Abstract

Posttraumatic stress disorder (PTSD) is traditionally understood as a disorder that occurs more commonly in women than in men, and in younger age groups than in older age groups. The objective of this study was to determine if these patterns are also observed in relation to International Classification of Diseases (ICD-11) PTSD and complex PTSD (CPTSD). Secondary data analysis was performed using data collected from three nationally representative samples from the Republic of Ireland (N=1,020), the United States (N=1,839), and Israel (N=1,003), and one community sample from the United Kingdom (N=1,051). Estimated prevalence rates of ICD-11 PTSD were higher in women than in men in each sample, and at a level consistent with existing data derived from Diagnostic and Statistics Manual of Mental Disorders (DSM)-based models of PTSD. Furthermore, rates of ICD-11 PTSD were generally lower in older age groups for men and women. For CPTSD, there was inconsistent evidence of sex and age differences, and some indication of a possible interaction between these two demographic variables. Despite considerable revisions to PTSD in ICD-11, the same sex and age profile was observed to previous DSM-based models of PTSD. CPTSD, however, does not appear to show the same sex and age differences as PTSD. Theoretical models that seek to explain sex and age differences in trauma-related psychopathology may need to be reconsidered given the distinct effects for ICD-11 PTSD and CPTSD.

Highlights

  • There are two systems used by mental healthcare professionals to diagnose trauma-related disorders: the fifth edition of the Diagnostic and Statistics Manual of Mental Disorders (DSM5) [1] and the 11th version of the International Classification of Diseases (ICD-11) [2]

  • ICD-11 Posttraumatic stress disorder (PTSD) includes 6 symptoms distributed across three clusters (Reexperiencing in the here and Avoidance, and Sense of Threat) and ICD-11 complex PTSD (CPTSD) includes 12 symptoms; the 6 PTSD symptoms and 6 “Disturbance in Self-Organization” (DSO) symptoms which are distributed across three symptom clusters (Affect Dysregulation, Negative Self Concept, and Difficulties in Relationships)

  • With ICD-11, PTSD was reconceptualised as a narrow, fearbased disorder, and CPTSD was introduced into the diagnostic nomenclature for the first time, sparking considerable research attention [30,38]

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Summary

Introduction

There are two systems used by mental healthcare professionals to diagnose trauma-related disorders: the fifth edition of the Diagnostic and Statistics Manual of Mental Disorders (DSM5) [1] and the 11th version of the International Classification of Diseases (ICD-11) [2]. The former describes Posttraumatic Stress Disorder (PTSD) using 20 symptoms categorized into four clusters (Intrusions, Avoidance, Negative Alterations in Cognitions and Mood [NACM], and Hyperarousal), while the latter includes two related-but-distinct disorders of PTSD and complex PTSD (CPTSD). Theoretical models that seek to explain sex and age differences in trauma-related psychopathology may need to be reconsidered given the distinct effects for ICD-11 PTSD and CPTSD

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