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Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder in DSM‐5 and ICD‐11 : Clinical and Behavioral Correlates
Open accessAbstract
The American Psychiatric Association and the World Health Organization provide distinct trauma‐based diagnoses in the fifth edition of the Diagnostic and Statistical Manual ( DSM‐5 ), and the forthcoming 11th version of the International Classification of Diseases ( ICD‐11 ), respectively. The DSM‐5 conceptualizes posttraumatic stress disorder (PTSD) as a single, broad diagnosis, whereas the ICD‐11 proposes two “sibling” disorders: PTSD and complex PTSD (CPTSD). The objectives of the current study were to: (a) compare prevalence rates of PTSD/CPTSD based on each diagnostic system; (b) identify clinical and behavioral variables that distinguish ICD‐11 CPTSD and PTSD diagnoses; and (c) examine the diagnostic associations for ICD‐11 CPTSD and DSM‐5 PTSD. Participants in a predominately female clinical sample ( N = 106) completed self‐report scales to measure ICD‐11 PTSD and CPTSD, DSM‐5 PTSD, and depression, anxiety, borderline personality disorder, dissociation, destructive behaviors, and suicidal ideation and self‐harm. Significantly more people were diagnosed with PTSD according to the DSM‐5 criteria (90.4%) compared to those diagnosed with PTSD and CPTSD according to the ICD‐11 guidelines (79.8%). An ICD‐11 CPTSD diagnosis was distinguished from an ICD‐11 PTSD diagnosis by higher levels of dissociation ( d = 1.01), depression ( d = 0.63), and borderline personality disorder ( d = 0.55). Diagnostic associations with depression, anxiety, and suicidal ideation and self‐harm were higher for ICD‐11 CPTSD compared to DSM‐5 PTSD (by 10.7%, 4.0%, and 7.0%, respectively). These results have implications for differential diagnosis and for the development of targeted treatments for CPTSD.
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“Chronic and cumulative exposure to multiple types of interpersonal trauma, especially in formative developmental periods in childhood but also including in adulthood [35], has repeatedly been shown to have an incremental dose-response relationship to cPTSD [6, 12, 18, 20, 51, 52, 54, 75, 77, 87, 122, 155].”
From Complex PTSD and borderline personality disorder (2021) · cites this paper as [77]
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“This is acknowledged in the ICD 11 concept of complex PTSD (29), re fl ecting more enduring disturbance of personality functioning (affect regulation, self-concept, and relationships) (30).”
Metadata
- Authors
- Hyland, P., Shevlin, M., Fyvie, C., & Karatzias, T.
- Affiliations
- National College of Ireland (IE)
- University of Ulster (GB)
- NHS Lothian (GB)
- Corresponding author
- Hyland, Philip
- Venue
- Journal of Traumatic Stress
- Publisher
- Wiley
- Published
- 2018-03-25
- Volume
- 31
- Issue
- 2
- Pages
- 174-180
- ISSN
- 0894-9867 (ISSN-L)
- 1573-6598
- OpenAlex
- W2790549978
- Cited by
- 148
- References
- 28
- Citations by year
- 2026: 15 · 2025: 20 · 2024: 22 · 2023: 22 · 2022: 19 · 2021: 17 · 2020: 18 · 2019: 13 · 2018: 2
- FWCI
- 14.69
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Traumatic Stress (publishedVersion)
- PubMed (publishedVersion)
- Maynooth University ePrints and eTheses Archive (Maynooth University) (acceptedVersion)
- Ulster University Research Portal (Ulster University) (acceptedVersion, other-oa)
- Edinburgh Napier Research Repository (Edinburgh Napier University) (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- post-traumatic stress disorder, complex PTSD, DSM-5, ICD-11, diagnostic classification, prevalence, dissociation, depression, borderline personality disorder, suicidal ideation, self-harm, anxiety, differential diagnosis
- MeSH terms
- Adult, Anxiety, Borderline Personality Disorder, Depression, Dissociative Disorders, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Stress Disorders, Post-Traumatic, Prevalence, Self-Injurious Behavior, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, Young Adult, Suicidal Ideation
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