A comparison between dissociative subtypes of PTSD and CPTSD among trauma-exposed adolescents.

Background

The dissociative subtype of posttraumatic stress disorder (D-PTSD) was recognized in DSM-5, and a dissociative subtype of complex posttraumatic stress disorder (D-CPTSD) in ICD-11 was recently proposed. It was documented that the DSM-5 PTSD criteria encompass all symptoms of the ICD-11 CPTSD. Exploring the relationship between D-PTSD and D-CPTSD may help to clarify whether the knowledge on D-PTSD could be extended to D-CPTSD.

Objective

The current study aimed to compare the symptomatic characteristics of DSM-5 D-PTSD and ICD-11 D-CPTSD.

Methods

The current study re-analyzed a database consisting of 57,984 trauma-exposed adolescents. Posttraumatic stress disorder (PTSD), complex PTSD (CPTSD), trauma-related dissociation, and functional impairment were assessed using the Global Psychotrauma Screen for Teenagers (GPS-T). Generalized anxiety disorder (GAD) and major depressive disorder (MDD) were measured with the Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-9, respectively. Prevalence, functional impairment, and comorbidities with GAD/MDD were compared between DSM-5 D-PTSD and ICD-11 D-CPTSD. Agreement between the D-CPTSD and D-PTSD was also examined.

Results

The agreement between D-PTSD and D-CPTSD was extremely high (Kappa = 0.90). All individuals with D-CPTSD met the criteria for D-PTSD and accounted for the majority of the D-PTSD group (82.4%). The D-CPTSD group exhibited higher levels of functional impairment and comorbidity with GAD/MDD compared to the D-PTSD group (All ps < 0.001).

Conclusions

These findings indicated that ICD-11 D-CPTSD might be a part of DSM-5 D-PTSD, informing that the previous basic, clinical, and practical knowledge on DSM-5 D-PTSD might be applicable to the ICD-11 D-CPTSD.