Evaluating Complex Post-Traumatic Stress Disorder (CPTSD): Construct Validity and Correlates

A new diagnosis present in the International Classification of Diseases-11 (ICD-11), complex posttraumatic stress disorder (CPTSD), has proven controversial due to some findings which reveal symptom overlap with other disorders such as post-traumatic stress disorder (PTSD) and borderline personality disorder (BPD). This study sought to further examine construct validity of CPTSD in a community sample of trauma exposed adults, further evaluating the symptom profiles in comparison to PTSD, BPD, and also major depressive disorder (MDD) symptomology. Samples (n=805-1000, 54.5%-68.6% Female, 56.4%-61.5% White, aged 20-79) were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) survey and evaluated using a series of latent class analyses. Overall results were mixed. In the first test, which included adults reporting trauma exposure (n=1000), results did not indicate a unique CPTSD profile, and this finding was replicated in an additional sample (n=1000). However, when individuals reporting a prior BPD diagnosis were removed from the samples, distinct profiles consistent with theorized CPTSD symptoms did emerge in the main sample (n=805), and in a replication study (n=826). Results from analysis of a sample reporting depression and trauma exposure which evaluated MDD, PTSD and CPTSD symptoms, yielded a profile similar to comorbid CPTSD and MDD, but this did not replicate when evaluated using an identical methodology on a different sample. Analyses of additional variables suggested a possible link between interpersonal trauma and CPTSD-like symptoms in the sample reporting major depressive disorder and trauma exposure. While results did not provide strong evident of the distinctiveness of the CPTSD construct, profiles consistent with this diagnosis did emerge at times, but this was sample dependent. Future directions for additional research and clinical implications are also discussed.