Exploring complex-PTSD comorbidity in trauma-exposed Northern Ireland veterans

Abstract

Background Complex posttraumatic stress disorder (CPTSD) describes the results of complex, prolonged, and/or inescapable trauma, and is typified by avoidance, re-experiencing, sense of threat, affect dysregulation, negative self-concept, and interpersonal disturbances. Additionally, CPTSD is highly comorbid with other common psychopathologies. Objectives A study was conducted in a trauma-exposed UK Armed Forces Veteran population resident in Northern Ireland ( N = 638, NI) to determine the prevalence of CPTSD and comorbid associations. Methods Data from the Northern Ireland Veterans Health and Wellbeing Study (NIVHWS), including self-report data describing traumatic stress, depression, anxiety, and suicidality, were used in a latent class analysis to identify distinct profiles of symptomology in the sample, and in a multinomial logistic regression to identify comorbidities associated with class membership. Results Three distinct classes emerged: a low endorsement ‘baseline’ class (36%), a ‘Moderate Symptomatic’ class (27%), and a high endorsement ‘Probable CPTSD’ class (37%). Both the Moderate Symptomatic and CPTSD classes were predicted by cumulative trauma exposure. Depression was highly comorbid ( OR = .06 in CPTSD), as was anxiety ( OR = .05 in CPTSD) and suicidal ideation ( OR = .32 in CPTSD), with suicidal attempt associated with the CPTSD class ( OR = .51). Conclusions Cases of probable CPTSD were more prevalent than cases of probable posttraumatic stress disorder (PTSD) without Difficulties in Self-Organisation (DSO) symptoms in a UK Armed Forces veteran sample, were associated with repeated/cumulative trauma, and were highly comorbid across a range of psychopathologies. Findings validate previous literature on CPTSD and indicate considerable distress and thus need for support in UK Armed Forces veterans resident in NI.

Caseness and comorbidity of probable (complex) post-traumatic stress disorder and depression in survivors of genocide against Tutsi in Rwanda: the role of social determinants

“…Previous studies have already shown that PTSD and CPTSD occur as responses to traumatic life events and that their prevalence was high both in the general population and in clinical samples (e.g., Maercker et al, 2022;Spikol et al, 2022). In addition, it has been shown by different studies that approximately half of the individuals affected by PTSD and CPTSD are also diagnosed with a depressive disorder (Flory & Yehuda, 2015;Karatzias et al, 2019).…”

“…Existing literature indicates that PTSD and CPTSD are usually comorbid with depression (e.g., Flory & Yehuda, 2015; Spikol et al, 2022). While there are studies that have shown high prevalence rates of PTSD and depression among genocide survivors (e.g., Kayiteshonga et al, 2022; Mutuyimana et al, 2021), these studies have not assessed the rate of comorbidity.…”

Anxiety, distress tolerance, and the relationship between complex posttraumatic stress disorder symptoms and alcohol use in veterans

“…The ITQ is also a useful tool for tracking clinically significant treatment‐related changes (Bongaerts et al, 2022; Cloitre et al, 2021) among the general population. Spikol et al (2022) reported that veterans experiencing CPTSD were also likely to have histories of repeated/cumulative trauma and report a range of associated psychopathologies. An assessment of the relative mediational roles played by risk factors and cognitive‐emotional mechanisms in the relation between ITQ‐assessed CPTSD and AUD is therefore warranted (Karatzias & Cloitre, 2019).…”

Reconsolidation of Traumatic Memories Protocol compared to Trauma Focussed Cognitive Behaviour Therapy for posttraumatic stress disorder in UK military veterans: a randomised controlled feasibility trial

“…A recent study showed that around 37% of Northern Irish veterans (n = 1,267) met criteria for PTSD [8] which is substantially higher than a general UK population prevalence rate of PTSD of 5% in any previous 12 months [9]. Furthermore, the relatively new diagnostic entity of Complex PTSD (CPTSD), characterised by a high symptom burden, appears particularly common amongst military veterans with studies showing that up to 80% of help-seeking veterans with PTSD also have CPTSD [9,10]. This suggests that veterans with PTSD are a population vulnerable to severe mental ill health and poor quality of life.…”