Complex Posttraumatic Stress Disorder Symptoms Research Articles

Complex PTSD symptom clusters and executive function in UK Armed Forces veterans: a cross-sectional study

BackgroundLess is known about complex posttraumatic stress disorder (CPTSD) than postrraumatic stress disorder (PTSD) in military veterans, yet this population may be at greater risk of the former diagnosis. Executive function impairment has been linked to PTSD treatment outcomes. The current study therefore aimed to explore possible associations between each CPTSD symptom cluster and executive function to understand if similar treatment trajectories might be observed with the disorder.MethodsA total of 428 veterans from a national charity responded to a self-report questionnaire which measured CPTSD symptom clusters using the International Trauma Questionnaire, and executive function using the Adult Executive Function Inventory. Single and multiple linear regression models were used to analyse the relationship between CPTSD symptom clusters and executive function, including working memory and inhibition.ResultsEach CPTSD symptom cluster was significantly associated with higher executive function impairment, even after controlling for possible mental health confounding variables. Emotion dysregulation was the CPTSD symptom cluster most strongly associated with executive function impairment.ConclusionsThis is the first study to explore the relationship between executive function and CPTSD symptom clusters. The study builds on previous findings and suggests that executive function could be relevant to CPTSD treatment trajectories, as is the case with PTSD alone. Future research should further explore such clinical implications.

Improvements of complex post-traumatic stress disorder symptoms during a multimodal psychodynamic inpatient rehabilitation treatment – results of an observational single-centre pilot study

ABSTRACT Background: Complex post-traumatic stress disorder (CPTSD) describes chronic disturbances in self-organization (i.e. affect dysregulation; negative self-concept; severe difficulties in relationships) which are frequently observed in survivors of prolonged, repeated or multiple traumatic stressors. So far, evidence of psychodynamic treatment approaches for CPTSD is scarce. Methods: In this single-centre observational pilot study, symptom change during a 6-week psychodynamic inpatient treatment in a multimodal psychosomatic rehabilitation centre was evaluated using repeated measures analyses of variance (ANOVAs). Patients completed questionnaires on PTSD and CPTSD symptoms (ITQ), anxiety, depression and somatization (BSI-18), functional impairment (WHODAS) and epistemic trust, mistrust and credulity (ETMCQ) before (T1) and at the end of treatment (T2). A hierarchical linear regression analysis was calculated to identify factors associated with improved CPTSD symptoms. Results: A total of n = 50 patients with CPTSD were included in the study, of whom n = 40 (80%) completed treatment. Patients reported a significant reduction of CPTSD symptoms during treatment with a large effect size (−3.9 points; p < .001; η 2 = .36), as well as a significant reduction of psychological distress (p < .001; η 2 = .55) and functional impairment (p < .001; η 2 = .59). At the end of treatment, 41.0% of patients no longer fulfilled the diagnostic criteria for CPTSD. Changes in epistemic stance included improved epistemic trust (β = –.34, p = .026) and decreased epistemic credulity (β = .37, p = .017), which together with lower age (β = .43, p = .012) and lower depression levels at baseline (β = .35, p = .054) were significantly associated with baseline adjusted mean change of CPTSD symptoms during therapy and explained 48% of its variance. Discussion: In our study, patients reported a significant reduction of CPTSD symptoms and comorbid symptoms during a multimodal psychodynamic inpatient rehabilitation treatment. Improved epistemic trust may facilitate the establishment of a trusting therapeutic relationship, thus fostering an environment of openness for knowledge transfer (i.e. social learning) and the exploration of diverse viewpoints and perspectives in the therapeutic process.

