Is dissociation a fundamental component of ICD-11 Complex Posttraumatic Stress Disorder?

Hyland, Philip; Hamer, Ruby; Fox, Robert; Vallières, Frédérique; Karatzias, Thanos; Shevlin, Mark; Cloitre, Marylene

Abstract

ICD-11 Complex Posttraumatic Stress Disorder (CPTSD) is a disorder of six symptom clusters including re-experiencing, avoidance, sense of threat, affective dysregulation, negative self-concept, and disturbed relationships. Unlike earlier descriptions of complex PTSD, ICD-11 CPTSD does not list dissociation as a unique symptom cluster. We tested whether the ICD-11 CPTSD symptoms can exist independently of dissociation in a nationally representative sample of adults (N = 1,020) who completed self-report measures. Latent class analysis was used to identify unique subsets of people with distinctive symptom profiles. The best fitting model contained four classes including a ‘low symptoms’ class (48.9%), a ‘PTSD’ class (14.7%), a ‘CPTSD’ class (26.5%), and a ‘CPTSD + Dissociation’ class (10.0%). These classes were related to specific adverse childhood experiences, notably experiences of emotional and physical neglect. The ‘PTSD’, ‘CPTSD’, and ‘CPTSD + Dissociation’ classes were associated with a host of poor health outcomes, however, the ‘CPTSD + Dissociation’ class had the poorest mental health and highest levels of functional impairment. Findings suggest that ICD-11 CPTSD symptoms can occur without corresponding dissociative experiences, however, when CPTSD symptoms and dissociative experiences occur together, health outcomes appear to be more severe.

Citation

Hyland, P., Hamer, R., Fox, R., Vallières, F., Karatzias, T., Shevlin, M., & Cloitre, M. (2024). Is dissociation a fundamental component of ICD-11 Complex Posttraumatic Stress Disorder?. Journal of Trauma & Dissociation, 25(1), 45-61. https://doi.org/10.1080/15299732.2023.2231928

• Journal Article Type: Article
• Acceptance Date: May 9, 2023
• Online Publication Date: Jul 4, 2023
• Publication Date: 2024
• Deposit Date: May 10, 2023
• Publicly Available Date: Jul 4, 2023
• Print ISSN: 1529-9732
• Electronic ISSN: 1529-9740
• Publisher: Taylor & Francis
• Peer Reviewed: Peer Reviewed
• Volume: 25
• Issue: 1
• Pages: 45-61
• DOI: https://doi.org/10.1080/15299732.2023.2231928
• Keywords: Complex PTSD, ICD-11 CPTSD, dissociation, trauma
• Public URL: http://researchrepository.napier.ac.uk/Output/3099237