A validation study of the International Trauma Questionnaire to assess post-traumatic stress disorder in treatment-seeking veterans

Murphy, Dominic; Shevlin, Mark; Pearson, Emily; Greenberg, Neil; Wessely, Simon; Busuttil, Walter; Karatzias, Thanos

doi:10.1192/bjp.2020.9

Cited by 62 publications

(61 citation statements)

References 27 publications

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“…Previous studies (Ho et al, 2020;Karatzias et al, 2017;Murphy et al, 2020; have shown that the latent structure of the ITQ is best represented by two models: a) A correlated six-factor model distinguishing between clusters of symptoms and b) a two-factor second-order model where the correlations between symptom clusters are explained by two second-order factors reflecting PTSD and DSO. Results from previous studies suggest that the second-order model has a better fit in clinical and highly trauma-exposed samples in studies that have used the ITQ (Cloitre et al, 2018;Karatzias et al, 2017;Møller et al, 2019;Vallières et al, 2018), and in studies using other measures for the PTSD and DSO constructs Nickerson et al, 2016;Tay, Rees, Chen, Kareth, & Silove, 2015), whereas the first-order model has displayed a better fit in general population and non-clinical samples studies using the ITQ (Ben-Ezra et al, 2018;Ho et al, 2020;Shevlin et al, 2017).…”

Section: Internal Structurementioning

confidence: 99%

“…The ITQ includes six items to assess symptoms of PTSD and six items that assess symptoms of DSO and additional items assessing functional impairment related to PTSD and DSO separately. The ITQ is the only existing self-report measure that enables assessment of both ICD-11 PTSD and DSO (Cloitre et al, 2018) and has been validated internationally with studies conducted in Europe (Karatzias et al, 2017;Murphy et al, 2020), the Middle East (Gilbar, Hyland, Cloitre, & Dekel, 2018;Vallières et al, 2018), Asia (Ho et al, 2020;Mordeno, Nalipay, & Mordeno, 2019), Africa (Owczarek et al, 2019), and North America (Cloitre et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

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Validation of ICD-11 PTSD and DSO using the International Trauma Questionnaire in five clinical samples recruited in Denmark

Vang

Dokkedahl

Løkkegaard

et al. 2021

European Journal of Psychotraumatology

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Background:The 11 th version of the International Classification of Diseases (ICD-11) revised the diagnosis of Posttraumatic Stress Disorder (PTSD) and introduced Complex PTSD as a sibling disorder to PTSD. As the Danish Health Authorities will implement the ICD-11 in 2022, it is more relevant than ever to introduce a measure that enables the identification of ICD-11 PTSD and CPTSD. Objective: The primary aim of the present study was to test the construct validity of the ICD-11 conceptualization of PTSD and DSO in five clinical samples using translated versions of the International Trauma Questionnaire (ITQ). Method: Data from existing studies of adult survivors of sexual abuse (n = 385), women in shelters (n = 147), psychiatric outpatients endorsing an ICD-10 diagnosis of PTSD (n = 111), a heterogenous sample of psychiatric outpatients (n = 178) and refugees and torture survivors (n = 385) was used for the current study. Confirmatory factor analyses were conducted to test the internal structure of the ITQ, and regression models were conducted to test the convergent and discriminant validity of the factor solutions for each sample. Results: Findings supported the ICD-11 formulation of PTSD and disorders in selforganization (DSO) as a representation of the latent structure of the ITQ across five Danish clinical samples. Uniquely for women in shelters, however, the model displayed an unacceptable fit. A revised operationalization of re-experiencing proved a better fit when 'recurrent nightmares' was exchanged with symptoms of intense emotional reactions to reminders of the trauma for women in shelter as well as ICD-10 PTSD psychiatric outpatients. Conclusion:This study supports the use of a Danish translated version of the ITQ to assess symptoms of ICD-11 PTSD and DSO for the introduction of ICD-11 in 2022. Future research is needed to further explore the operationalization of re-experiencing across different trauma exposed populations. Validación del tept y DSO de la CIE-11 usando el cuestionario internacional de trauma en cinco muestras clínicas reclutadas en DinamarcaAntecedentes: La décimo primera versión de la Clasificación Internacional de Enfermedades (CIE-11) revisó el diagnóstico de Trastorno de Estrés Postraumático (CIE-11) e introdujo el TEPT complejo como un diagnóstico hermano del TEPT. Como las autoridades de salud danesas implementarán la CIE-11 en el 2022, es más relevante que nunca introducir una medición que permita la identificación del TEPT y el TEPT complejo de acuerdo a la CIE-11. Objetivo: El principal objetivo del presente estudio fue probar la validez del constructo diagnóstico de la conceptualización del TEPT y de las Alteraciones en la Auto-Organización (DSO por sus siglas en inglés) en cinco muestras clínicas usando versiones traducidas del Cuestionario Internacional de Trauma (ITQ por sus siglas en inglés). Método: Se usaron para el presente estudio, datos de estudios ya existentes de sobrevivientes adultos de abuso sexual (n = 147), pacientes psiquiátricos ambulatorios con diagnóstico ...

