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Cited by 61Posttraumatic Stress Disorder ResearchMigration, Health and TraumaPsychoanalysis and Psychopathology Research

The complexity of trauma exposure and response: Profiling PTSD and CPTSD among a refugee sample.

Open access
Frost, Rachel, Hyland, Philip, McCarthy, Angela, Halpin, Rory, Shevlin, Mark, Murphy, Jamie·2019·Psychological Trauma: Theory, Research, Practice, and Policy
DOI 10.1037/tra0000408
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Abstract

OBJECTIVE: This study investigated the latent dimensional and categorical structure of ICD-11 complex posttraumatic stress disorder (CPTSD) within a refugee sample. METHOD: A subsample that identified as refugee (n = 308) was selected from the National Epidemiological Survey on Alcohol and Related Conditions. Factor mixture modeling (FMM) was employed to establish the dimensional structure of CPTSD symptomology and the categorical distribution of these dimensions. It was then evaluated whether trauma history could differentiate between the distribution of trauma response profiles. RESULTS: A correlated 6-factor model with 5 latent classes was the best fitting model. Two classes were characterized by symptom profiles that were consistent with ICD-11 CPTSD and PTSD formulations. The remaining classes were characterized by nonspecific variation across dimensions. CPTSD class membership was predicted by traumas that were predominantly interpersonal in nature (serious neglect, physical assault, and sexual assault), whereas PTSD class membership was predicted by situational traumatic experiences (unarmed civilian in a conflict environment and a serious accident). A distinct dose-response effect was evident between cumulative traumatic exposure and CPTSD class membership. CONCLUSION: FMM class profiles distinguished between PTSD and CPTSD symptom formulations. Moreover, class membership was determined by specific trauma-exposure histories. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

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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, has repeatedly been shown to have an incremental dose-response relationship to cPTSD.

    “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 [51]

    The Discussion reports that cumulative and interpersonal trauma predicted a complex symptom profile, and that increasing cumulative exposure raised the likelihood of CPTSD class membership in a dose-response manner. The Abstract identifies formative developmental periods as a particular vulnerability. However, the Discussion says this study could not determine when trauma occurred and that the effect of adult trauma without childhood maltreatment remains unclear, so it does not establish the claim's adulthood qualifier. (LLM, conf=0.86)

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Research works printed but not linked: 3

  1. Hyland, P., Ceannt, R., Daccahe, F., Daher, R. A., Sleiman, J. B., Gilmore, B., . . . Vallières, F. (In Press). Are PTSD and Complex-PTSD distinguishable within a treatment seeking sample of Syrian refugees living in Lebanon? Global Mental Health.
  2. Knefel, M., & Lueger-Schuster, B. (2013). An evaluation of ICD-11 PTSD and complex PTSD criteria in a sample of adult survivors of childhood institutional abuse. European journal of psychotraumatology, 4(1), 22608. http://dx.doi.org/10.3402/ejpt.v4i0.22608 · DOI
  3. Porter, M., & Haslam, N. (2005). Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta-analysis. Jama, 294(5), 602-612.

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Authors
Frost, R., Hyland, P., McCarthy, A., Halpin, R., Shevlin, M., & Murphy, J.
Affiliations
  • Ulster University, Derry-Londonderry Campus (GB)
  • National College of Ireland (IE)
  • Rape Crisis Network Ireland (IE)
Corresponding author
Frost, Rachel
ORCID
Venue
Psychological Trauma: Theory, Research, Practice, and Policy
Publisher
American Psychological Association (APA)
Published
2019-02
Volume
11
Issue
2
Pages
165-175
ISSN
  • 1942-9681 (ISSN-L)
  • 1942-969X
DOI
10.1037/tra0000408
OpenAlex
W2896690470
Cited by
61
References
51
Citations by year
2026: 7 · 2025: 9 · 2024: 14 · 2023: 7 · 2022: 6 · 2021: 10 · 2020: 5 · 2019: 3
FWCI
5.28
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • Psychological Trauma Theory Research Practice and Policy (publishedVersion)
  • PubMed (publishedVersion)
  • Maynooth University ePrints and eTheses Archive (Maynooth University) (acceptedVersion)
  • Ulster University Research Portal (Ulster University) (submittedVersion, other-oa)
Funders
European Commission’s Horizon (722523)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords
complex PTSD, post-traumatic stress disorder, refugees, trauma exposure, ICD-11, interpersonal trauma, cumulative trauma, dose-response relationship, sexual assault, physical assault, neglect, armed conflict
MeSH terms
Exposure to Violence, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Refugees, Sex Offenses, Stress Disorders, Post-Traumatic, United States, International Classification of Diseases, Young Adult

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