Abstract
Objective ICD‐11 introduces post‐traumatic stress disorder (PTSD) and complex PTSD (CPTSD) as two distinct trauma‐related disorders. Using the International Trauma Questionnaire (ITQ) as disorder‐specific measure, this study is the first to examine the factorial and construct validity of ICD‐11 PTSD, CPTSD and the ITQs’ applicability in children.MethodsTwo hundred and eight Austrian foster children completed a set of standardized measures. Excluding participants who reported not having experienced any kind of trauma, a final sample of 136 children completed the ITQ. Factorial and construct validity of ICD‐11 CPTSD and psychometric properties of ITQ scales were assessed by factor analysis and latent class analysis.ResultsConfirmatory factor analysis supported the two‐factor higher‐order model of ICD‐11 CPTSD in children by high factor loadings and excellent model fit. Reliability and regression analysis evidenced psychometric adequacy and discriminant validity of ITQ scales. Latent class analysis substantiated construct validity of ICD‐11 CPTSD, identifying a CPTSD (22.8%), PTSD (31.6%) and low symptoms class (45.6%). The CPTSD class showed highest rates of childhood trauma, comorbid psychopathology and functional impairment.ConclusionFactorial and construct validity of ICD‐11 CPTSD was evidenced in children for the first time using precise descriptions of ICD‐11 symptom content, supporting the reliability and validity of the ITQ in children.
Highlights
With the recent publication of the 11th version of the International Classification of Diseases (ICD11), the World Health Organisation [1] introduced two distinct trauma-related disorders under the general parent category ‘Disorders associated with stress’: post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD)
disturbances in self-organization (DSO) consists of three symptom clusters, including affective dysregulation (AD), negative self-concept (NSC) and disturbances in relationships (DR)
Research on DSM-5 PTSD in different age groups yielded a similar symptom structure in children and adults [11,12,13], providing evidence that this may be the case for ICD-11 PTSD and CPTSD
Summary
With the recent publication of the 11th version of the International Classification of Diseases (ICD11), the World Health Organisation [1] introduced two distinct trauma-related disorders under the general parent category ‘Disorders associated with stress’: post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD). CPTSD consists of the PTSD symptom clusters and disturbances in self-organization (DSO). The symptom structure of CPTSD according to ICD-11 is reflected in a multidimensional and hierarchical model, comprising PTSD and DSO as two distinct but related higher-order factors. In a number of factor-analytic studies, this twofactor higher-order model was examined along alternative models, testing the symptom structure and factorial validity of ICD-11 CPTSD. Despite extensive research in adult populations, to date no studies investigated the symptom structure of ICD-11 CPTSD in children and adolescents (hereafter referred to as ‘children’ unless otherwise specified). Research on DSM-5 PTSD in different age groups yielded a similar symptom structure in children and adults [11,12,13], providing evidence that this may be the case for ICD-11 PTSD and CPTSD. Examining the factorial validity of ICD-11 PTSD and CPTSD in children is highly important, as it comprises a number of practical implications for assessment and treatment [14, 15]
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