Examining accurate diagnosis of complex PTSD in ICD-11

Christopher S Kleva; Jared W Keeley; Spencer C Evans; Andreas Maercker; Marylene Cloitre; Chris R Brewin; Michael Roberts; Geoffrey M Reed

doi:10.1016/j.jad.2023.10.137

Examining accurate diagnosis of complex PTSD in ICD-11

J Affect Disord. 2024 Feb 1:346:110-114. doi: 10.1016/j.jad.2023.10.137. Epub 2023 Oct 31.

Authors

Christopher S Kleva¹, Jared W Keeley², Spencer C Evans³, Andreas Maercker⁴, Marylene Cloitre⁵, Chris R Brewin⁶, Michael Roberts⁷, Geoffrey M Reed⁸

Affiliations

¹ Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA. Electronic address: klevac@vcu.edu.
² Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.
³ Department of Psychology, University of Miami, Coral Gables, FL, USA.
⁴ Department of Psychology, University of Zurich, Zurich, Switzerland.
⁵ National Center for PTSD, Division of Dissemination and Training, VA Palo Alto Health Care System, CA, USA; Department of Psychiatry and Behavioral Sciences, Standford University, Stanford, CA, USA.
⁶ Department of Clinical, Educational and Health Psychology, University College London, London, UK.
⁷ Office of Graduate Studies and Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA.
⁸ Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland.

PMID: 37918575
DOI: 10.1016/j.jad.2023.10.137

Abstract

Background: Complex posttraumatic stress disorder (complex PTSD), the most frequently suggested new category for inclusion by mental health professionals, has been included in the Eleventh Revision of the World Health Organization's International Classification of Diseases (ICD-11). Research has yet to explore whether clinicians' recognition of the distinct complex PTSD symptoms predicts giving the correct diagnosis. The present study sought to determine if international mental health professionals were able to accurately diagnose complex PTSD and identify the shared PTSD features and three essential diagnostic features, specific to complex PTSD.

Methods: Participants were randomly assigned to view two vignettes and tasked with providing a diagnosis (or indicating that no diagnosis was warranted). Participants then answered a series of questions regarding the presence or absence of each of the essential diagnostic features specific to the diagnosis they provided.

Results: Clinicians who recognized the presence or absence of complex PTSD specific features were more likely to arrive at the correct diagnostic conclusion. Complex PTSD specific features were significant predictors while the shared PTSD features were not, indicating that attending to each of the specific symptoms was necessary for diagnostic accuracy of complex PTSD.

Limitations: The use of written case vignettes including only adult patients and a non-representative sample of mental health professionals may limit the generalizability of the results.

Conclusions: Findings support mental health professionals' ability to accurately identify specific features of complex PTSD. Future work should assess whether mental health providers can effectively identify symptoms of complex PTSD in a clinical setting.

Keywords: Complex Posttraumatic Stress Disorder (CPTSD); Diagnosis; ICD-11.

Publication types

Randomized Controlled Trial

MeSH terms

Adult
Health Personnel
Humans
International Classification of Diseases
Stress Disorders, Post-Traumatic* / diagnosis
Stress Disorders, Post-Traumatic* / psychology

Grants and funding

001/WHO_/World Health Organization/International