New findings questioning the construct validity of complex posttraumatic stress disorder (cPTSD): let’s take a closer look

Ford, Julian D.

doi:10.1080/20008198.2019.1708145

Cited by 54Posttraumatic Stress Disorder ResearchPersonality Disorders and PsychopathologyPsychoanalysis and Psychopathology Research

New findings questioning the construct validity of complex posttraumatic stress disorder (cPTSD): let’s take a closer look

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Ford, Julian D.·2020·European Journal of Psychotraumatology

DOI 10.1080/20008198.2019.1708145PMC PMC7006683

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Abstract

This commentary provides a broader context for interpreting evidence from Latent Class and Latent Profile analyses on complex posttraumatic stress disorder (CPTSD) that was provided in a recent contribution to the European Journal of Psychotraumatology. These data analytic strategies are not alone sufficient to test the construct validity of CPTSD. They base their conclusion on the empirical finding of substantial variation in latent models obtained with different analytic procedures and interpretations of the fit of different latent models, as well as interesting additional evidence of dispersion when individual patients’ symptom counts and symptom severity scores on PTSD and CPTSD are examined. However, the results of their analyses actually do provide support for one feature of construct validity, demonstrating discriminant validity by showing a consistent differentiation between PTSD and CPTSD (with expectable variation in both PTSD and CPTSD severity level by persons). Even in a sample of patients diagnosed with PTSD, there may be a Disorders of Self Organization (DSO) sub-group with low PTSD symptom severity. More detailed examination of which DSO symptoms and sub-domains characterize the DSO sub-group and the CPTSD sub-group is needed in order to clarify the nature of the DSO/CPTSD construct. Other analyses needed to fully test construct validity also are described.

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Summary and Conclusions
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Introduction
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Treatment for Posttraumatic Stress Disorder
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Risk, Resilience, and Trauma
Paris, J. (2022) · Oxford University Press eBooks · doi:10.1093/med/9780197615768.003.0004
Foreword
(2022) · Oxford University Press eBooks · doi:10.1093/med/9780197615768.002.0006
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(2022) · Oxford University Press eBooks · doi:10.1093/med/9780197615768.002.0003
Komplexe Traumasymptomatik nach Missbrauch und Misshandlung in der Kindheit: Stärken und Herausforderungen des Therapieprogramms STAIR-NT
Rojas, R., Hitzler, M., Palmer, S., Sauer, K. S., Wendler-Bödicker, C., Boos, A., Hoyer, J., & Niemeyer, H. (2022) · Verhaltenstherapie · doi:10.1159/000525707
Breaking the Silence: The Untold Journeys of Racialized Immigrant Youth through Family Violence
George, P., Medhekar, A., Osborne, B., Chaze, F., Cove, K., & Schmitz, S. (2023) · doi:10.32920/23989068
Breaking the Silence: The Untold Journeys of Racialized Immigrant Youth through Family Violence
George, P., Medhekar, A., Osborne, B., Chaze, F., Cove, K., & Schmitz, S. (2023) · doi:10.32920/23989068.v1
The Importance of a Differential Diagnosis in the Effective Intervention of Complex Post Traumatic Stress Disorder
Cláudia Caires, S. P. (2023) · doi:10.53902/jpssr.2023.03.000555
Posttraumatische Belastungsstörung in Kindheit und Jugend
Schmid, M., & Fegert, J. M. (2024) · Springer Reference Medizin · doi:10.1007/978-3-662-66744-6_109
Untangling Relational Trauma: A Symptom Network Model of Complex Posttraumatic Stress Disorder within a Relational Framework
Archuleta, W. P. (2022) · doi:10.12794/metadc1985982
Remapping Domestic Violence in India using an Extended Conceptual Framework Built on Complex Trauma Theory: Building a Praxis BridgePreprint
Sen, M., Rajvanshi, S., Khandelwal, S., & Ghosh, S. (2025) · SSRN Electronic Journal · doi:10.2139/ssrn.5383098
Le trouble de stress post-traumatique complexe : exploration de ses spécificités symptomatologiques et de ses liens avec les troubles dissociatifs. Une approche quantitative et physiologique
Simion, O. (2022) · theses.fr (ABES) · doi:10.70675/71a76c66z6199z47bbz911czefd60f131c6a

Assessing the application of latent class and latent profile analysis for evaluating the construct validity of complex posttraumatic stress disorder: cautions and limitations
Achterhof, R., Huntjens, R. J. C., Meewisse, M., & Kiers, H. A. L. (2019) · European Journal of Psychotraumatology · doi:10.1080/20008198.2019.1698223 · Cited by 70 · see citing works
Examining the Discriminant Validity of Complex Posttraumatic Stress Disorder and Borderline Personality Disorder Symptoms: Results From a United Kingdom Population Sample
Hyland, P., Karatzias, T., Shevlin, M., & Cloitre, M. (2019) · Journal of Traumatic Stress · doi:10.1002/jts.22444 · Cited by 89 · see citing works
Are all PTSD cases complex PTSD? Results from a latent profile analysis
Bertin, F., D, C., G, T., L, C., W, E., & A, V. (2024) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2024.100494 · Cited by 8 · see citing works
Latent Class Analysis of Complex Posttraumatic Stress Disorder in a Chinese Adult Clinical Sample
张驰, 刘平, 毕亚杰, 罗澍, 曹成琦, & 王力(4.5) (2026) · Institutional Repository of Institute of Psychology, Chinese Academy of Sciences (Institute of Psychology, Chinese Academy of Sciences) · doi:10.16128/j.cnki.1005-3611.2026.03.016
Validation of the CPTSD-DSO scale: A measure for assessing the disturbance in self-organization aspects of complex PTSD
Foster, S. D., & Teahan, P. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.02.111 · Cited by 1 · see citing works

Authors: Ford, J. D.
Affiliations: Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
ORCID: Ford, Julian D.
Venue: European Journal of Psychotraumatology
Publisher: Informa UK Limited
Published: 2020-01-21
Volume: 11
Issue: 1
Pages: 1708145-1708145
ISSN: 2000-8066 (ISSN-L)
DOI: 10.1080/20008198.2019.1708145
PMC: PMC7006683
OpenAlex: W3001873679
Cited by: 54
References: 40
Citations by year: 2026: 1 · 2025: 6 · 2024: 3 · 2023: 7 · 2022: 26 · 2021: 7 · 2020: 4
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by-nc
creativecommons.org/licenses/by-nc/4.0/ (vor)
Locations: European Journal of Psychotraumatology (publishedVersion, cc-by-nc)
PubMed Central (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: Substance Abuse and Mental Health Services Administration (5U79SM080013)
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords: complex PTSD, construct validity, discriminant validity, latent class analysis, latent profile analysis, PTSD symptom severity

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