A longitudinal study of ICD-11 PTSD and complex PTSD in the general population of Israel

Philip Hyland; Thanos Karatzias; Mark Shevlin; Marylène Cloitre; Menachem Ben-Ezra

doi:10.1016/j.psychres.2020.112871

A longitudinal study of ICD-11 PTSD and complex PTSD in the general population of Israel

Psychiatry Res. 2020 Feb 19:286:112871. doi: 10.1016/j.psychres.2020.112871. Online ahead of print.

Authors

Philip Hyland¹, Thanos Karatzias², Mark Shevlin³, Marylène Cloitre⁴, Menachem Ben-Ezra⁵

Affiliations

¹ Department of Psychology, Maynooth University, Kildare, Ireland. Electronic address: Philip.hyland@mu.ie.
² School of Health & Social Care, Edinburgh Napier University, Edinburgh, United Kingdom; NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, United Kingdom.
³ School of Psychology, Ulster University, Derry, Northern Ireland United Kingdom.
⁴ National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, United States; Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, CA, United States.
⁵ School of Social Work, Ariel University, Ariel, Israel.

PMID: 32143066
DOI: 10.1016/j.psychres.2020.112871

Abstract

The ICD-11 includes two trauma disorders: Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). CPTSD is a disorder comprised of PTSD and Disturbance in Self-Organization (DSO) symptoms. Evidence supports the construct validity of PTSD and CPTSD, however, the temporal stability of these constructs has rarely been tested. This study examined the diagnostic stability of PTSD and CPTSD, and the temporal associations between PTSD and DSO symptoms over a period of one-year. Data were collected from a nationally representative sample of Israeli adults (n = 1,003) and one year later a random half of this sample were reassessed (n = 543). There were no statistically significant changes in rates of PTSD (6.7%, 5.3%) and CPTSD (4.9%, 3.7%) over time. Latent variable cross-lagged analysis indicated that PTSD and DSO symptoms were stable over time and that DSO symptoms predicted subsequent PTSD symptoms. Results suggest that ICD-11 PTSD and CPTSD are stable constructs in the general population over a period of one year. We discuss the possibility that these findings are influenced by the specific cultural context of Israel. Additionally, given the stability and influence of DSO symptoms we discuss the potential value of psychological therapies that directly address these symptoms.

Keywords: Complex PTSD; Cross-lagged analysis; ICD-11; Longitudinal; PTSD; Trauma.