ICD-11 PTSD and CPTSD: Implications for the rehabilitation of survivors of torture seeking international protection

Abstract

Introduction: Rates of torture are especially high among those seeking asylum, with global estimates of forced migrants having experienced torture exceeding 50%. Torture is the strongest predictor of PTSD amongst refugee populations. This study assesses the construct validity of the International Trauma Questionnaire (ITQ), a self-report measure of ICD-11 PTSD and Complex PTSD (CPTSD) symptoms, within a population of torture survivors seeking asylum in Ireland. It further explores whether probable rates of PTSD and CPTSD differ by sex and torture or serious harm status. Methods: A secondary data analysis of 264 treatment-seeking asylum seekers and refugees who experienced torture or serious harm was conducted. Findings: A confirmatory factor analysis found that a six-factor correlated model consisting of re-experiencing (Re), avoidance (Av), threat (Th), affective dysregulation (AD), negative self-concept (NSC), and disturbed relationships (DR) provided optimal fit to the sample data. 32.4% of participants were diagnosed with PTSD and a further 36.9% met criteria for CPTSD. Experiencing torture was significantly associated with higher odds of meeting criteria for PTSD. No significant differences between the sexes were found for rates of PTSD or CPTSD. Discussion: Support for the construct validity of the ITQ was found among torture survivors actively seeking international protection in Europe. Given the high rates of PTSD and CPTSD found among torture survivors, rehabilitation centres for survivors of torture should consider CPTSD as part of their assessment and treatment programmes.