Testing the validity of ICD-11 PTSD and CPTSD among refugees in treatment using latent class analysis

Abstract

Introduction: The WHO has proposed posttraumatic stress (PTSD) and Complex PTSD (CPTSD) as trauma-related ‘sibling’ disorders in ICD-11. The proposal has received support from research among clinical and community samples alike but only a few studies have tested the validity of these disorders in a sample of refugees using the International Trauma Questionnaire especially designed for assessment of ICD-11 PTSD and CPTSD. Methods: Latent class analysis was used to test the validity of the ICD-11 PTSD and CPTSD distinction in a heterogeneous group of 284 highly symptomatic refugees registered for treatment at a Danish treatment center. Results: A two-class solution fit the data best. One group reported elevated levels of PTSD-symptoms and symptoms of affective dysregulation, and one group reported elevated levels of symptoms corresponding to CPTSD. The CPTSD group was considerably larger than the PTSD-group. Discussion: The current study supports the ICD-11 distinction between PTSD and CPTSD in a sample of treatment-seeking refugees. The assistance of interpreters was needed for some of the participants which affected the reliability of the assessment. Conclusion: The ICD-11 proposal for PTSD and CPTSD is supported in a heterogenous sample of refugees using the ITQ.