Evidence of symptom profiles consistent with posttraumatic stress disorder and complex posttraumatic stress disorder in different trauma samples
Open accessAbstract
BACKGROUND: The International Classification of Diseases, 11th version (ICD-11), proposes two related stress and trauma-related disorders, posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). A diagnosis of CPTSD requires that in addition to the PTSD symptoms, an individual must also endorse symptoms in three major domains: (1) affective dysregulation, (2) negative self-concepts, and (3) interpersonal problems. This study aimed to determine if the naturally occurring distribution of symptoms in three groups of traumatised individuals (bereavement, sexual victimisation, and physical assault) were consistent with the ICD-11, PTSD, and CPTSD specification. The study also investigated whether these groups differed on a range of other psychological problems. METHODS AND RESULTS: Participants completed self-report measures of each symptom group and latent class analyses consistently found that a three class solution was best. The classes were "PTSD only," "CPTSD," and "low PTSD/CPTSD." These classes differed significantly on measures of depression, anxiety, dissociation, sleep disturbances, somatisation, interpersonal sensitivity, and aggression. The "CPTSD" class in the three samples scored highest on all the variables, with the "PTSD only" class scoring lower and the "low PTSD/CPTSD" class the lowest. CONCLUSION: This study provides evidence to support the diagnostic structure of CPTSD and indicted that CPTSD is associated with a broad range of other psychological problems.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
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 [35]
The paper’s discussion of Cloitre et al. (2013) says chronic childhood abuse was associated with a greater likelihood of CPTSD than PTSD, and the Discussion identifies trauma history as a risk factor. It does not establish the cited phrase’s more specific claim about cumulative exposure to multiple types of interpersonal trauma, including exposure in adulthood. The dose-response assertion is attached to other citations in the citing sentence, not this source. (LLM, conf=0.85)
Experimental — accuracy not yet measuredLatent class analyses consistently document a class of individuals with high PTSD symptoms and high disturbances in self-organization, and another class with high PTSD symptoms and low disturbances in self-organization.
“latent class analyses have consistently documented that there is a class of individuals with high PTSD symptoms and high disturbances in self-organization, and another class with high PTSD symptoms and low disturbances in self-organization 12-16 .”
From Post‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges (2019) · cites this paper as [15]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369 · see citing works
Estimating the Dimension of a Model
Schwarz, G. (1978) · The Annals of Statistics · doi:10.1214/aos/1176344136 · Cited by 47,033 · see citing works
Diagnostic and Statistical Manual of Mental Disorders, 5th ed.
Carter, M. J. (2014) · Therapeutic Recreation Journal · Cited by 15,154 · see citing works
Nylund, K. L., Asparouhov, T., & Muthén, B. O. (2007) · Structural Equation Modeling: A Multidisciplinary Journal · doi:10.1080/10705510701575396 · Cited by 11,415 · see citing works
Posttraumatic Stress Disorder in the National Comorbidity Survey
Kessler, R. C. (1995) · Archives of General Psychiatry · doi:10.1001/archpsyc.1995.03950240066012 · Cited by 10,379 · see citing works
Akaike, H. (1987) · Psychometrika · doi:10.1007/bf02294359 · Cited by 5,264 · see citing works
Testing the number of components in a normal mixture
Lo, Y. (2001) · Biometrika · doi:10.1093/biomet/88.3.767 · Cited by 4,640 · see citing works
Akaike, H. (1987) · Springer Series in Statistics · doi:10.1007/978-1-4612-1694-0_29 · Cited by 4,027 · see citing works
Application of model-selection criteria to some problems in multivariate analysis
Sclove, S. L. (1987) · Psychometrika · doi:10.1007/bf02294360 · Cited by 2,541 · see citing works
Yuan, K.-H., & Bentler, P. (2000) · Sociological Methodology · doi:10.1111/0081-1750.00078 · Cited by 1,847 · see citing works
Mollica, R. F., Caspi-Yavin, Y., Bollini, P., Truong, T., Tor, S., & Lavelle, J. (1992) · PubMed · Cited by 1,551 · see citing works
MOLLICA, R. F., CASPI-YAVIN, Y., BOLLINI, P., TRUONG, T., TOR, S., & LAVELLE, J. (1992) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199202000-00008 · Cited by 1,489 · cited 1× · see citing works
“Twelve items that comprised the PTSD/CPTSD item set were selected from two standardised measures, the Trauma Symptom Checklist (TSC; Briere & Runtz, 1989) and the Harvard Trauma Questionnaire Part IV (HTQ: Mollica et al., 1992).”