Contemporaneous and temporal network analysis of complex Posttraumatic stress disorder among Chinese college students with Childhood adversity: A longitudinal study

ObjectiveTo enhance understanding of the longitudinal progression of complex posttraumatic stress disorder (CPTSD) symptoms, this longitudinal study examined how CPTSD symptoms interact over time in Chinese college students with childhood trauma. MethodsFrom 18,933 college students who took part in two surveys 12 months apart, 4,006 participants who reported adverse childhood experiences were screened. Cross-sectional network comparisons and cross-lagged panel network (CLPN) analysis characterized interactions among CPTSD symptoms. ResultsIn the cross-sectional networks, feeling like a failure and avoid activities reminiscent of the trauma were the central symptoms. Takes long time to calm down and exaggerated startle are important bridge symptoms in the two networks respectively. The comparison of cross-sectional networks indicates that the global network strength was stable. The findings of the CLPN model reveal that feel worthless and feel like a failure had the highest "out" expected influence; exaggerated startle and avoid thoughts and feelings about the trauma had the highest "in" expected influence. ConclusionsBy conducting cross-sectional network analyses, the study illuminated the attributes of CPTSD networks across various time points. Additionally, the CLPN analysis uncovered the longitudinal patterns of CPTSD symptoms.

Effects of Social Acknowledgment and Interpersonal Shame on Complex Posttraumatic Stress Disorder Symptoms of Sexual Violence Survivors in South Korea.

Sexual violence (SV) survivors face negative social reactions, which can affect their recovery. Based on the socio-interpersonal model of trauma, understanding how societal circumstances impact SV survivors' mental health is important. This study examined conditional indirect effects of interpersonal shame and social acknowledgment on the relationship between perceived SV event severity and complex post-traumatic stress disorder (CPTSD) symptoms. Cross-sectional data from 157 community-based adults who had previously experienced SV were collected from an online panel. Exploratory factor analysis of the Social Acknowledgment Questionnaire was conducted, followed by conditional indirect analyses using Models 1, 4, and 7 of PROCESS macro. First, results showed that a two-factor model of social acknowledgment consisting of "social disapproval" and "social recognition" was more suitable for this study than a three-factor model predominantly used by Western societies. Second, interpersonal shame partially mediated the relationship between perceived SV event severity and CPTSD symptoms. Third, the conditional indirect effect of social disapproval on the mediating effect of interpersonal shame was significant when the social disapproval level was high. This indicates that the indirect effect of interpersonal shame on CPTSD increases when the social disapproval level is high. This study supported the socio-interpersonal perspective of trauma and suggested that increasing social acknowledgment beyond personal-level intervention would be a critical step for recovery of SV survivors to decrease their interpersonal shame and CPTSD.

Associations between International Trauma Questionnaire complex posttraumatic stress disorder symptom clusters and moral injury in a sample of U.K. treatment-seeking veterans: A network approach.

Complex posttraumatic stress disorder (CPTSD) and moral injury are receiving increasing empirical attention. The network approach offers a novel method to understand the association between such mental health constructs. The present study investigated: (a) the network structure of CPTSD symptom clusters according to the International Trauma Questionnaire to determine centrality (i.e., the most influential symptom cluster) and (b) the network structure of CPTSD symptom clusters and moral injury symptoms according to the Moral Injury Outcome Scale to determine bridge symptoms (i.e., the symptoms linking comorbid presentation of CPTSD and moral injury) within a clinical sample of veterans. Emotional dysregulation, avoidance, and interpersonal difficulties were found to be most central in the CPTSD network, and interpersonal difficulties, negative self-concept, and emotional dysregulation were found to be the strongest bridge symptoms in the CPTSD and moral injury network. The two networks suggest a key role of disturbance in self-organization symptoms in the presentation of CPTSD and its association with moral injury among treatment-seeking veterans. Despite the limitations of the present study, it offers an insightful starting point as the first network analysis study of CPTSD in treatment-seeking veterans as well as its association with moral injury. Implications in terms of points of intervention and further research are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Sex Differences in the Relationship Between School Bullying Victimization and Complex Posttraumatic Stress Disorder: The Roles of Insecure Attachment.

