Citation: Thanos Karatzias, Marylene Cloitre, Andreas Maercker, Evaldas Kazlauskas, Mark Shevlin, Philip Hyland, Jonathan I. Bisson, Neil P. Roberts & Chris R. Brewin (2017) PTSD and Complex PTSD: ICD-11 updates on concept and measurement in the UK, USA, Germany and Lithuania European Journal of Psychotraumatology, 8:sup7, 1418103, DOI: 10.1080/20008198.2017.1418103
This paper looks at two aspects of trauma (1) defining two related conditions Post Traumatic Stress Disorder (PTSD) and Complex Post Traumatic Stress Disorder (CPTSD) (2) seeking to evaluate a questionnaire for defining each condition in a clinical context, and refining and testing the ITQ or International Trauma Questionnaire, across several countries- USA, UK, Germany and Lithuania. The authors cite 29 countries in all working on this standardisation of the ITQ (Within The WHO’s International Classification of Diseases ICD-11). This study outlines numerous further areas of research needed before the ITQ could be considered comparable pan-globally. In particular the need for cultural standardisation. The approach used in the four countries in the study offers respondents the question “How much have you been bothered by <symptom> in the past month? Respondents use Lickert Scale (1-4) to reply. Preliminary findings suggest CPTSD more debilitating that PTSD and linked more closely to multiple trauma events, genocide, childhood trauma, and sexual violence.
EFTi Editor’s notes:
Study found CPTSD more prevalent than PTSD. Only based on 4 countries. Limitations of the study include need for larger samples sizes, across more countries and cultural contexts to consider the cultural-bound factors in the two siblinig conditions. Cross referencing with International Trauma Interviewing (ITI)processes, also important to increase deepening of understanding of the ITQ use and of trauma-effects globally.
Assessment tools used: ITQ incorporating Likert scale ranging from 0 (‘not at all’) to 4 (‘extremely’) to ascertain “How bothered you have been by this symptom in the past month? Basing this around symptomology of the two conditions as follows - PTSD is comprised of three symptom groups (1) re-experiencing of the trauma in the here and now (Re), (2) avoidance of traumatic reminders (Av), and (3) a persistent sense of current threat that is manifested by exaggerated startle and hypervigilance (Th). ICD-11 CPTSD includes the three PTSD clusters and three additional clusters that reflect ‘disturbances in self-organization’ (DSO): (1) affective dysregulation (AD), (2) negative self-concept (NSC), and (3) disturbances in relationships (DR) (Maercker et al., 2013).
Link to Study: https://doi.org/10.1080/20008198.2017.1418103
Date Published: 2017 in Journal and 2018 online