MethodKing, D. W., Leskin, G. A., King, L. A., & Weathers, F. W. (1998) · Psychological Assessment · doi:10.1037/1040-3590.10.2.90 · Cited by 784 · see citing works
Diagnosis and classification of disorders specifically associated with stress: proposals for ICD-11
Maercker, A., Brewin, C. R., Bryant, R. A., Cloitre, M., van Ommeren, M., Jones, L. M., Humayan, A., Kagee, A., Llosa, A. E., Rousseau, C., et al. (2013) · World Psychiatry · doi:10.1002/wps.20057 · Cited by 762 · see citing works
Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis
Cloitre, M., Garvert, D. W., Brewin, C. R., Bryant, R. A., & Maercker, A. (2013) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v4i0.20706 · Cited by 751 · cited 4× · see citing works
“However, given that the study of Cloitre et al. (2013) was the first such study to assess for the presence of two distinct constructs in a trauma-exposed sample, significantly more research is required in order to determine the accuracy of a distinction between PTSD and CPTSD, as proposed by the…”
BackgroundResultInfluentialSimms, L. J., Watson, D., & Doebbeling, B. N. (2002) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.111.4.637 · Cited by 699 · see citing works
The Trauma Symptom Checklist (TSC-33)
Briere, J., & Runtz, M. (1989) · Journal of Interpersonal Violence · doi:10.1177/088626089004002002 · Cited by 600 · see citing works
Maercker, A., Brewin, C. R., Bryant, R. A., Cloitre, M., Reed, G. M., van Ommeren, M., Humayun, A., Jones, L. M., Kagee, A., Llosa, A. E., et al. (2013) · The Lancet · doi:10.1016/s0140-6736(12)62191-6 · Cited by 533 · see citing works
Simms, L. J., Watson, D., & Doebbelling, B. N. (2002) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.111.4.637 · Cited by 528 · see citing works
Zlotnick, C., Johnson, D. M., & Kohn, R. (2006) · Journal of Interpersonal Violence · doi:10.1177/0886260505282564 · Cited by 417 · see citing works
The WPA‐WHO Global Survey of Psychiatrists’ Attitudes Towards Mental Disorders Classification
Reed, G. M., Correia, J., Esparza, P., Saxena, S., & Maj, M. (2011) · World Psychiatry · doi:10.1002/j.2051-5545.2011.tb00034.x · Cited by 354 · see citing works
A meta-analytic investigation of the structure of posttraumatic stress disorder symptoms.
Yufik, T., & Simms, L. J. (2010) · Journal of Abnormal Psychology · doi:10.1037/a0020981 · Cited by 323 · see citing works
Elhai, J. D., & Palmieri, P. A. (2011) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2011.04.007 · Cited by 257 · see citing works
Briere, J., & Rickards, S. (2007) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0b013e31803044e2 · Cited by 163 · see citing works
Diagnostic and clinical considerations in prolonged grief disorder
Maercker, A. R. A., & Lalor, J. (2012) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2012.14.2/amaercker · Cited by 99 · see citing works
The latent structure of posttraumatic stress disorder: Different models or different populations?