School bullying victimization is a highly concerning issue that can lead to a range of negative outcomes. Despite the research showing a significant association between bullying victimization and complex posttraumatic stress disorder (CPTSD), the internal mechanisms with its two components (i.e., posttraumatic stress disorder symptoms [PTSD] and disorders of self-organization symptoms [DSO]) remain unclear. Previous studies have indicated that attachment style may influence the development of CPTSD symptoms and that there may be sex differences in attachment styles. Thus, the present study aims to examine the mediating role of insecure attachment between school bullying victimization and CPTSD symptoms in males and females. The study assessed bullying victimization, attachment orientation, and CPTSD (i.e., PTSD symptoms and DSO symptoms) symptoms in 675 college students (65.2% females; Mage = 19.6, SD = 1.34) from China who had reported bullying experiences at two different time points, 6 months apart. For females, school bullying victimization predicted PTSD and DSO symptoms through attachment anxiety and only predicted DSO symptoms through attachment avoidance. For males, we found that school bullying victimization predicted PTSD symptoms through attachment avoidance. These findings suggest that attachment is critical in understanding how school bullying victimization may lead to CPTSD symptoms among individuals of different sexes.

Predictors and moderators of treatment outcomes in phase-based treatment and trauma-focused treatments in patients with childhood abuse-related post-traumatic stress disorder

ABSTRACT Background: Knowledge of treatment predictors and moderators is important for improving the effectiveness of treatment for PTSD due to childhood abuse. Objective: The first aim of this study was to test the potential predictive value of variables commonly associated with PTSD resulting from a history of repeated childhood abuse, in relation to treatment outcomes. The second aim was to examine if complex PTSD symptoms act as potential moderators between treatment conditions and outcomes. Method: Data were obtained from a randomized controlled trial comparing a phase-based treatment (Skills Training in Affect and Interpersonal Regulation [STAIR] followed by Eye Movement Desensitization and Reprocessing [EMDR] therapy; n = 57) with a direct trauma-focused treatment (EMDR therapy only; n = 64) in people with PTSD due to childhood abuse. The possible predictive effects of the presence of borderline personality disorder, dissociative symptoms, and suicidal and self-injurious behaviours were examined. In addition, it was determined whether symptoms of emotion regulation difficulties, self-esteem, and interpersonal problems moderated the relation between the treatment condition and PTSD post-treatment, corrected for pre-treatment PTSD severity. Results: Pre-treatment PTSD severity proved to be a significant predictor of less profitable PTSD treatment outcomes. The same was true for the severity of dissociative symptoms, but only post-treatment, and not when corrected for false positives. Complex PTSD symptoms did not moderate the relationship between the treatment conditions and PTSD treatment outcomes. Conclusions: The current findings suggest that regardless of the common comorbid symptoms studied, immediate trauma-focused treatment is a safe and effective option for individuals with childhood-related PTSD. However, individuals experiencing severe symptoms of PTSD may benefit from additional treatment sessions or the addition of other evidence-based PTSD treatment approaches. The predictive influence of dissociative sequelae needs further research. The study design was registered in The Dutch trial register (https://www.trialregister.nl/trialreg/admin/rctview.asp?TC = 5991) NTR5991 and was approved by the medical ethics committee of Twente NL 56641.044.16 CCMO.

The influence of betrayal trauma on complex posttraumatic stress disorder symptoms.

Complex posttraumatic stress disorder (complex PTSD) is characterized by symptoms of PTSD combined with disturbance in self-organization and is distressing for many people who have experienced chronic and repetitive interpersonal trauma. Studies on the precursors to complex PTSD have thus far focused on the forms of trauma perpetrated rather than who perpetrated the trauma. Traumas that are associated with complex PTSD (i.e., chronic and repetitive interpersonal traumas) are often perpetrated by someone that is close to the victim and thus involve an element of betrayal. However, there is little research on whether traumas high in betrayal are more associated with complex PTSD symptoms than traumas lower in betrayal. The aim of this study is to examine the association between traumas with varying degrees of betrayal and complex PTSD symptoms. We examined this association in a sample of adults (N = 364) recruited using Amazon's Mechanical Turk using a Bayesian approach to multiple regression. Results suggest that interpersonal traumas both with and without a component of betrayal were associated with complex PTSD symptoms for both women and men. We further found that for men, noninterpersonal trauma was also associated with complex PTSD symptoms. Study findings highlight the role of interpersonal trauma on complex PTSD symptoms, especially for women. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Living with a friend mediates PTSD and CPTSD symptoms among trauma-exposed Ukrainians during the second year of 2022 Russian invasion

