ABSTRACT

Background: The 11^th version of the International Classification of Diseases (ICD-11) revised the diagnosis of Posttraumatic Stress Disorder (PTSD) and introduced Complex PTSD as a sibling disorder to PTSD. As the Danish Health Authorities will implement the ICD-11 in 2022, it is more relevant than ever to introduce a measure that enables the identification of ICD-11 PTSD and CPTSD.

Objective: The primary aim of the present study was to test the construct validity of the ICD-11 conceptualization of PTSD and DSO in five clinical samples using translated versions of the International Trauma Questionnaire (ITQ).

Method: Data from existing studies of adult survivors of sexual abuse (n = 385), women in shelters (n = 147), psychiatric outpatients endorsing an ICD-10 diagnosis of PTSD (n = 111), a heterogenous sample of psychiatric outpatients (n = 178) and refugees and torture survivors (n = 385) was used for the current study. Confirmatory factor analyses were conducted to test the internal structure of the ITQ, and regression models were conducted to test the convergent and discriminant validity of the factor solutions for each sample.

Results: Findings supported the ICD-11 formulation of PTSD and disorders in self-organization (DSO) as a representation of the latent structure of the ITQ across five Danish clinical samples. Uniquely for women in shelters, however, the model displayed an unacceptable fit. A revised operationalization of re-experiencing proved a better fit when ‘recurrent nightmares’ was exchanged with symptoms of intense emotional reactions to reminders of the trauma for women in shelter as well as ICD-10 PTSD psychiatric outpatients.

Conclusion: This study supports the use of a Danish translated version of the ITQ to assess symptoms of ICD-11 PTSD and DSO for the introduction of ICD-11 in 2022. Future research is needed to further explore the operationalization of re-experiencing across different trauma exposed populations.

摘要

背景: 第 11^版国际疾病分类 (ICD-11) 修订了创伤后应激障碍 (PTSD) 的诊断，并将复杂 PTSD 作为 PTSD 的兄弟障碍引入。由于丹麦卫生当局将在 2022 年实施 ICD-11，因此引入一项能够识别 ICD-11 PTSD 和 CPTSD 的措施比以往任何时候都更有意义。

目的：本研究的主要目的是使用国际创伤问卷 (ITQ) 的翻译版本在五个临床样本中测试 ICD-11 中 PTSD 和 DSO 概念化的结构有效性。

方法：现有研究的数据来自性虐待成年幸存者 ( n  = 385)、庇护所中的妇女 ( n  = 147)、支持 ICD-10 诊断为 PTSD 的精神科门诊患者 ( n  = 111)、精神科门诊患者的异质样本 ( n  = 178) 和难民和酷刑幸存者 ( n  = 385) 被用于当前的研究。进行了验证性因素分析以测试 ITQ 的内部结构，并进行了回归模型以测试每个样本的因素解决方案的收敛性和区分有效性。

结果：调查结果支持 ICD-11 对 PTSD 和自组织障碍 (DSO) 的表述，作为五个丹麦临床样本中 ITQ 潜在结构的表示。然而，该模型对于收容所中的女性来说是独一无二的，显示出不可接受的合身性。当“经常性噩梦”与对避难所妇女和 ICD-10 PTSD 精神病门诊患者的创伤提醒的强烈情绪反应症状交换时，重新体验的修订操作证明更合适。

结论：本研究支持使用 ITQ 的丹麦语翻译版本来评估 ICD-11 PTSD 和 DSO 的症状，以便在 2022 年引入 ICD-11。未来的研究需要进一步探索跨不同人群重新体验的操作化创伤暴露人群。