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Section: Internal Structurementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Validation of ICD-11 PTSD and DSO using the International Trauma Questionnaire in five clinical samples recruited in Denmark

Vang

Dokkedahl

Løkkegaard

et al. 2021

European Journal of Psychotraumatology

View full text Add to dashboard Cite

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“…To our knowledge, one study has examined CPTSD with treatment-seeking military service members or veterans. Focusing on 177 veterans from the United Kingdom (UK) who pursued mental health treatment in the recent past, Murphy et al (2020b) (2020a) documented veterans with probable CPTSD had higher overall scores than those with or without PTSD. In combination, findings indicate CPTSD might be more prevalent than PTSD among treatment-seeking veterans and MI-related problems could be particularly relevant among veterans with complex emotional responses to their traumas that warrant a diagnosis of CPTSD.…”

Section: Clinical Impact Statementmentioning

confidence: 99%

Moral injury and ICD-11 complex PTSD (CPTSD) symptoms among treatment-seeking veterans in the United Kingdom.

Currier¹,

Foster²,

Karatzias³

et al. 2021

Psychological Trauma: Theory, Research, Practice, and Policy

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Military veterans often encounter events with chronic or repeated traumas of an interpersonal nature that might lead to emotional, relational, and spiritual suffering. Research is needed to assess whether and/or how emerging conceptions of moral injury (MI) align with existing trauma-related conditions. Focusing on 173 veterans from the United Kingdom who had recently pursued mental health treatment, we examined associations between self-and other-directed outcomes related to MI and World Health Organization International Classifcation System for Diseases, 11 th version (ICD-11) criteria for posttraumatic stress disorder (PTSD) and Complex PTSD (CPTSD) in two ways. First, drawing on psychometrically validated tools for assessing MI (Currier et al., 2017) and PTSD/CPTSD (Cloitre et al., 2018), ANOVAs revealed the 57.2% of veterans in the sample who possibly met criteria for CPTSD reported greater MI related to both perpetration-and betrayal-based events compared to those with and without possible PTSD.

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“…Although the validity of CPTSD as a clinical syndrome has been questioned (Herman, 2012;Resick et al, 2012), primarily owing to overlapping symptomology with other trauma-related disorders (Wolf et al, 2015), there is now a significant body of literature that supports the hierarchical structure presented in the ICD-11. This includes a notable systematic review (Brewin et al, 2017) and a variety of validation studies: latent class analyses (Barbieri et al, 2019;Ho et al, 2020;Hyland et al, 2018;Jowett, Karatzias, Shevlin, & Albert, 2019;Karatzias et al, 2017), confirmatory factor analyses Karatzias et al, 2016;Kazlauskas, Gegieckaite, Hyland, Zelviene, & Cloitre, 2018;Murphy et al, 2020;Owczarek et al, 2020), and network analyses (Gilbar, 2020;Knefel et al, 2019Knefel et al, , 2020Knefel, Tran, & Lueger-Schuster, 2016;McElroy et al, 2019). These studies have used the only standardized self-report measure for symptoms of ICD-11 PTSD and CPTSD, the International Trauma Questionnaire (ITQ; Cloitre et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Evidence of distinct profiles of ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD in a South African sample

Rink

Lipinska

2020

European Journal of Psychotraumatology

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Background: Both post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD) have been included in the 11th edition of the International Classification of Diseases (ICD-11). Although the validity of CPTSD has been controversial, a growing number of studies support the distinction between PTSD and CPTSD. However, the majority of this research has originated in high-income countries (HICs), whereas the prevalence of trauma experience associated with PTSD/CPTSD diagnosis is significantly higher in low- and middle-income countries (LMICs). Objective: This study assessed whether a sample from an LMIC setting produced distinct classes that reflect ICD-11 criteria for PTSD and CPTSD. Furthermore, this study investigated whether childhood trauma distinguished between PTSD and CPTSD. Method: International Trauma Questionnaire responses from a sample of South African university undergraduates were used as indicator variables in a latent class analysis (LCA). Chi-squared tests of independence and Kruskal–Wallis H tests were used to assess between-class differences. Results: The LCA identified four distinct classes: a PTSD class with elevated symptoms of PTSD, but low endorsement of disturbances in self-organization (DSO; symptoms that are specific to CPTSD); a CPTSD class with elevated symptoms of PTSD and DSO; a DSO class with low symptoms of PTSD, but elevated symptoms of DSO; and a Low class with low endorsements on all symptoms. Regarding childhood trauma, participants in the CPTSD class had more severe childhood abuse and neglect, specifically emotional abuse and neglect, than participants in the PTSD class. Conclusions: Findings were consistent with the distinction between PTSD and CPTSD symptom profiles in the ICD-11. Our findings support a similar qualitative distinction between PTSD and CPTSD in our LMIC context, as previously reported in HICs. This distinction is especially relevant in LMICs because of the significant number of individuals vulnerable to these disorders.

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A validation study of the International Trauma Questionnaire to assess post-traumatic stress disorder in treatment-seeking veterans

Cited by 62 publications

References 27 publications

Validation of ICD-11 PTSD and DSO using the International Trauma Questionnaire in five clinical samples recruited in Denmark

Validation of ICD-11 PTSD and DSO using the International Trauma Questionnaire in five clinical samples recruited in Denmark

Moral injury and ICD-11 complex PTSD (CPTSD) symptoms among treatment-seeking veterans in the United Kingdom.

Evidence of distinct profiles of ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD in a South African sample

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