Purpose This study aims to develop and test multivariable psychosocial prediction models of perceived post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD) symptoms development among trauma-exposed Ukrainian adults (n = 761) after 1.5 years of the 2022 Russian invasion of Ukraine. Design/methodology/approach This research was designed as a survey in line with the methodology of “Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis” checklist. The survey included a questionnaire on sociodemographic characteristics and specifics of trauma exposure, as well as validated self-reported inventories: The International Trauma Questionnaire, Acceptance and Action Questionnaire – version 2, Connor–Davidson Resilience Scale-10 and the Modified BBC Subjective Well-being Scale. Findings Regression analysis revealed different prediction models for PTSD and CPTSD symptoms, explaining 18.4% and 41.4% of their variance with five and eight predictors, respectively. Four variables were similar in predicting PTSD and CPTSD: war-relatedness of trauma, living with a friend, perceived physical health and regret for the past. War-relatedness of trauma the respondents were exposed to was among the strongest predictors for PTSD and CPTSD severity. However, living with a friend was almost equally strong in mitigating these mental consequences. Regret for past and lowly rated physical health were assessed as relatively weaker but statistically significant predictors in this study. Originality/value Upon the original theoretical framework, two psychosocial prediction models were developed for PTSD and CPTSD symptoms in a non-clinical sample of trauma-exposed Ukrainian adults.

Exploring trauma exposure and post-traumatic stress in university students of different identity statuses in Lithuania and Japan.

Emerging adulthood is the time when identity questions are addressed. It is also a time of excessive stress and risk for mental health problems. Different identity statuses relate to different mental health outcomes. Yet, little research has addressed how identity status is interlinked with trauma exposure and post-traumatic stress reactions, especially in multicultural contexts. The current study aimed to explore whether different traumatic experiences are related to the current identity status of university students aged between 18 and 29 years and investigate to what extent trauma-exposed emerging adults of different identity statuses report symptoms of post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD). In total, 2237 university students from Lithuania (n = 791) and Japan (n = 1345) participated in the current study. Identity profiles were revealed by using the Latent Class Analysis approach. Lithuania and Japan were comparable in terms of identity profiles and structure of PTSD/CPTSD. Trauma-exposed emerging adults reported a higher probability of being in troubled diffusion identity status; students in achievement identity status had a lower probability of CPTSD and lower rates of symptoms of disturbances in self-organization. The diffused identity of emerging adults from Lithuania and Japan is associated with trauma exposure, and positive identity is linked with fewer CPTSD reactions.

COGNITIVE EMOTION REGULATION STRATEGIES IN RELATIONSHIP WITH CPTSD SYMPTOMS OF DOMESTIC VIOLENCE VICTIMS

Objective. The article is devoted to the peculiarities of traumatisation of victims affected by domestic violence. The subject is the nature of the relationship between strategies for cognitive regulation of emotions and symptoms of complex post-traumatic stress disorder (CPTSD). The impact of mental trauma, which is the basis of CPTSD, gives rise to cognitive distortions in a person, manifested in constant or periodic intense experiences of fear, helplessness, guilt, shame, anger, that is, it leads primarily to emotional disturbances and difficulties with relationships.&#x0D; Methodology. Method or methodology for carrying out work. The study was carried out using the International Trauma Questionnaire (ITQ) and the Cognitive Emotion Regulation Questionnaire (CERQ). The respondents were 99 people aged from 18 to 61 years with experience of domestic violence. The methods used were descriptive analysis, checking the normality of variables using the Kolmagorov-Smirnov test, and C. Spearman’s correlation analysis.&#x0D; Results. It has been shown that the severity of CPTSD symptoms is positively associated with such coping cognitive regulation of emotions as «rumination» and «catastrophizing», and negatively associated with «positive reappraisal».&#x0D; Practical implications. The results are applicable to the process of providing crisis and rehabilitation psychological assistance to victims of domestic violence.