Shevlin, M. E., & Elklit, A. (2012) · Journal of Abnormal Psychology · doi:10.1037/a0028591 · Cited by 36 · see citing works
Self-citationMåling af belastninger efter voldeligt overfald
Elklit, A. (1990) · Nordisk Psykologi · doi:10.1080/00291463.1990.10637006 · Cited by 29 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Sexual assault victimization and psychopathology: A review and meta-analysis
Dworkin, E. R., Menon, S. V., Bystrynski, J., & Allen, N. E. (2017) · Clinical Psychology Review · doi:10.1016/j.cpr.2017.06.002 · Cited by 825 · see citing works
A review of current evidence regarding the ICD-11 proposals for diagnosing PTSD and complex PTSD
Brewin, C. R., Cloitre, M., Hyland, P., Shevlin, M., Maercker, A., Bryant, R. A., Humayun, A., Jones, L. M., Kagee, A., Rousseau, C., et al. (2017) · Clinical Psychology Review · doi:10.1016/j.cpr.2017.09.001 · Cited by 678 · see citing works
Self-citationPost‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges
Bryant, R. A. (2019) · World Psychiatry · doi:10.1002/wps.20656 · Cited by 528 · see citing works
Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis
Cloitre, M., Garvert, D. W., Weiss, B., Carlson, E. B., & Bryant, R. A. (2014) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v5.25097 · Cited by 468 · see citing works
Psychological interventions for ICD-11 complex PTSD symptoms: systematic review and meta-analysis
Karatzias, T., Murphy, P., Cloitre, M., Bisson, J., Roberts, N., Shevlin, M., Hyland, P., Maercker, A., Ben-Ezra, M., Coventry, P., et al. (2019) · Psychological Medicine · doi:10.1017/s0033291719000436 · Cited by 352 · see citing works
Self-citationBen-Ezra, M., Karatzias, T., Hyland, P., Brewin, C. R., Cloitre, M., Bisson, J. I., Roberts, N. P., Lueger-Schuster, B., & Shevlin, M. (2018) · Depression and Anxiety · doi:10.1002/da.22723 · Cited by 241 · see citing works
Self-citationHyland, P., Murphy, J., Shevlin, M., Vallières, F., McElroy, E., Elklit, A., Christoffersen, M., & Cloitre, M. (2017) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-017-1350-8 · Cited by 221 · see citing works
Self-citationComplex PTSD and borderline personality disorder
Ford, J. D., & Courtois, C. A. (2021) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-021-00155-9 · Cited by 209 · see citing works
“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 Ford and Courtois Borderline Personality Disorder and Emotion Dysregulation (2021) 8:16 Page 5 of 21”
BackgroundWolf, E. J., Miller, M. W., Kilpatrick, D., Resnick, H. S., Badour, C. L., Marx, B. P., Keane, T. M., Rosen, R. C., & Friedman, M. J. (2015) · Clinical Psychological Science · doi:10.1177/2167702614545480 · Cited by 188 · see citing works
Sachser, C., Keller, F., & Goldbeck, L. (2017) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12640 · Cited by 156 · see citing works
Hyland, P., Shevlin, M., Fyvie, C., & Karatzias, T. (2018) · Journal of Traumatic Stress · doi:10.1002/jts.22272 · Cited by 148 · see citing works
Self-citationKeeley, J. W., Reed, G. M., Roberts, M. C., Evans, S. C., Robles, R., Matsumoto, C., Brewin, C. R., Cloitre, M., Perkonigg, A., Rousseau, C., et al. (2016) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2015.09.002 · Cited by 134 · see citing works
Haselgruber, A., Sölva, K., & Lueger‐Schuster, B. (2020) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.13100 · Cited by 132 · see citing works
Emotion regulation difficulties in traumatized youth: a meta-analysis and conceptual review
Villalta, L., Smith, P., Hickin, N., & Stringaris, A. (2018) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-018-1105-4 · Cited by 119 · see citing works
Hyland, P., Ceannt, R., Daccache, F., Abou Daher, R., Sleiman, J., Gilmore, B., Byrne, S., Shevlin, M., Murphy, J., & Vallières, F. (2018) · Global Mental Health · doi:10.1017/gmh.2018.2 · Cited by 99 · see citing works
“Individuals diagnosed with CPTSD are also repeatedly found to experience significantly higher levels of psychosocial impairment (Elklit et al., 2014; Murphy et al., 2016).”
