The first instrument for complex PTSD assessment: psychometric properties of the ICD-11 Trauma Questionnaire

Rocha, José Carlos; Rodrigues, Verónica; Santos, Emanuel; Azevedo, Inês; Machado, Sónia; Almeida, Vera; Silva, Celina; Almeida, Jacqueline; Cloitre, Marylène

doi:10.1590/1516-4446-2018-0272

Cited by 14 publications

(13 citation statements)

References 6 publications

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“…According to ICD-11 diagnostic guidelines, a person may receive a possible diagnosis for PTSD or cPTSD, but not both. For both scales, reliability was good with α = 0.84 for the PTSD scale and α = 0.88 for the cPTSD scale ( 53 ). The German version has been validated in a representative population-based sample and can be used for research and clinical practice ( 54 ).…”

Section: Methodsmentioning

confidence: 99%

Epistemic trust and personality functioning mediate the association between adverse childhood experiences and posttraumatic stress disorder and complex posttraumatic stress disorder in adulthood

et al. 2022

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BackgroundAdverse childhood experiences (ACEs) are associated with posttraumatic and complex posttraumatic stress disorder symptoms in adulthood (PTSD/cPTSD), as well as reduced epistemic trust (trust in the authenticity and personal relevance of interpersonally transmitted information) and impaired personality functioning. The present work aims to investigate the predictive value of epistemic trust—the capacity for social learning—on the mediating effect of personality functioning in the association of ACEs and PTSD/cPTSD.MethodsWe conducted structural equation modeling (SEM) based on representative data of the German population (N = 2,004). Personality functioning (OPD-SQS) was applied as a mediator between ACEs and PTSD/cPTSD (ITQ), while epistemic trust (ETMCQ) was added as predictor for OPD-SQS. TLI, CFI, and RMSEA (95%-CI) determined the models’ fit.ResultsN = 477 (23.8%) participants reported at least one ACE and n = 218 (10.9%) reported ≥4 ACEs. Fit indices were good for both PTSD (TLI = 0.96; CFI = 0.99; RMSEA = 0.06; 95%CI: 0.041–0.078) and cPTSD (TLI = 0.96; CFI = 0.99; RMSEA = 0.06; 95%CI: 0.043–0.081). ACEs were significantly associated with cPTSD (β = 0.44, p < 0.001) and PTSD (β = 0.29, p < 0.001), explaining 20 and 8% of its variance. Adding personality functioning as a mediator increased the explained variance of cPTSD and PTSD to 47 and 19% while the direct association between ACEs and cPTSD/PTSD decreased (β = 0.21/β = 0.17), thus, indicating a partial mediation. Including epistemic trust substantially increased the explained variance for personality functioning (41%) compared to ACEs as a single predictor (16%).ConclusionWe add to previous research emphasizing the association between ACEs and PTSD/cPTSD symptoms. Offering insights on underlying mechanisms, we show that epistemic trust and personality functioning are relevant mediators. Since both are modifiable by psychotherapy, knowledge about the role of these constructs can inform research on psychotherapeutic interventions and prevention.

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Section: Methodsmentioning

confidence: 99%

Epistemic trust and personality functioning mediate the association between adverse childhood experiences and posttraumatic stress disorder and complex posttraumatic stress disorder in adulthood

et al. 2022

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“…Karatzias et al ( 2016 ) found weak factor loadings (< .60) for seven out of nine items on the affect dysregulation scale. Hyland et al ( 2017 ) report higher factor loadings, > .70 for six out of nine items, whereas Rocha et al ( 2019 ) propose that affect dysregulation should be split into three different factors. The samples in the above studies vary in the extent and type of traumatic experiences.…”

Section: Discussionmentioning

confidence: 99%

Psychometric properties of the International Trauma Questionnaire (ITQ) examined in a Norwegian trauma-exposed clinical sample

Sele

Hoffart

Bækkelund

et al. 2020

European Journal of Psychotraumatology

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Background: The International Trauma Questionnaire (ITQ) is a self-report measure for posttraumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD), corresponding to the diagnostic criteria in the International Classification of Diseases, 11th Revision (ICD-11). A 12-item version of the ITQ based on samples from English-speaking countries has been presented, and the wider generalizability to other languages needs to be examined. Objective: The current study examines the psychometric properties of scores from a longer, preliminary 22-item version of the ITQ and the current reduced 12-item version by means of generalizability theory (G-theory) and confirmatory factor analysis (CFA). Method: The 22-item version of the ITQ was translated into Norwegian and administered to patients in two trauma treatment trials (total N = 202). A generalizability study was used to investigate the psychometric properties of scores reflecting CPTSD. G-theory was also used to investigate alternative measurement designs to optimize the sufficient number of items that provide acceptable generalizability and dependability of scores. Model fit to the theoretical factor structure was then examined by CFA, both for the 22-item version and for the 12-item version of the ITQ. Results: The two subscales negative self-concept and relational disturbances had acceptable generalizability coefficients. We found substantial measurement error related to affective dysregulation, mainly attributable to affective hyperactivation. A latent factor structure model with two separate affective dysregulation factors: hyperactivation and deactivation, represented the data well in the 22-item version. The proposed confirmatory structure model for the 12-item short form did not converge in the CFA. Conclusion: This study supports the applicability of the ITQ in a non-English-speaking country and provides support for the validity of the Norwegian translation. Further research is needed to improve the psychometric properties of the affective dysregulation subscale.

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“…However, most of this research has been restricted to high-income countries (HICs), whereas significantly fewer studies have analysed samples from low- and middle-income countries (LMICs); e.g. Uganda (Dokkedahl, Ovuga, & Elklit, 2015 ; Murphy, Elklit, Dokkedahl, & Shevlin, 2016 , 2018 ); Angola (Rocha et al, 2019 ); Ghana, Kenya, and Nigeria (Ben-Ezra et al, 2020 ; Owczarek et al, 2020 ); Ukraine (McElroy et al, 2019 ; Shevlin et al, 2018 ); and Lebanon (Hyland et al, 2018 ; Vallières et al, 2018 ). Further research in LMICs is therefore necessary to determine whether ICD-11 criteria for PTSD and CPTSD are internationally relevant.…”

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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The first instrument for complex PTSD assessment: psychometric properties of the ICD-11 Trauma Questionnaire

Cited by 14 publications

References 6 publications

Epistemic trust and personality functioning mediate the association between adverse childhood experiences and posttraumatic stress disorder and complex posttraumatic stress disorder in adulthood

Epistemic trust and personality functioning mediate the association between adverse childhood experiences and posttraumatic stress disorder and complex posttraumatic stress disorder in adulthood

Psychometric properties of the International Trauma Questionnaire (ITQ) examined in a Norwegian trauma-exposed clinical sample

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

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