Utilizing Real-Time Heart Rate Variability during Psychological Intervention Program for Complex Post-Traumatic Stress Disorder: A Case Study

This study explores the use of real-time heart rate variability (HRV) monitoring as an innovative tool in a psychological intervention program for complex post-traumatic stress disorder (CPTSD). The research focuses on a 25-year-old male subject, presenting severe symptoms of CPTSD resulting from prolonged exposure to traumatic events. The intervention program, conducted over four sessions, integrated cognitive and physical therapies, including bottom-up and top-down approaches. Real-time HRV data, reflecting autonomic nervous system activity, were collected using a wearable heart rate sensor and analyzed alongside qualitative data from session transcripts and observational notes. The findings demonstrated a significant correlation between HRV changes and the subject’s psychological state during therapeutic interventions. Key HRV metrics, such as the change ratio of the RMSSD and SDNN, responded notably to traumatic event recounting and stabilization techniques, suggesting their potential as indicators of emotional and physiological states during therapy. The study, while limited by its single-subject design, lays the groundwork for further investigations into HRV-assisted psychotherapy for a broader CPTSD patient cohort.

Symptom structure of complex posttraumatic stress disorder among Chinese young adults with childhood trauma: a network analysis

BackgroundThe 11th revision of the World Health Organization’s International Classification of Diseases (ICD-11) includes a new disorder, complex posttraumatic stress disorder (CPTSD), the diagnostic applicability of which has not been discussed sufficiently in Chinese culture. The network approach to psychopathology enables investigation of the structure of disorders at the symptom level, which allows for analysis of direct symptom interactions. The main objectives of the present study were to explore CPTSD symptom structure and identify key symptoms in CPTSD among young adults in China.MethodsThe present study collected a large, stratified sample of Beijing university students (1368), ranging from 18 to 25 years old, the majority of whom (65.4%) were female. CPTSD symptoms were assessed using the International Trauma Questionnaire (ITQ). A regularized partial correlation network and Bayesian network were applied to estimate the network structure and the upstream symptoms of CPTSD, respectively.ResultsThe regularized partial correlation network showed that the high central symptoms were feelings of failure and hypervigilance, while the bridge symptom between posttraumatic stress disorder (PTSD) and disturbance in self-organization (DSO) domains was long-term upset. The Bayesian network showed that external avoidance and hypervigilance symptoms were upstream in CPTSD symptoms.ConclusionsHypervigilance is a central symptom that can be predictive of other symptoms of CPTSD. While feeling of failure is also a highly central symptom, it may be influenced by other symptoms. In the diagnosis and intervention of CPTSD, more attention should be given to hypervigilance symptoms.

Polytraumatization, defense mechanisms, PTSD and complex PTSD in Indian adolescents: a mediation model

BackgroundAdolescence is recognized as a particularly susceptible developmental period for experiencing multiple types of Adverse Childhood Experiences (ACE), increasing the vulnerability to higher levels of Post-Traumatic Stress Disorder (PTSD) and Complex PTSD symptoms. Some studies found that defense mechanisms play an important role on the association between ACE and psychological symptoms.MethodsWe analyzed the associations between direct and indirect exposure to ACE and PTSD and Complex PTSD (affective dysregulation, negative self-concept and disturbances in relationships) through the mediation role of mature defense mechanisms: mature, neurotic, and immature defense mechanisms in Indian adolescents. A sample of 411 Indian adolescents (M = 14.2 years old; S.D. = 0.5) completed validated self-report questionnaires. Serial multiple mediation models were tested by conducting a structural equation modelling employing Preacher and Hayes’ procedures (2008).ResultsImmature and neurotic defense mechanisms mediated the association between direct exposure to ACE with PTSD symptoms. Immature defense mechanisms were mediators of the relationship between direct exposure to ACE and Complex PTSD symptoms clusters.ConclusionsMaladaptive defense mechanisms can disturb the process of self-regulation and emotion regulation capabilities in coping with traumatic experiences, leading to higher PTSD and Complex PTSD symptoms severity.

The contribution of childhood adversity and potentially traumatic events during military service to PTSD and complex PTSD symptoms among Israeli women veterans.

