Abstract
BackgroundOne reason for the inclusion of Complex Posttraumatic Stress Disorder (CPTSD) in the 11th revision of the International Classification of Diseases (ICD-11) was its suspected relevance for treatment indications. We investigated whether CPTSD predicted and moderated treatment outcomes of Prolonged Exposure (PE), intensified PE (iPE) and Skills Training in Affective and Interpersonal Regulation followed by PE (STAIR + PE). We expected that CPTSD would predict worse treatment outcomes across treatments. Secondly, we expected that CPTSD would lead to better treatment effect in STAIR + PE compared to PE and iPE. MethodsWe analyzed 149 patients with childhood-abuse related PTSD from a randomized clinical trial. CPTSD diagnosis and symptom severity were measured with the International Trauma Questionnaire. The main outcome was change in clinician-assessed PTSD symptoms. Assessments took place at baseline, week 4, week 8, week 16 (post-treatment) and at a 6-and 12-month follow-up. Analyses were based on an intention-to-treat sample using mixed effect models. ResultsMore than half (54 %) of the patients met criteria for CPTSD at baseline. CPTSD was related to more severe PTSD symptoms and higher comorbidity at baseline. CPTSD neither predicted nor moderated treatment outcome. LimitationsInclusion was limited to patients with PTSD related to childhood abuse. Replication is needed in different samples. ConclusionsCPTSD is associated with more severe PTSD and with higher comorbidity. CPTSD did not predict treatment outcome and did not indicate differential treatment outcome of STAIR + PE compared to PE and iPE.
Highlights
In the 11th revision of the International Classification of Diseases (ICD-11), Posttraumatic Stress Disorder (PTSD) was divided into two sibling diagnoses: PTSD and Complex PTSD (CPTSD; World Health Or ganization, 2018)
Several terms have been used to describe the clinical picture of Complex Posttraumatic Stress Disorder (CPTSD), including ‘disorders of extreme stress not otherwise specified’ (DESNOS), ‘posttraumatic personality disorder’ and ‘enduring person ality change after catastrophic experience’ (Classen, Pain, Field, & Woods, 2006; Wilson, Friedman, & Lindy, 2001; World Health Organi zation, 1992; Yehuda, 2002)
The aim of the current study was to investigate whether CPTSD predicts and/or moderates treatment outcomes in patients with PTSD related to childhood abuse
Summary
In the 11th revision of the International Classification of Diseases (ICD-11), Posttraumatic Stress Disorder (PTSD) was divided into two sibling diagnoses: PTSD and Complex PTSD (CPTSD; World Health Or ganization, 2018). One reason for the inclusion of Complex Posttraumatic Stress Disorder (CPTSD) in the 11th revision of the International Classification of Diseases (ICD-11) was its suspected relevance for treatment indications. We investigated whether CPTSD predicted and moderated treatment outcomes of Prolonged Exposure (PE), inten sified PE (iPE) and Skills Training in Affective and Interpersonal Regulation followed by PE (STAIR + PE). We expected that CPTSD would lead to better treatment effect in STAIR + PE compared to PE and iPE. CPTSD was related to more severe PTSD symptoms and higher comorbidity at baseline. CPTSD did not predict treatment outcome and did not indicate differential treatment outcome of STAIR + PE compared to PE and iPE
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