Research Output

Does requiring trauma exposure affect rates of ICD-11 PTSD and complex PTSD? Implications for DSM-5

  Objective: There is little evidence that posttraumatic stress disorder (PTSD) is more likely to follow traumatic events defined by Criterion A than non-Criterion A stressors. Criterion A events might have greater predictive validity for ICD-11 PTSD which is a condition more narrowly defined by core features. We evaluated the impact of using Criterion A, an ‘expanded’ trauma definition in line with ICD-11 guidelines, and no exposure criterion on rates of ICD-11 PTSD and Complex PTSD (CPTSD). We also assessed if five psychologically threatening events included in the expanded definition were as strongly associated with PTSD and CPTSD as ‘standard’ Criterion A events.

Method: A nationally representative sample from Ireland (N = 1,020) completed self-report measures.

Results: Most participants were trauma-exposed based on Criterion A (82%) and the ‘expanded’ (88%) criterion. When no exposure criterion was used, 13.7% met diagnostic requirements for PTSD or CPTSD; 13.2% when the expanded criterion was used, and 13.2% when Criterion A was used. The five psychologically threatening events were as strongly associated with PTSD and CPTSD as the Criterion A events. In a multivariate analysis, only the psychologically threatening events were significantly associated with PTSD (stalking) and CPTSD (bullying, emotional abuse, and neglect).

Conclusions: Certain non-Criterion A events involving extreme fear and horror should be considered traumatic. The ICD-11 approach of providing clinical guidance rather than a formal definition offers a viable solution to some of the problems associated with the current and previous attempts to define traumatic exposure.

  • Type:

    Article

  • Date:

    10 September 2020

  • Publication Status:

    In Press

  • DOI:

    10.1037/tra0000908

  • ISSN:

    1942-9681

  • Library of Congress:

    RA790 Mental health

  • Dewey Decimal Classification:

    616.8 Nervous & mental disorders

  • Funders:

    Edinburgh Napier Funded

Citation

Hyland, P., Karatzias, T., Shevlin, M., Mcelroy, E., Ben-Ezra, M., Cloitre, M., & Brewin, C. R. (in press). Does requiring trauma exposure affect rates of ICD-11 PTSD and complex PTSD? Implications for DSM-5. Psychological Trauma: Theory, Research, Practice, and Policy, https://doi.org/10.1037/tra0000908

Authors

Keywords

trauma exposure, Criterion A, PTSD, Complex PTSD

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