Adverse childhood experiences (ACEs) and exposure to potentially traumatic events (PTEs) during military service are associated with mental health problems. However, knowledge about relative contributions of these factors to non-U.S. women combat veterans' posttraumatic sequelae is sparse. This study examines associations between ACEs, combat exposure (CES), military sexual trauma (MST), potentially morally injurious events (PMIEs), posttraumatic stress disorder (PTSD), and complex PTSD (CPTSD) symptoms among women veterans. A volunteer sample of Israeli women combat veterans (n = 885) and noncombat veterans (n = 728) responded to self-report questionnaires in a cross-sectional design study. Combat veterans reported higher total average ACEs and were more likely to experience three or more ACEs and specific ACEs of physical abuse and emotional neglect, as compared to noncombat veterans. Combat veterans also reported higher levels of CES, PMIEs, higher prevalence of MST, and higher levels of PTSD symptoms, but not CPTSD symptoms, as compared to noncombat veterans. Importantly, ACEs, CES, MST-assault, and PMIEs of betrayal predicted PTSD symptoms, while only ACEs and PMIEs of betrayal predicted CPTSD symptoms. This study emphasized the relatively high exposure to PTEs and PTSD symptoms of women combat veterans as compared to noncombat veterans. Our findings also confirm prior studies demonstrating associations between ACEs, CES, MST, and mental health problems. Importantly, we demonstrated the unique contribution of betrayal-based PMIEs and the differential associations of PTEs with PTSD and CPTSD symptoms among combat veterans. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The effect of childhood trauma on complex posttraumatic stress disorder: the role of self-esteem

ABSTRACT Background: Due to the short time that complex posttraumatic stress disorder (CPTSD) has been an independent diagnosis, few studies have explored the role that self-esteem might play in the relationship between childhood trauma and CPTSD. Objective: The current study aimed to explore the impact of childhood trauma on CPTSD and the role of self-esteem in this relationship. Methods: Study 1 involved a questionnaire survey in which a total of 360 young Chinese adults with childhood trauma participated. Study 2 used experimental research by manipulating short-term self-esteem to explore the effect of self-esteem on CPTSD. A total of 80 young Chinese adults with childhood trauma participated. Results: The results of Study 1 showed that childhood trauma positively predicts adulthood CPTSD, while self-esteem partially mediates the relationship between the two. It also found that self-esteem has a greater mediating effect on the disordered self-organization (DSO) dimension of CPTSD than on the PTSD dimension. In Study 2, participants in the high manipulated-self-esteem group reported fewer CPTSD symptoms than those in the low manipulated-self-esteem group. Conclusion: Overall, this study emphasized the role of self-esteem in CPTSD among individuals with a childhood trauma history. In practice, we provided a potential optimization direction for CPTSD clinical treatment, suggesting a method of self-esteem reconstruction.

Examining accurate diagnosis of complex PTSD in ICD-11

BackgroundComplex posttraumatic stress disorder (complex PTSD), the most frequently suggested new category for inclusion by mental health professionals, has been included in the Eleventh Revision of the World Health Organization's International Classification of Diseases (ICD-11). Research has yet to explore whether clinicians' recognition of the distinct complex PTSD symptoms predicts giving the correct diagnosis. The present study sought to determine if international mental health professionals were able to accurately diagnose complex PTSD and identify the shared PTSD features and three essential diagnostic features, specific to complex PTSD. MethodsParticipants were randomly assigned to view two vignettes and tasked with providing a diagnosis (or indicating that no diagnosis was warranted). Participants then answered a series of questions regarding the presence or absence of each of the essential diagnostic features specific to the diagnosis they provided. ResultsClinicians who recognized the presence or absence of complex PTSD specific features were more likely to arrive at the correct diagnostic conclusion. Complex PTSD specific features were significant predictors while the shared PTSD features were not, indicating that attending to each of the specific symptoms was necessary for diagnostic accuracy of complex PTSD. LimitationsThe use of written case vignettes including only adult patients and a non-representative sample of mental health professionals may limit the generalizability of the results. ConclusionsFindings support mental health professionals' ability to accurately identify specific features of complex PTSD. Future work should assess whether mental health providers can effectively identify symptoms of complex PTSD in a clinical setting.