BackgroundResultInfluentialSelf-citationTraumatic experiences, ICD‐11 PTSD, ICD‐11 complex PTSD, and the overlap with ICD‐10 diagnoses
Møller, L., Augsburger, M., Elklit, A., Søgaard, U., & Simonsen, E. (2020) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.13161 · Cited by 78 · see citing works
Self-citationSleep disturbances in bereavement: a systematic review
Lancel, M., Stroebe, M., & Eisma, M. C. (2020) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2020.101331 · Cited by 80 · see citing works
Murphy, S., Elklit, A., Dokkedahl, S., & Shevlin, M. (2016) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v7.32678 · Cited by 71 · see citing works
Self-citationComplex posttraumatic stress disorder (CPTSD) following captivity: a 24-year longitudinal study
Zerach, G., Shevlin, M., Cloitre, M., & Solomon, Z. (2019) · European Journal of Psychotraumatology · doi:10.1080/20008198.2019.1616488 · Cited by 70 · see citing works
Self-citationGilbar, O., Hyland, P., Cloitre, M., & Dekel, R. (2018) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2018.01.004 · Cited by 66 · see citing works
Self-citationThe complexity of trauma exposure and response: Profiling PTSD and CPTSD among a refugee sample.
Frost, R., Hyland, P., McCarthy, A., Halpin, R., Shevlin, M., & Murphy, J. (2019) · Psychological Trauma: Theory, Research, Practice, and Policy · doi:10.1037/tra0000408 · Cited by 61 · see citing works
Self-citationMarinova, Z., & Maercker, A. (2015) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v6.25913 · Cited by 42 · see citing works
Dorahy, M. J., Corry, M., Black, R., Matheson, L., Coles, H., Curran, D., Seager, L., Middleton, W., & Dyer, K. F. W. (2017) · Journal of Clinical Psychology · doi:10.1002/jclp.22339 · Cited by 34 · see citing works
Tay, A. K., Mohsin, M., Rees, S., Tam, N., Kareth, M., & Silove, D. (2018) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2018.05.001 · Cited by 33 · see citing works
- Authors
- Elklit, A., Hyland, P., & Shevlin, M.
- Affiliations
- University of Ulster (GB)
- National College of Ireland (IE)
- Corresponding author
- Shevlin, Mark
- Venue
- European Journal of Psychotraumatology
- Publisher
- Informa UK Limited
- Published
- 2014-05-19
- Volume
- 5
- Issue
- 1
- ISSN
- 2000-8066 (ISSN-L)
- PMC
- PMC4028608
- OpenAlex
- W2141891449
- Cited by
- 172
- References
- 27
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 11 · 2023: 11 · 2022: 13 · 2021: 16 · 2020: 25 · 2019: 17 · 2018: 19 · 2017: 15 · 2016: 15 · 2015: 15 · 2014: 2
- FWCI
- 18.54
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- European Journal of Psychotraumatology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Maynooth University ePrints and eTheses Archive (Maynooth University) (acceptedVersion)
- TRAP@NCI (National College of Ireland) (acceptedVersion)
- NORMA (submittedVersion)
- Ulster University Research Portal (Ulster University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion, cc-by)
- Figshare (cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- post-traumatic stress disorder, complex PTSD, ICD-11, symptom profiles, emotional dysregulation, negative self-concept, interpersonal problems, bereavement, sexual victimization, physical assault, depression, anxiety, dissociation, sleep disorders, somatization, aggression, latent class analysis
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
