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Evidence for two different ICD-11 posttraumatic stress disorders in a community sample of adolescents and young adults

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Abstract

For the 11th revision of the International classification of diseases, a general category of posttraumatic stress disorders has been proposed with two distinct sibling disorders: posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). General population data are examined on evidence for these two disorders. Data were drawn from a 10-year prospective longitudinal, epidemiological study with a representative community sample (N = 3021, 14–24 years at baseline) in Germany. Mixture modelling on latent classes was conducted in a subset of all reported episodes with exposure to interpersonal traumas. Associations between class membership, symptom criteria, and other mental disorders were investigated. Four distinctly interpretable latent classes were found. Class 1 episodes (N = 181) typically included core PTSD symptoms associated with strong impairment (OR 11.68; 95 % CI 4.54–30.05). 18.3 % of these episodes matched the criteria of ICD-11 PTSD. Class 2 episodes (N = 78) had a high probability of PTSD core symptoms and disturbances in self-organization and were associated with strong impairment (OR 38.47; 95 % CI 15.77–93.86). Half of them (49.4 %) matched the proposed ICD-11 criteria of CPTSD. Class 3 (N = 79) was typically characterized by episodes with disturbances in self-organization but a low probability of PTSD core symptoms and impairment. Class 4 (N = 633) was related to a relatively low probability of symptom reports. Membership in class 2 was associated with lower educational attainment, a lower social class, and more other mental disorders. Findings support the ICD-11 proposal to differentiate between PTSD and CPTSD. Further studies should extend exploration to other types of traumatic events in samples covering the full age range.

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Acknowledgments

This work is part of the early developmental stages of psychopathology (EDSP) Study. The EDSP Study has been funded by the German Federal Ministry of Education and Research (BMBF) project no. 01EB9405/6, 01 EB 9901/6, EB01016200, 01EB0140, and 01EB0440. Part of the field work and analyses were also additionally supported by grants of the Deutsche Forschungsgemeinschaft (DFG) LA1148/1-1, WI2246/1-1, WI 709/7-1, and WI 709/8-1. Principal investigators of the EDSP are Dr. Hans-Ulrich Wittchen and Dr. Roselind Lieb. Core staff members of the EDSP group are: Dr. Kirsten von Sydow, Dr. Gabriele Lachner, Dr. Axel Perkonigg, Dr. Peter Schuster, Dr. Michael Höfler, Dipl.-Psych. Holger Sonntag, Dipl.-Psych. Tanja Brückl, Dipl.-Psych. Elzbieta Garczynski, Dr. Barbara Isensee, Dipl.-Psych. Agnes Nocon, Dr. Chris Nelson, Dipl.-Inf. Hildegard Pfister, Dr. Victoria Reed, Dipl.-Soz. Barbara Spiegel, Dr. Andrea Schreier, Dr. Ursula Wunderlich, Dr. Petra Zimmermann, Dr. Katja Beesdo-Baum, Dr. Antje Bittner, Dr. Silke Behrendt, and Dr. Susanne Knappe. Scientific advisors are Dr. Jules Angst (Zurich), Dr. Jürgen Margraf (Basel), Dr. Günther Esser (Potsdam), Dr. Kathleen Merikangas (NIMH, Bethesda), Dr. Ron Kessler (Harvard, Boston), and Dr. Jim van Os (Maastricht).

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Authors and Affiliations

  1. Division of Psychopathology and Clinical Intervention, Department of Psychology, University of Zurich, Binzmühlestr. 14/17, 8050, Zurich, Switzerland

    Axel Perkonigg & Andreas Maercker

  2. Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Straße 46, 01187, Dresden, Germany

    Michael Höfler, Hans-Ulrich Wittchen & Sebastian Trautmann

  3. National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA

    Marylène Cloitre

  4. Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA

    Marylène Cloitre

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  1. Axel Perkonigg
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  2. Michael Höfler
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  3. Marylène Cloitre
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  4. Hans-Ulrich Wittchen
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  6. Andreas Maercker
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Correspondence to Axel Perkonigg.

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Perkonigg, A., Höfler, M., Cloitre, M. et al. Evidence for two different ICD-11 posttraumatic stress disorders in a community sample of adolescents and young adults. Eur Arch Psychiatry Clin Neurosci 266, 317–328 (2016). https://doi.org/10.1007/s00406-015-0639-4

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  • DOI: https://doi.org/10.1007/s00406-015-0639-4

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