Anxiety, distress tolerance, and the relationship between complex posttraumatic stress disorder symptoms and alcohol use in veterans.

Little is known about whether distress tolerance and anxiety mediate the relationship between comorbid complex posttraumatic stress disorder (CPTSD) and alcohol use among military veterans. Here, we investigated the contribution of distress tolerance and anxiety on the strength of the CPTSD and alcohol use association. We hypothesized that the impact of a two-factor model of CPTSD derived from subscale scores on the International Trauma Questionnaire (ITQ)-namely ITQ PTSD and ITQ Disturbances in Self Organization (DSO; e.g., issues with affective regulation/self-belief and shame)-on alcohol use severity would be mediated by anxiety but not by distress tolerance. Participants included 403 community-dwelling United Kingdom (UK) veterans (91.64% male, Mage = 51.15 years, SD = 12.48) recruited as part of a larger, online study. Findings indicated that the influence of CPTSD symptoms on alcohol use severity was mediated by anxiety, not by distress tolerance, with greater relative impact due to ITQ DSO status than ITQ PTSD status. We identified the mediational influence of anxiety and distress tolerance on the association between CPTSD subscales and alcohol use in UK veterans. Interventions for anxiety may be adapted for reducing problematic alcohol use and the impact of CPTSD symptoms in veterans with comorbid PTSD and alcohol use disorder.

Sex Differences in Complex Posttraumatic Stress Disorder Network among Chinese Young Adults.

Evidence suggests that sex differences commonly occur in trauma-related disorders. The current study aims to explore sex differences in complex posttraumatic stress disorder (CPTSD) symptom networks among Chinese young adults with childhood trauma. The current study utilized a representative sample of college students in Beijing and included 1416 participants (409 men and 907 women) who had childhood trauma experience. CPTSD symptoms were evaluated using the International Trauma Questionnaire. Regularized partial correlation network analysis and Bayesian network analysis were used to estimate the network structure and possible causality of CPTSD symptoms for both sexes. Male and female CPTSD symptom networks had differences in strength centrality and bridge centrality. Nightmares and feelings of failure had the highest strength centrality, and long-term upset and nightmares had the highest bridge centrality for men. Hypervigilance and feelings of failure had the highest strength centrality, and long-term upset and exaggerated startle response had the highest bridge centrality for women. The current study provides the first evidence of sex differences in the CPTSD symptom network among Chinese young adults with childhood trauma. Young men and women differed in highly central symptoms, which may speak to sex specificity in the main manifestations of CPTSD symptoms.

Changes in the networks of complex posttraumatic stress disorder symptoms among Chinese college students with childhood trauma.

To advance understanding of the development of complex posttraumatic stress disorder (CPTSD) symptoms longitudinally and facilitate future treatments, the present study investigated changes in the network of CPTSD symptoms among Chinese college students with childhood trauma. A longitudinal study was conducted with college students, following them three times at 3-month intervals. CPTSD symptoms were measured using the International Trauma Questionnaire, and childhood trauma was assessed by the revised Adverse Childhood Experiences Scale. The final sample consisted of 294 participants with childhood trauma at baseline measurement (28.9% were males, Mage = 20.76 years). Comparisons of cross-sectional networks and cross-lagged panel network (CLPN) analysis were performed to characterize the features and changes of interactions among CPTSD symptoms. Sense of failure and isolation were the core symptoms in the cross-sectional networks of CPTSD symptoms. The comparison of cross-sectional networks indicated that the global network strength was stable, and no node's strength centrality and only one edge weight changed significantly from Time 1 (T1) to Time 3 (T3). The findings of the CLPN model reveal that worthlessness, difficulties with intimacy, and flashbacks have the highest out-expected influence. In the T1-T3 network, the strongest edge was from worthlessness to sense of failure. Cross-sectional network analyses and comparisons revealed the characteristics of CPTSD networks at multiple time points, while the CLPN analysis identified the longitudinal dynamics of CPTSD symptoms. These provide insights for designing more targeted intervention plans for college students with childhood trauma. (PsycInfo Database Record (c) 2023 APA, all rights reserved).