Commentary on the Special Section on Complex PTSD: Still Going Strong After All These Years

Ford, Julián D.

doi:10.1002/jts.22474

Cited by 8 publications

(6 citation statements)

References 25 publications

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“…Clinicians suggested the need for a CPTSD diagnosis following observations that survivors of these kinds of traumatic events tended to develop problems that included but were not limited to classic PTSD symptoms (Courtois & Ford, 2013;Herman, 1992). Consistent with this, research suggests that persistent and repeated interpersonal traumas are associated with CPTSD symptoms over and above other forms of trauma that are more time-limited and/or less interpersonally salient (Cloitre et al, 2009;Ford, 2019;Karatzias et al, 2017).…”

Section: Childhood Trauma and Cptsdmentioning

confidence: 94%

“…CPTSD is an especially severe form of posttraumatic distress that consists of symptoms characteristic of posttraumatic stress disorder (PTSD; hyperarousal, memory intrusions, avoidance of trauma reminders, etc.) combined with impairment in affective, interpersonal, and intrapersonal functioning (Cloitre et al, 2009; Ford, 2019). In contrast to PTSD, which is associated with a variety of traumas (e.g., car accidents, combat, etc.…”

Section: Childhood Trauma and Cptsdmentioning

confidence: 99%

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Relative effects of childhood trauma, intimate partner violence, and other traumatic life events on complex posttraumatic stress disorder symptoms.

Gallagher¹,

Moreland²,

Watters³

et al. 2023

Traumatology

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Complex posttraumatic stress disorder (CPTSD) follows persistent and repeated trauma and is a serious mental health problem among women. One of the strongest predictors of CPTSD symptoms is childhood trauma, especially child abuse and neglect, both of which are traumas that tend to be persistent and repeated. CPTSD is also associated with intimate partner violence (IPV; physical, emotional, and/or sexual violence in an intimate relationship), a trauma that, similar to child abuse and neglect, is also persistent and repeated. However, it is unclear how child abuse/neglect and IPV may jointly influence CPTSD symptoms vis-à-vis other traumatic events. In this study, we examined the relative effects of child abuse/ neglect and IPV on CPTSD symptoms over and above other traumatic events in a sample of women (N = 553) using a partial least squares approach to multiple regression and structural equation modeling. Results indicated that in general childhood trauma was the strongest predictor of CPTSD symptoms. However, when we analyzed specific aspects of child abuse, child neglect, and IPV, we found that childhood emotional abuse was the primary predictor of CPTSD symptoms over and above the effects of other traumatic life events, with sexual and emotional IPV also having small effects. These results highlight the salient effects of childhood emotional trauma on CPTSD symptoms among women, underscoring the importance of assessing for this in women presenting for treatment of CPTSD.

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Section: Childhood Trauma and Cptsdmentioning

confidence: 94%

Section: Childhood Trauma and Cptsdmentioning

confidence: 99%

Relative effects of childhood trauma, intimate partner violence, and other traumatic life events on complex posttraumatic stress disorder symptoms.

Gallagher¹,

Moreland²,

Watters³

et al. 2023

Traumatology

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“…Here, most studies find clear commonalities between CPTSD and BPD (Ford, 2019 ; Frost, Hyland, Shevlin, & Murphy, 2020 ; Frost et al, 2020 ; Giourou et al, 2018 ; Hyland, Karatzias, Shevlin, & Cloitre, 2019 ; Jowett, Karatzias, & Albert, 2020 ; Jowett, Karatzias, Shevlin, & Albert, 2020 ; Saraiya et al, 2021 ; van Dijke, Hopman, & Ford, 2018 ), specifically regarding affective dysregulation, which is attributed to transdiagnostic risk factors. Several of these studies have used latent class analyses (Frost et al, 2020 ; Jowett et al, 2020 ; Saraiya et al, 2021 ), but also extended analyses such as structure equation modelling have been used (Frost et al, 2020 ; Hyland et al, 2019 ; van Dijke et al, 2018 ) to address limitations in factor analytical methods for discriminative purposes, as BPD and CPTSD have conceptual similarities (Achterhof et al, 2019 ; Ford, 2020 ; Hyland et al, 2019 ).…”

Section: Differential Diagnosticsmentioning

confidence: 95%

Complex PTSD: what is the clinical utility of the diagnosis?

