Self-harm, suicide, and ICD-11 complex posttraumatic stress disorder in treatment-seeking adolescents with major depression

Liu, Huanzhong; Ho, Grace W.K.; Karatzias, Thanos; Shevlin, Mark; Wong, Kwan Ho; Hyland, Philip

Abstract

Posttraumatic stress disorder (PTSD) is linked with self-harm and suicide, but few studies have examined these severe outcomes in relation to complex trauma. This study examined the associations between self-harm and suicide-related phenomena with ICD-11 complex PTSD (CPTSD) among treatment-seeking youths. A convenience sample of 109 adolescents with major depression (69.7% female; mean age = 15.24) were recruited from an outpatient psychiatric clinic. Participants completed measures for ICD-11 CPTSD, adverse childhood experiences (ACEs), self-harm behaviors, and past-year history of four suicide-related phenomena. Relationships between each self-harm and suicide-related variable with CPTSD were assessed at the symptom and diagnostic levels. Participants reported an average of three ACEs; 33.9% met diagnostic requirements for ICD-11 CPTSD. Past-year suicidal thought and attempt, but not self-harm, significantly associated with CPTSD status. At the symptom level, self-harm associated with CPTSD total symptom and all symptom clusters scores, with strongest associations found with symptoms of negative self-concept. CPTSD total symptom scores also associated strongly with past-year history of suicidal thought, plan, and attempt; the three core PTSD symptom clusters scores consistently and strongly linked with these suicide-related phenomena. For symptoms of complex trauma, relationship disturbances associated with having a suicide attempt, and negative self-concept associated with both having a plan and an attempt. Assessing and targeting ICD-11 CPTSD symptoms have potential to reduce self-harm and suicidality in young people experiencing mental distress, particularly for those with a trauma history and regardless of whether they meet criteria for a diagnosable trauma response.

Citation

Liu, H., Ho, G. W., Karatzias, T., Shevlin, M., Wong, K. H., & Hyland, P. (2024). Self-harm, suicide, and ICD-11 complex posttraumatic stress disorder in treatment-seeking adolescents with major depression. Journal of Child and Adolescent Trauma, 17(4), 1057-1066. https://doi.org/10.1007/s40653-024-00655-0

• Journal Article Type: Article
• Acceptance Date: Aug 12, 2024
• Online Publication Date: Aug 21, 2024
• Publication Date: 2024-12
• Deposit Date: Aug 13, 2024
• Publicly Available Date: Aug 21, 2024
• Journal: Journal of Child & Adolescent Trauma
• Print ISSN: 1936-1521
• Electronic ISSN: 1936-153X
• Publisher: Routledge
• Peer Reviewed: Peer Reviewed
• Volume: 17
• Issue: 4
• Pages: 1057-1066
• DOI: https://doi.org/10.1007/s40653-024-00655-0
• Keywords: CPTSD, Adolescents, Youths, Self-harm, ICD-11, Suicide