposure to a single-incident trauma.MethodData were analysed from a prospective cohort study of youth aged 8-17 years who had attended an emergency department following a single trauma. Assessments of PTSD, CPTSD, depressive and anxiety symptoms were performed at two to four weeks (n = 226) and nine weeks (n = 208) post-trauma, allowing us to calculate and compare the prevalence and predictive value of ICD-10 and ICD-11 PTSD criteria, along with CPTSD. Predictive abilities of different diagnostic thresholds were undertaken using positive/negative predictive values, sensitivity/specificity statistics and logistic regressions.ResultsAt Week 9, 15 participants (7%) were identified as experiencing ICD-11 PTSD, compared to 23 (11%) experiencing ICD-10 PTSD. There was no significant difference in comorbidity rates between ICD-10 and ICD-11 PTSD diagnoses. Ninety per cent of participants with ICD-11 PTSD also met criteria for at least one CPTSD feature. Five participants met full CPTSD criteria.ConclusionsReduced prevalence of PTSD associated with the use of ICD-11 criteria is likely to reduce identification of PTSD relative to using ICD-10 criteria but not relative to DSM-4 and DSM-5 criteria. Diagnosis of CPTSD is likely to be infrequent following single-incident trauma.

Project description:Background: The 11th edition of the International Classification of Diseases (ICD-11) introduces Posttraumatic Stress Disorder (PTSD) and Complex Posttraumatic Stress Disorder (CPTSD) as two distinct trauma-related disorders. Numerous studies support the proposed symptom structure of ICD-11 CPTSD in adults, but only a few studies have examined CPTSD symptom structure in children, reporting diverging results. To assess ICD-11 CPTSD in children, the International Trauma Questionnaire (ITQ) was recently adapted for children and adolescents (ITQ-CA), with no validated German version available yet. Objective: This study aimed (1) to test the symptom structure of ICD-11 CPTSD in a sample of trauma-exposed foster children using the ITQ-CA, and (2) to examine the concurrent, convergent and discriminant validity of the German ITQ-CA. Method: Altogether, 161 Austrian foster children completed a set of standardized measures, resulting in a final sample of 135 trauma-exposed foster children meeting the inclusion criteria. Psychometric properties of the ITQ-CA were assessed using confirmatory factor analysis (CFA), bivariate correlations and multivariate regression. Results: CFA supported ICD-11 CPTSD symptom structure in children as a two-factor higher-order model with PTSD and Disturbances in Self-Organization (DSO) as correlated factors with very good model fit, while a one-factor higher-order model also fitted the data very well. High factor loadings and excellent levels of internal reliability evidenced the psychometric adequacy of the ITQ-CA. Concurrent and convergent validity were evidenced by high correlations between ITQ-CA scales and criterion variables (PTSD symptoms, depression, anxiety, dissociation, lifetime traumatization). Discriminant validity was partly supported by PTSD and DSO being differently predicted by exogenous criterion variables. Conclusions: CPTSD symptom structure in children is in support of the ICD-11 conceptualization. The reliability and validity of the German ITQ-CA are evidenced for the first time, identifying it as an easy-to-use screening instrument to assess ICD-11 PTSD and CPTSD in children. Further implications and areas for upcoming studies are discussed.

Dataset Information

Examining the factor structure of ICD-11 posttraumatic stress disorder (PTSD) and complex-PTSD among prison staff exposed to potentially traumatic experiences.

Publications

Examining the factor structure of ICD-11 posttraumatic stress disorder (PTSD) and complex-PTSD among prison staff exposed to potentially traumatic experiences.

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