Rød

Schmidt

2021

European Journal of Psychotraumatology

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Background The diagnosis of complex posttraumatic stress disorder (CPTSD) was included in the 11th revised edition of the International Classification of Diseases (ICD-11). CPTSD shares trauma-specific symptoms with its sibling disorder PTSD but is additionally characterized by disturbances of the individual’s self-organization (DSO). The clinical utility of the CPTSD diagnosis has yet to be thoroughly investigated. Objective The current study aimed to examine the clinical utility of the CPTSD diagnosis, considering the upcoming implementation of ICD-11 in clinical practice. Method International field studies, construct- and validity analyses leading up to the inclusion in ICD-11 are reviewed, and the diagnostic measures; International Trauma Questionnaire (ITQ) and International Trauma Interview (ITI) are presented. Also, the relationship between CPTSD and borderline personality disorder (BPD) is elaborated in an independent analysis, to clarify their differences in clinical relevance to treatment. Treatment implications for CPTSD are discussed with reference to existing guidelines and clinical needs. Results The validation of ITQ and ITI contributes to the cementation of CPTSD in further clinical practice, providing qualified assessment of the construct, with intended informative value for both clinical communication and facilitation of treatment. CPTSD is found distinguishable from both PTSD and BPD in empirical studies, while the possibility of comorbid BPD/PTSD cases being better described as CPTSD is acknowledged. Practitioners need to employ well-established methods developed for PTSD, while considering additional DSO-symptoms in treatment of CPTSD. Conclusions The inclusion of CPTSD in ICD-11 may potentially facilitate access to more tailored treatment interventions, as well as contribute to increased research focus on disorders specifically associated with stress. The clinical utility value of this additional diagnosis is expected to reveal itself further after ICD-11 is implemented in clinical practice in 2022 and onwards. Yet, CPTSD’s diagnostic inclusion gives future optimism to assessing and treating complex posttraumatic stress symptoms.

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“…The conceptualization of CPTSD was originally proposed by Herman (1992) to describe symptoms of long-term trauma that were associated with difficulties with emotion regulation, self-identity, and interpersonal capacities, among other traumatic reactions (see Ford, 2019). The symptoms included in the ICD-11 CPTSD are based on those endorsed by populations exposed to chronic trauma in investigations of DSM-IV complex PTSD (Ford & Kidd, 1998) and observations by expert clinicians treating complex forms of PTSD (Cloitre et al, 2011).…”

Section: Icd-11 Ptsd and Cptsdmentioning

confidence: 99%

Factor structure of the international trauma questionnaire in trauma exposed LGBTQ+ adults: Role of cumulative traumatic events and minority stress heterosexist experiences.

Charak¹,

Cano-Gonzalez²,

Ronzón-Tirado³

et al. 2023

Psychological Trauma: Theory, Research, Practice, and Policy

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Exposure to prolonged and/or multiple types of psychological trauma and stressors has been shown to be more strongly associated with ICD-11 complex posttraumatic stress disorder (CPTSD) than posttraumatic stress disorder (PTSD). Lesbian, gay, bisexual, trans-and queer adults (LGBTQ+) are at a heightened risk of exposure to traumatic events, and minority stressors including harassment, discrimination, rejection by family, and isolation. Objective: To examine the factor structure of the international trauma questionnaire (ITQ), a self-report measure of PTSD and CPTSD, and the associations of cumulative lifetime trauma exposure assessed via the life events checklist and minority stress assessed via the daily heterosexist experiences scale, with CPTSD (three PTSD symptom clusters, three clusters reflecting disturbances in self-organization [DSO]) among LGBTQ+ adults. Method: Participants comprised 225 LGBTQ+ adults (including 74 transgender and gender diverse individuals; age range: 18-60 years; M/SD = 31.35/9.48) residing in Spain. Results: Confirmatory factor analyses indicated that both a first-order six-factor model and a hierarchical two-factor model, comprising PTSD and DSO as second-order factors, fit the data best. Cumulative traumatic events score was associated with PTSD, and cumulative minority stress was associated with PTSD and DSO. Among the minority stress subscales, harassment based on gender expression was positively associated with all symptom clusters of PTSD and DSO. Conclusion: This is the first study to examine the role of minority stressors alongside exposure to psychological traumas in ICD-11 PTSD and CPTSD and emphasizes the inclusion of minority stressors in trauma-related assessments. Clinical Impact StatementThe present study findings validated the structure of CPTSD comprising PTSD and DSO, using the ITQ in LGBTQ+ adults from Spain. Findings further suggested that exposure to cumulative minority stressors (i.e., heterosexism/cissexism) was positively associated with the PTSD and DSO clusters of complex PTSD emphasizing the importance of inclusion of minority stressors in clinical assessments and traumafocused treatments. Ruby Charakhttps://orcid.org/0000-0002-5806-6884 Ruby Charak served as lead for conceptualization, investigation, methodology, project administration, resources, software, validation and writingoriginal draft and contributed equally to formal analysis. Ines Cano-Gonzalez served as lead for formal analysis and served in a supporting role for data curation, methodology, project administration and writing-review and editing. Roman Ronzón-Tirado served in a supporting role for writing-review and editing. Julian D. Ford served in a supporting role for writing-review and editing. Brianna M. Byllesby served in a supporting role for writing-review and editing. Mark Shevlin served in a supporting role for writing-review and editing. Thanos Karatzias served in a supporting role for writing-review and editing. Philip Hyland served in a supporting role for conceptualization, investig...

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Commentary on the Special Section on Complex PTSD: Still Going Strong After All These Years

Cited by 8 publications

References 25 publications

Relative effects of childhood trauma, intimate partner violence, and other traumatic life events on complex posttraumatic stress disorder symptoms.

Relative effects of childhood trauma, intimate partner violence, and other traumatic life events on complex posttraumatic stress disorder symptoms.

Complex PTSD: what is the clinical utility of the diagnosis?

Factor structure of the international trauma questionnaire in trauma exposed LGBTQ+ adults: Role of cumulative traumatic events and minority stress heterosexist experiences.

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