ABSTRACT

Background: Complex Posttraumatic Stress Disorder (C-PTSD) was recently included in the revised International Classification of Diseases (ICD-11) by the World Health Organization (WHO, 2018). C-PTSD is a new trauma related disorder which may develop after prolonged and multiple exposures to trauma. It is a sister disorder of PTSD and is further characterized by symptomatology of disorganized self-organization (DSO). To qualify for the diagnosis, individuals must first meet the diagnostic criteria for PTSD, then report DSO symptoms and functional impairment. A body of work is emerging which has focused on the underlying dimensionality of C-PTSD across both adult and more recently adolescent populations from differing index trauma groups and from across several nations and cultures. However, few studies have been conducted in populations exposed to combat trauma despite the obvious prolonged and multiple nature of their trauma histories.

Objective: To contribute to emerging evidence of the factor structure of ICD-11 C-PTSD in a novel population.

Methods: This is the first factor analytic study to explore C-PTSD in a sample of UK Armed Forces veterans residing in Northern Ireland (N = 732). C-PTSD was measured via the ITQ and we utilized CFA to assess the fit of 7 competing models.

Results: Based on established CFA fit indices, a correlated, first order, 6-factor model of C-PTSD, representing 3 PTSD and 3 DSO symptom groupings, was deemed to provide superior fit to the data compared to 6 alternative C-PTSD models. The superiority of the model was further supported by statistical comparisons of competing C-PTSD models. All factor loadings (0.866–0.998) and inter-factor correlations (.746-.975) of the optimally fitting model were statistically significant and high.

Conclusion: These results provide support for the construct validity of ICD-11 C-PTSD in a unique sample of Armed Forces veterans residing in Northern Ireland.

摘要

背景：复杂的创伤后应激障碍 (C-PTSD) 最近被世界卫生组织 (WHO, 2018 ) 纳入修订后的国际疾病分类 (ICD-11)）。C-PTSD 是一种新的与创伤相关的疾病，可能在长期和多次创伤后发展。它是 PTSD 的姐妹疾病，其特征还在于无组织的自组织 (DSO) 的症状。要获得诊断资格，个人必须首先满足 PTSD 的诊断标准，然后报告 DSO 症状和功能障碍。一系列工作正在涌现，其重点是来自不同指数创伤群体以及来自多个国家和文化的成人和最近的青少年人群中 C-PTSD 的潜在维度。然而，尽管他们的创伤史具有明显的长期和多重性质，但很少有针对遭受战斗创伤的人群进行的研究。

目的：为新人群中 ICD-11 C-PTSD 的因素结构提供新证据。

方法：这是在居住在北爱尔兰 ( N  = 732) 的英国武装部队退伍军人样本中探索 C-PTSD 的第一个因素分析研究。C-PTSD 是通过 ITQ 测量的，我们使用 CFA 来评估 7 个竞争模型的拟合度。

结果：基于已建立的 CFA 拟合指数，与 6 种替代 C-PTSD 模型相比，代表 3 个 PTSD 和 3 个 DSO 症状分组的 C-PTSD 相关的一阶 6 因子模型被认为对数据的拟合度更好. 竞争 C-PTSD 模型的统计比较进一步支持了该模型的优越性。最佳拟合模型的所有因子载荷 (0.866-0.998) 和因子间相关性 (.746-.975) 均具有统计学意义且较高。

结论：这些结果为居住在北爱尔兰的武装部队退伍军人的独特样本中 ICD-11 C-PTSD 的结构有效性提供了支持。