Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis

TLDR

The WHO ICD‑11 proposes separate diagnoses of PTSD and complex PTSD within trauma‑related disorders. The study aimed to use latent profile analysis to identify distinct symptom classes and examine differences in trauma type and impairment. Latent profile analysis was applied to 302 treatment‑seeking individuals exposed to interpersonal traumas ranging from chronic abuse to single‑incident events. The analysis revealed three classes—complex PTSD, PTSD, and low symptoms—showing that chronic trauma predicts complex PTSD, single‑event trauma predicts PTSD, complex PTSD is linked to greater impairment, and the classes remain stable with or without borderline personality disorder, supporting the ICD‑11 distinction.

Abstract

The WHO International Classification of Diseases, 11th version (ICD-11), has proposed two related diagnoses, posttraumatic stress disorder (PTSD) and complex PTSD within the spectrum of trauma and stress-related disorders.To use latent profile analysis (LPA) to determine whether there are classes of individuals that are distinguishable according to the PTSD and complex PTSD symptom profiles and to identify potential differences in the type of stressor and severity of impairment associated with each profile.An LPA and related analyses were conducted on 302 individuals who had sought treatment for interpersonal traumas ranging from chronic trauma (e.g., childhood abuse) to single-incident events (e.g., exposure to 9/11 attacks).THE LPA REVEALED THREE CLASSES OF INDIVIDUALS: (1) a complex PTSD class defined by elevated PTSD symptoms as well as disturbances in three domains of self-organization: affective dysregulation, negative self-concept, and interpersonal problems; (2) a PTSD class defined by elevated PTSD symptoms but low scores on the three self-organization symptom domains; and (3) a low symptom class defined by low scores on all symptoms and problems. Chronic trauma was more strongly predictive of complex PTSD than PTSD and, conversely, single-event trauma was more strongly predictive of PTSD. In addition, complex PTSD was associated with greater impairment than PTSD. The LPA analysis was completed both with and without individuals with borderline personality disorder (BPD) yielding identical results, suggesting the stability of these classes regardless of BPD comorbidity.Preliminary data support the proposed ICD-11 distinction between PTSD and complex PTSD and support the value of testing the clinical utility of this distinction in field trials. Replication of results is necessary.