Background

Adverse childhood experiences (ACE) are known as risk factors for poor adulthood mental health, including ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). While many studies focused on the association of ACE and CPTSD, examining variant symptom patterns related to ACE is lacking.

Objective

This study aimed to identify the factorial validity of the ICD-11 CPTSD and its distinctive symptom classes in Korean adults with ACE from a representative community sample and examine the risk factors and clinical symptoms that distinguish the CPTSD symptom classes.

Methods

We conducted a cross-sectional retrospective study with the International Trauma Questionnaire data from 800 adult general population with ACE histories. A confirmatory factor analysis, latent class analysis, analysis of variance and multinomial logistic regression were conducted.

Results

Results of confirmatory factor analysis supported a six-factor correlation model, while a two-factor higher-order model with PTSD and disturbances in self-organization (DSO) as correlated constructs also showed excellent fit. A latent class analysis identified six classes, including a distinctive ICD-11 CPTSD and PTSD, additionally a DSO with sense of threat, a DSO, an emotion dysregulation, and a low symptom class, showing distinguished features in ACE patterns, lifetime trauma, depression, somatization, panic disorder, and subtypes of dissociation.

Conclusions

The factorial and discriminant validity of ICD-11 CPTSD for Korean ACE survivors were confirmed. Recognizing the pervasive impact of patterns of ACEs and lifetime trauma would be helpful in access to and delivery of appropriate mental health services. Variation in symptom presentations of CPTSD and the role of dissociation should be of concern, that it may bring complicated life outcomes to people with ACEs.

中文翻译：

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具有不良童年经历的韩国一般人群样本中 ICD-11 复杂创伤后应激障碍的因素结构和症状类别

背景

童年不良经历 (ACE) 被称为成年期心理健康状况不佳的危险因素，包括 ICD-11 创伤后应激障碍 (PTSD) 和复杂的 PTSD (CPTSD)。虽然许多研究都集中在 ACE 和 CPTSD 的关联上，但缺乏对与 ACE 相关的变异症状模式的研究。

客观的

本研究旨在从具有代表性的社区样本中确定 ICD-11 CPTSD 及其独特症状类别在韩国成人 ACE 中的因子有效性，并检查区分 CPTSD 症状类别的风险因素和临床症状。

方法

我们使用来自 800 名具有 ACE 病史的成人一般人群的国际创伤问卷数据进行了一项横断面回顾性研究。进行了验证性因素分析、潜在类别分析、方差分析和多项逻辑回归。

结果

验证性因素分析的结果支持六因素相关模型，而以 PTSD 和自组织扰动 (DSO) 作为相关结构的二因素高阶模型也显示出极好的拟合。潜在类别分析确定了六个类别，包括独特的 ICD-11 CPTSD 和 PTSD，此外还有具有威胁感的 DSO、DSO、情绪失调和低症状类别，显示出 ACE 模式、终生创伤、抑郁症的显着特征、躯体化、惊恐障碍和分离亚型。

结论

确认了 ICD-11 CPTSD 对韩国 ACE 幸存者的析因效度和判别效度。认识到 ACE 模式和终生创伤的普遍影响将有助于获得和提供适当的心理健康服务。CPTSD 症状表现的变化和分离的作用应该引起关注，因为它可能会给 ACE 患者带来复杂的生活结果。