ICD-11 posttraumatic stress disorder (PTSD) in male prisoners

Abstract

The eleventh version of the ICD, expected to be published in 2018, leads to changed criteria for post-traumatic stress disorder (PTSD) according to the online beta version. Such changes are likely to affect previously known features of PTSD, including the prevalence rate. Little is known about the prevalence of ICD-11 PTSD in imprisoned men. The present study examined this issue in this high-risk group for trauma disorders, as male prisoners are known to be more often affected by traumatic events compared to the general population. In n = 49 men imprisoned in Switzerland, cross-sectional and standardized self-assessment procedures (ACE, Cidi list, IES-R) were used to record traumatic events and possible trauma symptoms. The frequency of ICD-11 PTSD was calculated using the diagnostic heuristic of Hyland et al. (2017), on the basis of which ICD-11 PTSD is estimated by means of the IES-R. Overall, 88 % of the detained men examined had been traumatized during childhood and / or life span; 78 % reported at least one event on the ACE, on average 1.5, with 25 % reporting four or more events. Emotional abuse was reported most frequently (51 %). Furthermore, 71 % reported at least one event on the Cidi list, on average 1.8, with 45 % reporting serious physical threat. The analysis of ICD-11 PTSD was carried out with n = 34 inmates after exclusion of those without a traumatic event and those who did not complete the IES-R, and ICD-11 PTSD was estimated at 26.5 %. The study shows that imprisoned men are likely to be a high risk group for the development of PTSD even according to the new ICD. Considering the high prevalence of traumatic events and the numerous negative consequences for mental as well as physical health, specific psychotherapeutic programs and a trauma-informed imprisonment are necessary.